WO2018086952A1 - Conseiller de transfusion sanguine à multiples paramètres - Google Patents

Conseiller de transfusion sanguine à multiples paramètres Download PDF

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Publication number
WO2018086952A1
WO2018086952A1 PCT/EP2017/077836 EP2017077836W WO2018086952A1 WO 2018086952 A1 WO2018086952 A1 WO 2018086952A1 EP 2017077836 W EP2017077836 W EP 2017077836W WO 2018086952 A1 WO2018086952 A1 WO 2018086952A1
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Prior art keywords
recommendation
subject
blood transfusion
transfusion
inputs
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PCT/EP2017/077836
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English (en)
Inventor
Minnan XU
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Koninklijke Philips N.V.
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Publication of WO2018086952A1 publication Critical patent/WO2018086952A1/fr

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    • 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
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems

Definitions

  • the present disclosure relates to methods and systems for evaluating multiple subject parameters in order to provide a healthcare provider with a blood transfusion recommendation.
  • Blood transfusion is the process of receiving blood or blood products from a donor. In some cases, the blood or blood products can be provided by the recipient at an earlier time and stored for the later transfusion. Blood transfusion is a common intervention in the acute care setting, and is often provide to patients with anemia or to patients who are bleeding as a result of surgery or trauma. Anemia, for example, is very common in the intensive care unit. Approximately 95% of intensive care (ICU) patients have abnormally low hemoglobin levels by ICU day three.
  • ICU intensive care
  • Hemoglobin is the iron-containing protein that makes up approximately 96% of the content by weight of red blood cells. The amount of hemoglobin in the blood is readily measurable, and is most often reported in grams per deciliter (g/dL). Hematocrit is the volume percentage (vol%) of red blood cells in blood, and is normally approximately 45% for males and 40% for females.
  • transfusion thresholds for anemia for example, is 30/10, which refers to an HCT of ⁇ 30% and/or an Hgb of ⁇ 10 g/dL.
  • Hgb ⁇ 7 g/dL - should be applied to critically ill patients, because red blood cell transfusions > 7 g/dL in a variety of patient populations has actually shown harm to the patient.
  • adverse effects of transfusion therapy include hospital acquired infections, immunological impairment, lung injury, hemolytic reactions, and higher cancer incidence.
  • HCT and/or Hgb alone do not provide the most efficient or accurate transfusion indicators.
  • a HCT and/or Hgb measurement fails to reflect plasma volume, and both HCT and Hgb concentrations can change drastically with plasma volume.
  • a simple postural change from standing to lying down can mobilize enough fluid from the leg to the torso to alter a HCT value such that a blood transfusion can be indicated.
  • HCT and Hgb are poor indicators of tissue perfusion. An Hgb value could be low, but if a patient can increase cardiac output to compensate, this patient would not benefit from blood transfusions.
  • the present disclosure is directed to methods and systems for evaluating multiple parameters and/or measurements in order to provide a blood transfusion recommendation.
  • Various embodiments and implementations herein are directed to a device or system that receives input including patient vital data, lab results, and/ or demographic data, and outputs a transfusion indication score which indicates the system's confidence that a transfusion would be appropriate for the patient.
  • the system can also provide an indication of which of the inputs contributed to the transfusion indication score, or which were the largest contributor or contributors to the score.
  • the transfusion indication score can be calculated by, for example, comparing clinical rules against the provided inputs, and/or by applying a recommendation algorithm developed by applying machine- learning concepts to a large clinical database to discern the features among the input that are relevant to transfusion indication score.
  • inputs can include, but are not limited to, heart rate, blood pressure, Sa0 2 , Sv0 2 , HCT, Hgb, lactate, fluid balance, central venous pressure, age, patient history, one or more indications of comorbidities, cardiac output changes, ECG signs for myocardial ischemia, tachycardia, compensatory mechanisms, duration of anemia, and hemodynamic status, among many others.
  • a method for providing a blood transfusion recommendation for a subject includes the steps of: (i) providing a blood transfusion recommendation system comprising a processor; (ii) receiving, by the processor, two or more subject inputs comprising information about the subject; (iii) calculating, by the processor and based on the received two or more subject inputs, a blood transfusion recommendation; and (iv) providing the blood transfusion recommendation to a user.
