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Decision-Support Algorithms

Decision-Support Algorithms

To advance automated decision-support systems for deployment in unstructured, pre-hospital environments, this project develops algorithms and technologies for 1) real-time capture and analysis of vital-sign data (APPRAISE), 2) automatic assessment of the reliability of vital signs, 3) automated diagnosis of combat injuries, such as hemorrhage and traumatic brain injury, and 4) assessment of novel physiological sensor modalities.

Publications

Reisner, A. T., S. Edla, J. Liu, J. T. Rubin, J. E. Thorsen, E. Kittell, J. B. Smith, D. D. Yeh, and J. Reifman. Muscle oxygen saturation improves diagnostic association between initial vital signs and major hemorrhage: a prospective observational study. Academic Emergency Medicine. 2016 March; 23(3):353-357. [PDF 316 KB]

Reifman, J., J. Liu, M. Y. Khitrov, S. Edla, and A. T. Reisner. Automated analysis of vital signs identified patients with substantial bleeding prior to hospital arrival. Proceedings of the HFM-254 Symposium on Health Surveillance and Informatics in Missions: Multidisciplinary Approaches and Perspectives. Paris, France. 2015 October 12-14; 17:1-14. [PDF 478 KB]

Edla, S., A. T. Reisner, J. Liu, V. A. Convertino, R. Carter III, and J. Reifman. In reply to "Utility of shock index calculation in hemorrhagic trauma." American Journal of Emergency Medicine. 2015 July; 33(7):978-979. [PDF 152 KB]

Liu, J., M. Y. Khitrov, J. D. Gates, S. R. Odom, J. M. Havens, M. A. de Moya, K. Wilkins, S. K. Wedel, E. O. Kittell, J. Reifman, and A. T. Reisner. Automated analysis of vital signs to identify patients with substantial bleeding before hospital arrival: a feasibility study. Shock. 2015 May; 43(5):429-436. [PDF 3739 KB]

Edla, S., A. T. Reisner, J. Liu, V. A. Convertino, R. Carter, III, and J. Reifman. Is heart rate variability better than routine vital signs for prehospital identification of major hemorrhage? American Journal of Emergency Medicine. 2015 February; 33(2):254-261. [PDF 642 KB]

Smith, J. B., A. T. Reisner, S. Edla, J. Liu, S. Liddle, and J. Reifman. A platform for real-time acquisition and analysis of physiological data in hospital emergency departments. Proceedings of the 36th IEEE EMBS Annual International Conference. Chicago, IL. 2014 August 26-30; 2678-2681. [PDF 697 KB]

Liu, J., A. T. Reisner, S. Edla, and J. Reifman. A comparison of alerting strategies for hemorrhage identification during prehospital emergency transport. Proceedings of the 36th IEEE EMBS Annual International Conference. Chicago, IL. 2014 August 26-30; 2670-2673. [PDF 728 KB]

Chen, X., A. T. Reisner, L. Chen, S. Edla, and J. Reifman. The matching of sinus arrhythmia to respiration: are trauma patients without serious injury comparable to healthy laboratory subjects? Proceedings of the 36th IEEE EMBS Annual International Conference. Chicago, IL. 2014 August 26-30; 3398-3401. [PDF 657 KB]

Reisner, A., X. Chen, K. Kumar, and J. Reifman. Prehospital heart rate and blood pressure increase the positive predictive value of the Glasgow Coma Scale for high-mortality traumatic brain injury. Journal of Neurotrauma. 2014 May 15; 31(10):906-913. [PDF 192 KB]

Khitrov, M. Y., S. Laxminarayan, D. Thorsley, S. Ramakrishnan, S. Rajaraman, N. J. Wesensten, and J. Reifman. PC-PVT: a platform for psychomotor vigilance task testing, analysis, and prediction. Behavior Research Methods. 2014 March; 46(1):140-147. [PDF 480 KB]

