2 Related Works
The CinC/Physionet Challenge 2015 produced several papers aiming to reduce false alarms on their dataset. On Table it is listed the five life-threatening alarms present in their dataset.
Alarm | Definition |
---|---|
Asystole | No QRS for at least 4 seconds |
Extreme Bradycardia | Heart rate lower than 40 bpm for 5 consecutive beats |
Extreme Tachycardia | Heart rate higher than 140 bpm for 17 consecutive beats |
Ventricular Tachycardia | 5 or more ventricular beats with heart rate higher than 100 bpm |
Ventricular Flutter/Fibrillation | Fibrillatory, flutter, or oscillatory waveform for at least 4 seconds |
They used as score the following formula, which penalizes five times the false negatives (since we do not want to miss any real event):
\[Score=\frac{TP+TN}{TP+TN+FP+5*FN}\]
The five-best scores in this challenge are presented on Table 10–14.
Score | Authors |
---|---|
81.39 | Filip Plesinger, Petr Klimes, Josef Halamek, Pavel Jurak |
79.44 | Vignesh Kalidas |
79.02 | Paula Couto, Ruben Ramalho, Rui Rodrigues |
76.11 | Sibylle Fallet, Sasan Yazdani, Jean-Marc Vesin |
75.55 | Christoph Hoog Antink, Steffen Leonhardt |
Their algorithm did a pretty good job on the Physionet test-set. However, independently of their approach to this problem, none of the authors reported benchmarks, memory usage, robustness test, or context invariance that could assure its implementation on real monitors to reduce alarm fatigue indeed.
There are other arrhythmias that this challenge did not assess, like atrial standstill (hyperkalemia), third-degree atrioventricular block, and others that may be life-threatening in some settings. Pulseless electrical activity is a frequent condition in cardiac arrest but cannot be identified without blood pressure information. This information is usually present in ICU settings but not in other locations.