  • the two or more subject inputs comprise a hematocrit measurement, a hemoglobin measurement, and at least one other measurement.
  • the two or more subject inputs comprise information other than a hematocrit measurement or a hemoglobin measurement.
  • the two or more subject inputs comprise at least one subject vital sign measurement, one laboratory result, and demographic information about the subject.
  • the blood transfusion recommendation comprises a transfusion indication score.
  • the blood transfusion recommendation comprises an output comprising at least one of the two or more subject inputs, wherein the at least one of the two or more subject inputs contributed to the blood transfusion recommendation.
  • the method further includes the step of monitoring, by the processor, a response of the subject to the recommended blood transfusion.
  • the method further includes the step of communicating, to a user, the response of the subject to the recommended blood transfusion.
  • a device for providing a blood transfusion recommendation for a subject includes: a display configured to provide a blood transfusion recommendation to a user; and a processor configured to: (i) receive two or more subject inputs, the subject inputs comprising information about the subject; (ii) calculate, based on the received two or more subject inputs, a blood transfusion recommendation; and (iii) cause the display to provide the blood transfusion recommendation to the user.
  • a method for providing a blood transfusion recommendation for a subject includes the steps of: (i) providing a blood transfusion recommendation system comprising a processor, and a display configured to provide the blood transfusion recommendation to a user; (ii) receiving, by the processor, two or more subject inputs, the subject inputs comprising information about the subject, wherein the two or more subject inputs comprise at least one subject vital sign measurement, one laboratory result, and demographic information about the subject; (iii) calculating, by the processor and based on the received two or more subject inputs, a blood transfusion recommendation; and (iv) providing, via the display, the blood transfusion recommendation to a user, wherein the blood transfusion recommendation comprises a transfusion indication score.
  • processor is used generally to describe various apparatus components relating to the operation of the recommendation apparatus, system, or method.
  • a processor can be implemented in numerous ways (e.g., such as with dedicated hardware) to perform various functions discussed herein.
  • a "processor” can employ one or more microprocessors that may be programmed using software (e.g., microcode) to perform various functions discussed herein.
  • a processor may also be implemented as a combination of dedicated hardware to perform some functions. Examples of processor components that may be employed in various embodiments of the present disclosure include, but are not limited to, conventional microprocessors, application specific integrated circuits (ASICs), and field-programmable gate arrays (FPGAs).
  • ASICs application specific integrated circuits
  • FPGAs field-programmable gate arrays
  • a processor may be associated with one or more storage media (generically referred to herein as "memory,” e.g., volatile and non-volatile computer memory such as RAM, PROM, EPROM, and EEPROM, floppy disks, compact disks, optical disks, magnetic tape, etc.).
  • the storage media may be encoded with one or more programs that, when executed on one or more processors and/or controllers, perform at least some of the functions discussed herein.
  • Various storage media may be fixed within a processor or controller or may be transportable, such that the one or more programs stored thereon can be loaded into a processor or controller so as to implement various aspects discussed herein.
  • program or “computer program” are used herein in a generic sense to refer to any type of computer code (e.g., software or microcode) that can be employed to program one or more processors or controllers.
  • non-transitory machine-readable medium will be understood to encompass both volatile and non-volatile memories, but to exclude transitory signals.
  • user interface refers to an interface between a human user or operator and one or more devices that enables communication between the user and the device(s).
  • user interfaces that may be employed in various implementations of the present disclosure include, but are not limited to, switches, potentiometers, buttons, dials, sliders, track balls, display screens, various types of graphical user interfaces (GUIs), touch screens, microphones and other types of sensors that may receive some form of human-generated stimulus and generate a signal in response thereto.
  • GUIs graphical user interfaces
  • Various embodiments may further include non-transitory computer-readable storage media, having embodied thereon a firewall program executable by a processor to perform methods described herein.
  • FIG. 1 is a flowchart of a method for evaluating multiple parameters and/or measurements in order to provide a blood transfusion recommendation, in accordance with an embodiment.
  • FIG. 2 is a schematic representation of a blood transfusion recommendation engine, device, or system, in accordance with an embodiment.
  • FIG. 3 is a schematic representation of a blood transfusion recommendation display, in accordance with an embodiment.