Reisner, A. T., M. Y. Khitrov, L. Chen, A. Blood, K. Wilkins, W. Doyle, S. Wilcox, T. Denison, and J. Reifman. Development and validation of a portable platform for deploying decision-support algorithms in prehospital settings. Applied Clinical Informatics. 2013 August 21; 4:392-402. [PDF 1191 KB]

Chen, L., A. T. Reisner, X. Chen, A. Gribok, and J. Reifman. Are standard diagnostic test characteristics sufficient for the assessment of continual patient monitoring? Medical Decision Making. 2013 February; 33(2):225-234. [PDF 1213 KB]

Reisner, A. T., L. Chen, and J. Reifman. The association between vital signs and major hemorrhagic injury is significantly improved after controlling for sources of measurement variability. Journal of Critical Care. 2012 October; 27(5):533.e1-10. [PDF 442 KB]

Chen, X., L. Chen, A. T. Reisner, and J. Reifman. Using confidence intervals to assess the reliability of instantaneous heart rate and respiratory rate. Proceedings of the 33rd IEEE EMBS Annual International Conference. Boston, MA. 2011 August 30-September 3; 6939-6942. [PDF 487 KB]

Gribok, A. V., X. Chen, and J. Reifman. A robust method to estimate instantaneous heart rate from noisy electrocardiogram waveforms. Annals of Biomedical Engineering. 2011 February; 39(2):824-834. [PDF 592 KB]

Chen, L., A. T. Reisner, A. Gribok, and J. Reifman. Is respiration-induced variation in the photoplethysmogram associated with major hypovolemia in patients with acute traumatic injuries? Shock. 2010 November; 34(5):455-460. [PDF 233 KB]

Reifman, J., L. Chen, M. Y. Khitrov, and A. T. Reisner. Automated decision-support technologies for prehospital care of trauma casualties. Proceedings of the RTO HFM Symposium on NATO Human Use of Advanced Technologies and New Procedures in Medical Field Operations. Essen, Germany. 2010 April 19-21; 40:1-14. [PDF 256 KB]

Chen, L., A. T. Reisner, and J. Reifman. Automated beat onset and peak detection algorithm for field-collected photoplethysmograms. Proceedings of the 31st IEEE EMBS Annual International Conference. Minneapolis, MN. 2009 September 2-6; 5689-5692. [PDF 462 KB]

Khitrov, M. Y., M. Rutishauser, K. Montgomery, A. T. Reisner, and J. Reifman. A platform for testing and comparing of real-time decision-support algorithms in mobile environments. Proceedings of the 31st IEEE EMBS Annual International Conference. Minneapolis, MN. 2009 September 2-6; 3417-3420. [PDF 448 KB]

Chen, L., A. T. Reisner, A. Gribok, and J. Reifman. Exploration of prehospital vital sign trends for the prediction of trauma outcomes. Prehospital Emergency Care. 2009 July-September; 13(3):286-294. [PDF 435 KB]

Chen, L., A. T. Reisner, A. Gribok, T. M. McKenna, and J. Reifman. Can we improve the clinical utility of respiratory rate as a monitored vital sign? Shock. 2009 June; 31(6):574-580. [PDF 1477 KB]

Reisner, A. T., L. Chen, T. M. McKenna, and J. Reifman. Automatically-computed prehospital severity scores are equivalent to scores based on medic documentation. Journal of Trauma-Injury, Infection, and Critical Care. 2008 October; 65(4):915-923. [PDF 627 KB]

Chen, L., A. Gribok, A. T. Reisner, and J. Reifman. Exploiting the existence of temporal heart-rate patterns for the detection of trauma-induced hemorrhage. Proceedings of the 30th IEEE EMBS Annual International Conference. Vancouver, Canada. 2008 August 20-24; 2865-2868. [PDF 586 KB]

Chen, L., T. M. McKenna, A. T. Reisner, A. Gribok, and J. Reifman. Decision tool for the early diagnosis of trauma patient hypovolemia. Journal of Biomedical Informatics. 2008 June; 41(3):469-478. [PDF 367 KB]

