Utilization of the Signature Method to Identify the Early Onset of Sepsis From Multivariate Physiological Time Series in Critical Care Monitoring

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Abstract
Objectives: Patients in an ICU are particularly vulnerable to sepsis. It is therefore important to detect its onset as early as possible. This study focuses on the development and validation of a new signature-based regression model, augmented with a particular choice of the handcrafted features, to identify a patient’s risk of sepsis based on physiologic data streams. The model makes a positive or negative prediction of sepsis for every time interval since admission to the ICU. Design: The data were sourced from the PhysioNet/Computing in Cardiology Challenge 2019 on the “Early Prediction of Sepsis from Clinical Data.” It consisted of ICU patient data from three separate hospital systems. Algorithms were scored against a specially designed utility function that rewards early predictions in the most clinically relevant region around sepsis onset and penalizes late predictions and false positives. Setting: The work was completed as part of the PhysioNet 2019 Challenge alongside 104 other teams. Patients: PhysioNet sourced over 60,000 ICU patients with up to 40 clinical variables for each hour of a patient’s ICU stay. The Sepsis-3 criteria was used to define the onset of sepsis. Interventions: None. Measurements and Main Results: The algorithm yielded a utility function score which was the first placed entry in the official phase of the challenge.

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