  • FIG. 4 is a schematic representation of a blood transfusion recommendation display, in accordance with an embodiment.
  • the present disclosure describes various embodiments of a method and system for providing a blood transfusion recommendation to a healthcare provider. More generally, Applicant has recognized and appreciated that it would be beneficial to provide a blood transfusion recommendation device or system that receives input about a patient and provides a blood transfusion recommendation to a healthcare provider. A particular goal of utilization of certain embodiments of the present disclosure is to provide a blood transfusion recommendation to a healthcare provider that considers factors other than HCT and/or Hgb, and that prevents the possible adverse effects of transfusion therapy.
  • various embodiments and implementations are directed to a method and system that receives multiple inputs, including one or more measurements, about a patient and outputs a transfusion indication score which indicates the system's confidence that a transfusion is indicated.
  • inputs utilized to determine the transfusion indication score include, but are not limited to, heart rate, blood pressure, Sa0 2 , Sv0 2 , HCT, Hgb, lactate, fluid balance, central venous pressure, age, patient history, one or more indications of comorbidities, cardiac output changes, ECG signs for myocardial ischemia, tachycardia, compensatory mechanisms, duration of anemia, and hemodynamic status, among many others.
  • the blood transfusion recommendation device or system is used in conjunction with the healthcare provider's decision-making process.
  • a recommendation system is unnecessary, such as an acute condition where the patient is bleeding profusely.
  • the blood transfusion recommendation device or system monitors the patient continuously and provides continuous or periodic feedback or information to the healthcare provider, which the provider can then incorporate into the decision-making process.
  • Another benefit of the recommendation system is that it can integrate and consider an enormous amount of clinical information that the healthcare provider would need significant amounts of time to review and interpret.
  • the recommendation system also provides additional evidence for or against transfusion which is only available after analyzing and incorporating data from large clinical databases.
  • a method 100 for providing a blood transfusion recommendation about a patient or subject is a method 100 for providing a blood transfusion recommendation about a patient or subject.
  • the patient or subject can be anyone in a setting or with a condition, emergency, wound, or other situation that may suggest or indicate a blood transfusion now and/or in the near future.
  • the most common settings would be emergency rooms, operating rooms, intensive care units, field hospitals, emergency transportation vehicles, and similar locations, among many other possible settings.
  • a blood transfusion recommendation system or device is provided.
  • the blood transfusion recommendation device or system may be any of the systems described or otherwise envisioned herein, including but not limited to system 200 in FIG. 2.
  • the blood transfusion recommendation device or system receives multiple inputs about the patient.
  • the inputs are measurements, parameters, and/or characteristics from, of, or about the patient or subject.
  • Examples of possible inputs include, but are not limited to, the traditional inputs of hemoglobin (Hgb) and hematocrit (HCT), heart rate, blood pressure, percentage of oxygen saturation of arterial blood (Sa0 2 ), percentage of oxygen saturation of venous blood (Sv0 2 ), lactate, fluid balance, central venous pressure, age, patient history, indications of comorbidities, cardiac output, changes in cardiac output over time, ECG, signs of myocardial ischemia, tachycardia compensatory mechanisms, duration of anemia, and hemodynamic status, among many, many others.
  • Hgb hemoglobin
  • HCT hematocrit
  • HCT hematocrit
  • heart rate blood pressure
  • Sa0 2 percentage of oxygen saturation of arterial blood
  • Sv0 2 percentage of oxygen saturation of venous blood
  • lactate
  • the multiple inputs about the patient can include one or more of a vital sign measurement (heart rate, blood pressure, temperature, Sa0 2 , Sv0 2 , and others), a laboratory result (HCT, Hgb, lactate, and others), and/or demographic information (age, comorbidities, history, and others).
  • a vital sign measurement heart rate, blood pressure, temperature, Sa0 2 , Sv0 2 , and others
  • a laboratory result HCT, Hgb, lactate, and others
  • demographic information age, comorbidities, history, and others.
  • the blood transfusion recommendation device or system analyzes the two or more inputs and calculates a recommendation, such as transfusion indication score 310.
  • the blood transfusion recommendation device or system utilizes two more inputs other than or in addition to HCT and Hgb to determine the blood transfusion recommendation.
