EP3678541A1 - Systeme d'evaluation de la maturation d'un bebe premature - Google Patents
Systeme d'evaluation de la maturation d'un bebe prematureInfo
- Publication number
- EP3678541A1 EP3678541A1 EP18773812.5A EP18773812A EP3678541A1 EP 3678541 A1 EP3678541 A1 EP 3678541A1 EP 18773812 A EP18773812 A EP 18773812A EP 3678541 A1 EP3678541 A1 EP 3678541A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- maturation
- module
- baby
- index
- indices
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7271—Specific aspects of physiological measurement analysis
- A61B5/7275—Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02405—Determining heart rate variability
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/369—Electroencephalography [EEG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/742—Details of notification to user or communication with user or patient ; user input means using visual displays
- A61B5/743—Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2503/00—Evaluating a particular growth phase or type of persons or animals
- A61B2503/02—Foetus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2503/00—Evaluating a particular growth phase or type of persons or animals
- A61B2503/04—Babies, e.g. for SIDS detection
- A61B2503/045—Newborns, e.g. premature baby monitoring
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02411—Detecting, measuring or recording pulse rate or heart rate of foetuses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/366—Detecting abnormal QRS complex, e.g. widening
Definitions
- the present invention relates to a system for evaluating a level of maturation of a premature baby from statistical elements.
- Heart rate variability also known as HRV
- HRV Heart rate variability
- HRV is a practical, non-invasive and reproducible measure of autonomic nervous system function.
- HRV is the variation over time of consecutive heartbeats. It is supposed to correspond to the balance between sympathetic and parasympathetic influences on the intrinsic rhythm of the sinoatrial node. The HRV measurement is of great interest in medical practice for predicting and evaluating cardio-metabolic risks.
- heart rate analysis is useful for detecting an abnormality that can occur either during pregnancy or during childbirth.
- Fetal heart rate analysis is generally based on four criteria: the baseline rhythm, the variability of this basic rate, the accelerations and the possible presence of a slowdown.
- obstetric ultrasound and Doppler ultrasound help to establish biophysical scores for assessing fetal status.
- the invention makes it possible to improve at least some of the disadvantages of the prior art by proposing a system for determining an index for objectively evaluating the maturation of babies.
- the invention relates to a system for determining the maturation of a baby comprising a module for sampling a baby's cardiac signal (acquisition of the baby's electrocardiographic signal and its conversion into a new series) to produce a series of temporal samples respectively defining time intervals that separate two successive heart beats, the system comprising in particular:
- an analysis module suitable for comparing this at least one determined index with one or more statistical indices representing the maturation of a plurality of babies
- FIG. 1 is a diagram representing steps of the method according to a particular and non-limiting embodiment of the invention.
- FIG. 2 shows a system adapted to the implementation of the method illustrated in Figure 1, according to a particular and non-limiting embodiment of the invention.
- FIG 3 illustrates the principle of visibility graphs cleverly used in the method of assessing the maturity of a baby according to the invention.
- FIG. 1 is a representation diagram of steps of a method implemented by a system according to the invention.
- Step S0 is a step of initializing the method after which a system implementing the method is configured to operate from data representative of a baby's heart signal consisting of a series of samples. temporal RRi respectively defining time intervals that separate two successive heart beats.
- Step S0 constitutes, in addition to the initialization and configuration of the various elements of the system, recording and preprocessing of signals analogs taken during an electrocardiogram performed on the baby subject to an analysis to determine its degree of maturation.
- the RRi intervals are extracted by implementing an algorithm similar to that of Pan and Tompkins, which detects QRS complexes based on numerical analyzes of the slope, amplitude and width of the ECG signal. By implementing filter coefficients specifically adapted to newborns.
- a sliding window of five minutes with an overlap of 50% is used. Cardiac variability parameters are calculated on five-minute time segments (time intervals) selected as the most stationary segments every thirty minutes.
- Kaplan filters are used to eliminate certain artifacts from the digitized RRi series.
- a sequence of data RRi is recorded in a memory of the system implementing the method.
- Step S1 constitutes a conversion of the plurality of temporal samples RRi thus made available in memory in data representative of a visibility graph GV.
- Each of the points of the time series RRi is transformed into a node of the visibility graph then instantiated in the system memory. Connectivities between the different nodes are determined by a visibility criterion such as:
- the link number of (f /, v) is represented by the degree k (i).
- a visibility graph representing a time series RRi is characterized by its sequence of degrees (the number of links connected to a node), the average of the MD_V sequence and the distribution of the degree.