Liu, J., T. M. McKenna, A. Gribok, B. A. Beidleman, W. J. Tharion, and J. Reifman. A fuzzy logic algorithm to assign confidence levels to heart and respiratory rate time series. Physiological Measurement. 2008 January; 29(1):81-94. [PDF 333 KB]

Chen, L., A. T. Reisner, T. M. McKenna, A. Gribok, and J. Reifman. Diagnosis of hemorrhage in a prehospital trauma population using linear and nonlinear multiparameter analysis of vital signs. Proceedings of the 29th IEEE EMBS Annual International Conference. Lyon, France. 2007 August 23-26; 3748-3751. [PDF 97 KB]

McKenna, T. M., G. Bawa, K. Kumar, and J. Reifman. The physiology analysis system: an integrated approach for warehousing, management and analysis of time-series physiology data. Computer Methods and Programs in Biomedicine. 2007 April; 86(1):62-72. [PDF 989 KB]

Chen, L., T. McKenna, A. Reisner, and J. Reifman. Algorithms to qualify respiratory data collected during the transport of trauma patients. Physiological Measurement. 2006 September; 27(9):797-816. [PDF 1232 KB]

Yu, C., Z. Liu, T. McKenna, A. T. Reisner, and J. Reifman. A method for automatic identification of reliable heart rates calculated from ECG and PPG waveforms. Journal of the American Medical Informatics Association. 2006 May-June; 13(3):309-320. [PDF 319 KB]

Liu, J., T. M. McKenna, A. Gribok, B. A. Beidleman, W. T. Tharion, and J. Reifman. Estimation of confidence levels for physiology variables measured by a vital signs detection system. Proceedings of the Chemical and Biological Sensing VIII - The International Society for Optical Engineering. Orlando, FL. 2006 April 17-21; 6218:18-26. [PDF 101 KB]

Chen, L., T. McKenna, A. Gribok, and J. Reifman. LAM: a landscape matching algorithm for respiratory data alignment. Proceedings of the Signal Processing, Sensor Fusion, and Target Recognition XV - The International Society for Optical Engineering. Orlando, FL. 2006 April 17-21; 6235:1-10. [PDF 915 KB]

Reifman, J., J. Gunawardena, and Z. Liu. Physiology analysis system. Proceedings of the 4th IEEE International Symposium on Signal Processing and Information Technology. Rome, Italy. 2004 December 18-21; 521-525. [PDF 582 KB]

Oleng', N., J. Reifman, L. Berglund, and R. Hoyt. Alternative approaches to improve physiological predictions. Proceedings of the 24th Army Science Conference. Orlando, FL. 2004 November 29-December 2; 415-422. [PDF 620 KB]

Savell, C. T., M. Borsotto, J. Reifman, and R. W. Hoyt. Life sign decision support algorithms. Proceedings of the 11th World Congress on Medical Informatics. San Francisco, CA. 2004 September 7-11; 107(Pt 2):1453-1457. [PDF 290 KB]

Borsotto, M., C. T. Savell, J. Reifman, R. W. Hoyt, G. Nunns, and C. J. Crick. Life-signs determination model for warfighter physiological status monitoring. Proceedings of the RTO HFM Symposium on Combat Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures. St. Pete Beach, FL. 2004 August 16-18; 28:1-10. [PDF 414 KB]

Reifman, J., G. Gilbert, M. Parker, and D. Lam. Challenges of electronic medical surveillance systems. Proceedings of the RTO HFM Symposium on NATO Medical Surveillance and Response, Research and Technology Opportunity and Options. Budapest, Hungary. 2004 April 19-21; 12:1-17. [PDF 428 KB]

Hoyt, R. W., J. Reifman, T. S. Coster, and M. J. Buller. Combat medical informatics: present and future. Proceedings of the AMIA Annual Symposium. San Antonio, TX. 2002 November 9-13; 335-339. [PDF 43 KB]