  • the utilized two or more inputs can be any combination of one or more vital sign measurements, one or more laboratory results, and/or one or more pieces of demographic information.
  • the blood transfusion recommendation device or system utilizes one or more programmed or predetermined rules to evaluate the two or more inputs and to calculate the transfusion indication score.
  • the programmed or predetermined rules can be determined or programmed as a default, and can be modified by a manufacturer, supplier, or healthcare provider, among others. The modification could be based on experience, new experimental data, the patient or subject, institutional preferences, and/or many other factors.
  • the transfusion indication score 310 could be determined by one programmed or predetermined rule, or a combination of two or more programmed or predetermined rules.
  • the programmed or predetermined rule could also be specific to one or more demographic characteristics of the subject, such as sex, age, height, weight, comorbidities, and many other factors. These rules could be derived experimentally, or could be mined from datasets or research studies.
  • the blood transfusion recommendation device or system utilizes a recommendation algorithm to evaluate the two or more inputs and to calculate the transfusion indication score.
  • the recommendation algorithm could be preprogrammed or could be learned over time, such as through machine learning using a dataset.
  • the system could be trained using data from a large clinical database such as MIMIC or eRI, among others.
  • Factors which could be analyzed by the learning algorithm include, but are not limited to, cardiac output changes, either measured or estimated, lactate, patient history, comorbidities such as kidney disease or coronary artery disease, evidence of heart disease such as ECG data, tachycardia or other arrhythmias, anemia, hemodynamic status, age, disease progression or state such as cardiac patient or cancer patient, and many others.
  • the blood transfusion recommendation device or system provides the recommendation to the healthcare provider.
  • the recommendation is provided to the healthcare provider using any method or means capable of communicating information.
  • the recommendation can be, for example, a transfusion indication score 310, and can be provided to the healthcare provider via a bedside display and/or handheld device.
  • Other methods of communication include a printout, graphical display, text message, sound, alert, or any other communication method.
  • the recommendation comprises a number, an icon, or other indication of the need or lack of a need for a blood transfusion.
  • the recommendation comprises information about which of the programmed or predetermined rules, if any, have been satisfied to trigger a transfusion indication.
  • the recommendation may comprise an indication that Hgb has fallen below 7 g/dL, and/or that it is currently 6.5 g/dL and a transfusion is recommended.
  • the recommendation may comprise an indication that Sa0 2 - Sv0 2 is below 50%, and/or that it is currently 48% and a transfusion is recommended.
  • the recommendation comprises information about which of the factors, parameters, measurements, or demographic information was utilized in the analysis, and/or which weighed most heavily toward the transfusion recommendation.
  • the communicated recommendation may provide an indication that the cardiac condition of the patient, her age, and the Hgb concentration all factored most heavily toward the transfusion recommendation.
  • the communicated recommendation may provide an indication that the recent history and age of the subject weighed most heavily against a transfusion recommendation.
  • the factors may be communicated as text, a graphical representation, an icon, and/or via many other communication methods.
  • the blood transfusion recommendation device or system monitors the effect of the recommended blood transfusion on the subject.
  • the monitoring can be performed in order to provide information to the healthcare provider, and/or to modify or improve the recommendation system for future recommendations.
  • the healthcare provider may use the monitoring information to ensure that the subject responds favorably to the transfusion.
  • the system may use the monitoring information to learn that the transfusion had a positive effect on the subject, thus reinforcing the decision-making process or algorithm that led to the recommendation for a transfusion.
  • the system may use the monitoring information to learn that the transfusion had a negative effect on the subject, thus leading the decision-making process or algorithm to modify future recommendations or analysis under a similar set of facts.
  • the blood transfusion recommendation device or system monitors one or more vital signs (heart rate, blood pressure, temperature, Sa0 2 , Sv0 2 , and others), laboratory results (HCT, Hgb, lactate, lactate, PTT, fibrinogen, and others), and/or other measurements, parameters, or characteristics.
  • vital signs heart rate, blood pressure, temperature, Sa0 2 , Sv0 2 , and others
  • laboratory results HCT, Hgb, lactate, lactate, PTT, fibrinogen, and others
  • the blood transfusion recommendation device or system can store the subsequent monitoring information, and/or can communicate the information to the healthcare provider using any of the communication methods or means described or otherwise envisioned herein.