- Luque et al. [B. Luque et al, "Horizontal visibility graphs: exact results for random time series," ArXivI 0024526 Cond-Mat Physicsphysics, Feb. 2010] introduced horizontal visibility VH, which is a subset of the visibility graph GV, and in which (f /,) and (tj, y) are connected if:
- a new visibility graph VD can then be obtained by making the difference between the links of the visibility graph GV and the links of the horizontal visibility VH.
- the average of the sequence of VD is equal to:
- MD_D MD_V - MD_H
- the visibility graph GV is extracted from the coefficients (indices) characterizing it. That is to say that according to the connections between the nodes of the network resulting from the visibility graph GV one or more indices are calculated which characterize this network of nodes. It may be ASSOR assortativity or TRANS transitivity, as non-limiting examples. This method is valid when the observation times are the same for the definition of pre-recorded parameters representing a cohort of babies and the index or indices characterizing the maturity of a baby considered in isolation.
- Step S2 is a step of determining one or more indices that characterize a network defined by the set of nodes obtained. For example, ASSOR and TRANS transitivity indices are determined. Assorativity ASSOR is a global measure equivalent to the Pearson correlation between the degrees of each pair of nodes, it provides information on the dynamic behavior of the network and the TRANS transitivity quantifies how well the neighbors of a node are connected and therefore reflects the density of the network.
- Step S3 constitutes a comparison of at least the index determined in step S2 with one or more statistical indices (ATi, Pmi, Epi) representative of the maturation of a plurality of babies.
- the ATi indices are statistical indices that represent a cohort of full-term infants
- the Pmi indices are statistical indices that represent a cohort of babies born prematurely
- the Epi indices are statistical indices. which represent a cohort of babies born extremely prematurely.
- Step S4 constitutes a visual representation of a distance D or of a magnitude representative of this distance D between at least one determined index and several indices predefined by statistical analysis, recorded in the system memory.
- the representation may be graphical, of the star graph type, or superimposed point of areas of a space which are respectively representative of degrees of maturity, or of the "bargraph” type indicating a degree of maturity between "futures” extremes and “Very premature", as examples. This list of examples is obviously non-exhaustive.
- the visual representation method is based on one or more graphs showing a superimposed point of one or more representative zones of a state, such as, for example , a degree of pre-maturation or ripening and making possible a classification or a trend among or towards predetermined degrees of ripening.
- the representation uses graphs called "boxes with mustache” commonly used in the representation of statistical quantities.
- step S3 constitutes a comparison of the indices determined in step S2 and which are obtained by operations implementing a visibility graph (and the network of matching nodes) and predetermined indicators and previously stored in system memory, describing heart rate variability (temporal, frequency and non-linear indices). These indices are calculated from cohorts of premature infants and babies, some of whom are born term, representative of the population in terms of maturation, before the analysis described according to the method of the invention applied to a newborn subject considered isolation.
- Step S4 constitutes a visual representation of a distance D or of a magnitude representative of this distance D between the index (s) determined by the method according to the invention and a determined set of similar predefined and pre-recorded indices.
- the visual representation method is based on a statistical procedure that uses an orthogonal linear transformation to convert all the indices coming from full-term infants into a new space where the information is summarized keeping the greatest variance, showing one or more representative areas of a state, such as, for example, a degree of pre-ripening or maturation. Premature babies are then projected onto this space as additional individuals by making possible classification among predetermined degrees of maturation.
- the representation uses graphs called "boxes with mustache" commonly used in the representation of statistical quantities.
- modules shown are functional units, which may or may not correspond to physically distinguishable units.
- these modules or some of them are grouped into a single component, or consist of the functionality of the same software.
- some modules are composed of separate physical entities.
- FIG. 2 shows a system SYS for determining the maturation of a baby from a sampling of a baby's cardiac signal subject to analysis.
- the SYS system comprises a control unit suitable for carrying out conventional analog and digital signal and data acquisition and processing operations, numerical and statistical analysis calculation operations as well as any other operation conventionally done by a computer.
- the control and analysis unit CTRL includes one or more internal microcontrollers as well as a connection interface to a BUS1 fast, bidirectional and multiplexed shared bus.
- the SYS system also comprises an ADC module for converting analog signals into digital data, a CONVERTER module for numerical analysis and calculation configured for implementing operations on data instantiating one or more visibility graphs, a COMPAR module.
- the ADC module is able to convert analog signals from a plurality of probes P1, P2,... Pn used for the production of electrocardiograms, and in particular adapted to the practice of electrocardiograms on a newborn.
- the ADC module also includes one or more filters configured for the removal of spurious noise during signal recording sequences constituting an electrocardiogram.
- the SYS system also comprises all the usual elements of a microcontroller system, such as, by way of non-limiting examples, supply circuits, power interfaces, one or more circuits of clocks, one or more reset circuits, input-output ports, interrupt inputs, bus-sharing management modules and memory modules.
- a microcontroller system such as, by way of non-limiting examples, supply circuits, power interfaces, one or more circuits of clocks, one or more reset circuits, input-output ports, interrupt inputs, bus-sharing management modules and memory modules.
- the SYS system finally comprises a DISP display module comprising a high-resolution screen adapted to the representation of graphical and textual objects, in color, and provided with an audio output interface comprising a sound generator device.
- analog signals representative of the heart beats of a premature baby are recorded during an electrocardiogram and transmitted to the ADC module via the P1 probes. , P2, ... Pn. These signals are then processed by the ADC module and converted into a series of temporal samples RRi respectively defining time intervals that separate two successive heart beats of a premature baby, subject to analysis to determine its degree of maturation.
- the temporal samples RRi are stored in an area of the random access memory MEM reserved for this purpose.
- the conversion module CONVERTER then translates the plurality of temporal samples RRi into data representative of the visibility graph GV previously described and determines at least one indicator from these data.
- the COMPAR module makes comparisons between at least the predetermined indicator and one or more statistical indices representative of the maturation of a plurality of babies, some of whom are born at term, these statistical indices being prerecorded in a dedicated area of the NVMEM memory. -volatile.
- Each of the CONVERTER, COMPAR and DISP modules includes its own control and processing unit, similar to that already described and implemented in the CTRL module.
- the CTRL module supervises all the operations of the system by executing in particular the corresponding algorithms from executable routines whose code is stored in non-volatile memory NVMEM.
- the visual representation module DISP proceeds to display a quantity representative of a distance D determined by the COMPAR module between at least the index determined by the CONVERTER module working on the visibility graph and the several prerecorded statistical indices.
- the DISP module displays one or more graphs making it possible to position a point defining the maturation of the preterm baby subject to analysis with respect to a set of points representative of predetermined and pre-recorded maturation levels in the system.
- the DISP module under control of the CTRL module, displays the level of maturation determined by the method and associated with the baby subject of the analysis highlighted on a scale of predefined maturation values.
- Figure 3 includes two schematic representations of the visibility graphs as used by the described method. The left side of Figure 3, referenced a) illustrates a graph of vertical visibility. Two arbitrary points (f /, yv) and ⁇ tj, yj) of the time series will become two connected nodes of the associated graph (node network) if an arbitrary point (f / c, y3 ⁇ 4) placed between them fulfills the following criterion: y k ⁇ y. + (. - yj) yr
- FIG. 3 The right side of FIG. 3, referenced b), illustrates a horizontal visibility graph for which two arbitrary points (f /, yy) and (f ,, yy) of the time series will become two connected nodes of the graph (network of nodes). associated if they are bigger than all the points that are between them.
- Vc e [a, b] is> y c and y b> incl
- Other parameters can be calculated with the method of visibility graphs, which are the degrees of distribution.
- a degree of distribution DD is the probability that any point has a visibility index x. To calculate it we count the number of points with x for the degree of visibility and divide it by the total number of points.
- these degrees have been calculated for analysis time windows of thirty seconds.
- visibility indices such as, for example, ASSOR assortativity, TRANS transitivity or the average degree of the sequence.
- these indices constitute a valuable estimate of the dynamic properties of the complex network formed by the cardiac variability of the subject subjected to analysis by the implementation of the method according to the invention.
- TRANS transitivity can be expressed by:
- Tri (G) being the set of all the triangles in the graph GV and Tri (N) being the set of all possible triangles considering all the nodes of the graph GV.
- a degree is the number of links to each node. For each link (/ ' ) there are two nodes connected to it and ji is the degree of the first node and ki is the degree of the other node.
- the sampling of a cardiac signal of a subject consisting of a series of temporal samples (RRi) and respectively defining time intervals that separate two successive heartbeats, is replaced by a sampling of signals representative of waves of cerebral origin (also called electroencephalographic signals).
- This representative sampling of brain waves is performed by means of sensors adapted to the measurement of EEG (electroencephalogram) type by silver electrodes placed on the scalp, for example.
- EEG electroencephalogram
- the raw signals obtained by the EEG sensors are then digitally filtered by a 50 Hz band-stop filter and then by a band-pass filter (0.53 Hz to 30 Hz).
- the sequence of temporal samples (RRi) derived from the ECG signal is replaced by an EEG signal thus filtered.