  • the system may report to the provider that "Subject's Hgb is 7.5 g/dL at 2 hours posttransfusion," or "No adverse reaction(s) to transfusion has been reported or detected at 5 hours post-transfusion,” or "Subject J. Smith's Hgb has decreased to 6.0 g/dL at 1 hour post-transfusion.”
  • information is only communicated to the provider if a predetermined or programmed threshold is satisfied, at certain time points, and/or only if the monitoring information indicates that the subject is not responding favorably to the transfusion.
  • the blood transfusion recommendation device or system tracks the healthcare provider's use of the device or system.
  • the tracking information could include data about the subject, the subject's condition, the transfusion recommendation, the transfusion analysis, historical information, vital signs, lab results, demographics, and/or other information.
  • the tracking information can be utilized as feedback to the system. For example, the fact that a provider rejects a transfusion recommendation under a set of conditions suggests to the system that the set of conditions are not optimal for a transfusion recommendation.
  • the tracking information can be utilized to monitor the healthcare provider's adherence to organizational protocols. For example, it may be required by an organization that a healthcare provider always administer a blood transfusion under a certain set of conditions, such as HCT and/or Hgb measurements, in addition to many other possible factors, lab results, demographic information, or other information. If the tracking information indicates that the healthcare provider is not administering the blood transfusion pursuant to the requirement, the requirement and/or the provider may need review.
  • the tracking information can be utilized to monitor the organization's use of blood products.
  • the blood transfusion recommendation device or system can track whenever red blood cells are recommended and applied, and can report this usage on a minute-by-minute, hourly, and/or daily basis, in addition to any other timeframe.
  • the blood transfusion recommendation device or system may also or alternatively report when a certain amount of blood product has been recommended and/or utilized.
  • Blood transfusion recommendation device or system 200 monitors a subject 210.
  • the patient or subject 210 can be anyone in a setting or with a condition, emergency, wound, or other situation that may suggest or indicate a blood transfusion now and/or in the near future.
  • the most common settings would be emergency rooms, operating rooms, intensive care units, field hospitals, emergency transportation vehicles, and similar locations, among many other possible settings.
  • the blood transfusion recommendation device or system 200 comprises a processor 212 which is configured or programmed to receive one or more signals from a sensor 214, an internal database 220, a user interface 216, a communications module 218, a laboratory 230, and/or an external database 250, and configured or programmed to transmit a recommendation such as a transfusion indication score 310 to a display 224.
  • the processor 212 may be programmed using software to perform various functions discussed herein, and can be utilized in combination with a memory 222 and/or database 220.
  • Memory 222 and/or database 220 can store data, including one or more commands or software programs for execution by processor 212, as well as various types of data.
  • the memory 222 may comprise a non-transitory computer readable storage medium that includes a set of instructions that are executable by processor 212, and which cause the system to execute one or more of the steps of the methods described herein.
  • the blood transfusion recommendation device or system 200 also comprises a battery or power supply 226, which provides power for operation of the device.
  • the battery or power supply 226 may be a standard AC plug receptacle for a wall outlet, or may be permanently hardwired to a power source. Additionally and/or alternatively, the battery or power supply 226 may be implemented through the use of a lithium ion battery, for example. In some embodiments, the power supply 226 may also be implemented through the use of a capacitor. It may be possible to have the power supply 226 be capable of being charged or re-charged through the use of an external power source, such as a wired and/or wireless battery charger or charging field.
  • an external power source such as a wired and/or wireless battery charger or charging field.
  • the communications module 218 of the device facilitates wired or wireless communication between the blood transfusion recommendation device or system 200 and other devices and/or networks, such as network 240.
  • the communication module 218 may be facilitated through the use of one or more antennas, for example.
  • the communication module 218 can facilitate communication with one or more networks or with other devices, for example, by using wireless methods that are known, including but not limited to Wi-Fi, Bluetooth, 3G, 4G, LTE, and/or ZigBee, among others.
  • the communication module 218 is in wired and/or wireless communication with a subject 210, most likely through a sensor or monitor obtaining information from the user, an external database 250, and a laboratory 230.
  • the blood transfusion recommendation device or system 200 also comprises one or more sensors 214, which may be integral to the device or may be connected to or otherwise monitoring the subject 210.