- a sample analysis (RRi) is performed over a period of approximately 2 minutes and it is determined, by the implementation of the visibility graph method on these samples (RRi), a number of peaks visible at from the central node of a window, for successive windows of a predetermined duration of 250 ms.
- the window is shifted by one sample.
- a mean visibility index is then obtained, over the duration of the EEG sampling, by calculating an average value of the visibility indices respectively attributed to the different windows, which average visibility index is representative of the maturity of a baby.
- the more the child on which is realized the EEG sampling is mature the more the value of the average index of calculated visibility decreases.
- the number of points considered per window is equal to 64.
- points considered in a window can be obtained by interpolation from measured samples.
- the duration of a window may be between 50 ms and 1 second.
- the ECG cardiac signal is scanned in order to define periods suitable for analysis of the electroencephalographic origin signal.
- an analysis of the ECG cardiac signal makes it possible to define moments for which the subject (baby) is calm, which makes it possible to increase the efficiency of an analysis according to the variant of embodiment for which the RRi samples are samples of the signal of encephalic origin.
- At least two indices respectively derived from a first analysis from the ECG signal and a second analysis from the EEG signal are combined so as to optimize the performance of the method of evaluation of the maturation of a baby according to the invention.
- the invention is not limited to the embodiments described above but also relates to any method for determining the maturation of a baby comprising a conversion of temporal samples into data representative of a visibility graph (GV), a determination at least one index from data representative of this graph of visibility, a comparison of the at least one index thus determined with one or more statistical indices representative of the maturation of a plurality of babies and a visual representation of a distance between the at least one determined index and the several statistical indices, as well as any system implementing such a method.
- GV visibility graph
- the representation of the determined distance may be sound.
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR1700895A FR3070590B1 (fr) | 2017-09-05 | 2017-09-05 | Methode d'evaluation de maturation d'un bebe premature et systeme associe |
PCT/FR2018/052165 WO2019048775A1 (fr) | 2017-09-05 | 2018-09-05 | Systeme d'evaluation de la maturation d'un bebe premature |
Publications (1)
Publication Number | Publication Date |
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EP3678541A1 true EP3678541A1 (fr) | 2020-07-15 |
Family
ID=61132451
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP18773812.5A Pending EP3678541A1 (fr) | 2017-09-05 | 2018-09-05 | Systeme d'evaluation de la maturation d'un bebe premature |
Country Status (4)
Country | Link |
---|---|
US (1) | US11464458B2 (fr) |
EP (1) | EP3678541A1 (fr) |
FR (1) | FR3070590B1 (fr) |
WO (1) | WO2019048775A1 (fr) |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
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CN113392731B (zh) * | 2021-05-31 | 2023-06-23 | 浙江工业大学 | 一种基于图神经网络的调制信号分类方法和系统 |
CN113436728B (zh) * | 2021-07-05 | 2022-10-28 | 复旦大学附属儿科医院 | 新生儿临床视频脑电图自动分析的方法及设备 |
CN114515156B (zh) * | 2022-02-10 | 2023-09-15 | 南京邮电大学 | 基于交叉可视图的睡眠心脑信号关联性分析方法 |
Family Cites Families (3)
Publication number | Priority date | Publication date | Assignee | Title |
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IL164030A0 (en) * | 2003-09-12 | 2005-12-18 | Revital Pery Shechter | Photoacoustic analyzer of a region of interest in a human body |
WO2015142046A1 (fr) * | 2014-03-19 | 2015-09-24 | 주식회사 메디코아 | Dispositif pour évaluer la capacité d'équilibrage et de commande de nerf du système autonome, et son procédé de commande |
CA3022848C (fr) * | 2016-05-02 | 2023-03-07 | University Of Virginia Patent Foundation | Indices predictifs d'oxymetrie pulsee de developpement neurologique defavorable chez les prematures |
-
2017
- 2017-09-05 FR FR1700895A patent/FR3070590B1/fr active Active
-
2018
- 2018-09-05 EP EP18773812.5A patent/EP3678541A1/fr active Pending
- 2018-09-05 WO PCT/FR2018/052165 patent/WO2019048775A1/fr unknown
- 2018-09-05 US US16/643,866 patent/US11464458B2/en active Active
Also Published As
Publication number | Publication date |
---|---|
US11464458B2 (en) | 2022-10-11 |
US20200281487A1 (en) | 2020-09-10 |
WO2019048775A1 (fr) | 2019-03-14 |
FR3070590A1 (fr) | 2019-03-08 |
FR3070590B1 (fr) | 2019-09-06 |
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