  • the one or more sensors 214 are used to monitor and obtain sensor data, and thus evaluate a condition of the subject.
  • the one or more sensors 14 may comprise, for example, a sensor configured to measure, determine, or derive blood pressure, heart rate, pulse, blood oxygen, body temperature, respiratory rate, heart sound, breathing sound, movement, skin moisture, or similar health measurements, and other sensors known in the art.
  • the one or more sensors 214 may be a sphygmomanometer, heart rate monitor, pulse oximeter, thermometer, accelerometer, microphone, electromagnetic sensor, and/or any other type of sensor.
  • the blood transfusion recommendation device or system 200 may comprise a user interface 216 to receive input from a healthcare provider 260.
  • the user interface may be a button or multiple buttons, a microphone, a key stroke input, a slider, a touchscreen, or any of a variety of other inputs.
  • healthcare provider 260 may provide the input remotely via a computer which communicates the input to the device via network 240.
  • the blood transfusion recommendation device or system 200 also comprises a display 224 which is utilized to provide information such as the transfusion recommendation to the healthcare provider 260, and/or to otherwise facilitate interaction between the healthcare provider and the device.
  • the display may be, for example, an LED-based, LCD-based, or e-paper type display. In other embodiments, the display may be a touch screen display that allows the user to directly interact with the wearable device through physical contact and/or gestures.
  • the components of the blood transfusion recommendation device or system 200 can be connected via a single bus, and/or through one or more data transport means. As such, some components may be connected via a local microprocessor bus, and others may be connected via one or more input/output (1/0) buses.
  • system 200 can optionally comprise a display device 270, which may also serve as a user input device.
  • the device 270 may be, for example, a smartphone or other portable device.
  • the device 270 may be a computer such as a desktop, laptop, tablet, or other permanent or semi-permanent computing device.
  • the device 270 may receive input from the healthcare provider 260 and may also display information to the healthcare provider 260, as described or otherwise envisioned herein.
  • processor 212 of the blood transfusion recommendation device or system 200 is configured to execute one or more of the steps of the methods described herein.
  • the processor can be configured to receive multiple inputs about the patient via the sensor 214, database 220, user interface 2016, and/or the network 240, including but not limited to historical data about the subject stored in the internal database 220, information about the subject 210 obtained by sensor 214, demographic or historical data obtained from the external database 250, laboratory results obtained directly or indirectly from the laboratory 230, information about the subject from the healthcare provider via the user interface 216, and many other possible inputs.
  • the inputs are measurements, parameters, and/or characteristics from, of, or about the patient or subject.
  • Examples of possible inputs include, but are not limited to, the traditional inputs of hemoglobin (Hgb) and hematocrit (HCT), heart rate, blood pressure, percentage of oxygen saturation of arterial blood (Sa0 2 ), percentage of oxygen saturation of venous blood (Sv0 2 ), lactate, fluid balance, central venous pressure, age, patient history, indications of comorbidities, cardiac output, changes in cardiac output over time, ECG, signs of myocardial ischemia, tachycardia compensatory mechanisms, duration of anemia, and hemodynamic status, among many, many others.
  • Hgb hemoglobin
  • HCT hematocrit
  • the multiple inputs about the patient can include one or more of a vital sign measurement (heart rate, blood pressure, temperature, Sa0 2 , Sv0 2 , and others), a laboratory result (HCT, Hgb, lactate, and others), and/or demographic information (age, comorbidities, history, and others).
  • a vital sign measurement heart rate, blood pressure, temperature, Sa0 2 , Sv0 2 , and others
  • a laboratory result HCT, Hgb, lactate, and others
  • demographic information age, comorbidities, history, and others.
  • the processor 212 of the device can also be configured to analyze the two or more inputs and calculate a recommendation.
  • the processor utilizes two more inputs other than or in addition to HCT and Hgb to determine the blood transfusion recommendation.
  • the utilized two or more inputs can be any combination of one or more vital sign measurements, one or more laboratory results, and/or one or more pieces of demographic information.
  • the blood transfusion recommendation device or system utilizes one or more programmed or predetermined rules to evaluate the two or more inputs and to calculate the transfusion indication score.
  • the blood transfusion recommendation device or system utilizes a recommendation algorithm to evaluate the two or more inputs and to calculate the recommendation.
  • the processor 212 of the device can also be configured to provide the calculated recommendation to the healthcare provider via display 224, display device 270, and/or any other communication method or means.
  • the recommendation can be, for example, a transfusion indication score 310, and can be provided to the healthcare provider via a bedside display and/or handheld device.
  • Other methods of communication include a printout, graphical display, text message, sound, alert, or any other communication method.
  • the recommendation comprises a number, an icon, or other indication of the need or lack of a need for a blood transfusion.
  • the processor 212 of the device can also be configured to monitor the effect of the recommended blood transfusion on the subject.
  • the monitoring can be performed in order to provide information to the healthcare provider, and/or to modify or improve the recommendation system for future recommendations.
  • the healthcare provider may use the monitoring information to ensure that the subject responds favorably to the transfusion.
  • the system may use the monitoring information to learn that the transfusion had a positive effect on the subject, thus reinforcing the decision-making process or algorithm that led to the recommendation for a transfusion.
  • the system may use the monitoring information to learn that the transfusion had a negative effect on the subject, thus leading the decision-making process or algorithm to modify future recommendations or analysis under a similar set of facts.
  • the processor 212 of the device can also be configured to track the healthcare provider' s use of the device or system.
  • the tracking information could include data about the subject, the subject's condition, the transfusion recommendation, the transfusion analysis, historical information, vital signs, lab results, demographics, and/or other information.
  • the tracking information can be utilized as feedback to the system.
  • the tracking information can be utilized to monitor the healthcare provider's adherence to organizational protocols.
  • the tracking information can be utilized to monitor the organization's use of blood products.
  • FIG. 3 is an embodiment of a display 224 of a blood transfusion recommendation system 200.
  • the display 224 provides a transfusion indication score 310 and historical data 320 about the score over time.
  • the transfusion indication score 310 is, for example, a score out of 100, which in this case is 95/100.
  • a score of 100 may indicate that a transfusion is necessary, although many other scales and scores are possible. This is just one possible embodiment of the recommendation provided to the healthcare provider, and many other methods of communication are possible.
  • the display 224 provides a transfusion indication score 310 and transfusion indication factors 330, which can be, for example, the one or more factors that were most important or influential in making the transfusion recommendation, among other options.
  • the blood transfusion recommendation shown in FIG. 4 may be accompanied, for example, by an alert such as a noise and/or vibration, a text message, a pager message, or any of a variety of other alerts or notifications.
  • the phrase "at least one,” in reference to a list of one or more elements, should be understood to mean at least one element selected from any one or more of the elements in the list of elements, but not necessarily including at least one of each and every element specifically listed within the list of elements and not excluding any combinations of elements in the list of elements.
  • This definition also allows that elements may optionally be present other than the elements specifically identified within the list of elements to which the phrase "at least one" refers, whether related or unrelated to those elements specifically identified.

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Abstract

Selon l'invention, un procédé (100) permettant de fournir une recommandation de transfusion sanguine pour un sujet (210) comprend les étapes suivantes : (i) fournir (110) un système de recommandation de transfusion sanguine (200) comprenant un processeur (212); (ii) recevoir (120), par le processeur, au moins deux entrées de sujet comprenant chacune des informations concernant le sujet; (ii) calculer (130) une recommandation de transfusion sanguine par le processeur en fonction desdites entrées du sujet reçues; et (iii) fournir (140) la recommandation de transfusion sanguine à un utilisateur (260).
PCT/EP2017/077836 2016-11-10 2017-10-30 Conseiller de transfusion sanguine à multiples paramètres WO2018086952A1 (fr)

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US20210174962A1 (en) * 2019-12-05 2021-06-10 University Hospitals Cleveland Medical Center Blood transfusion management using artificial intelligence analytics
US20210174963A1 (en) * 2019-12-05 2021-06-10 University Hospitals Cleveland Medical Center Blood transfusion management using artificial intelligence analytics
US11929175B2 (en) * 2019-12-05 2024-03-12 University Hospitals Cleveland Medical Center Blood transfusion management using artificial intelligence analytics
US11935653B2 (en) * 2019-12-05 2024-03-19 University Hospitals Cleveland Medical Center Blood transfusion management using artificial intelligence analytics

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