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DECISION-SUPPORT ALGORITHMS

Decision-Support Algorithms

To accelerate the deployment of automated decision-support systems in unstructured, pre-hospital environments, this project develops algorithms and technologies for 1) real-time capture and analysis of vital-sign data (APPRAISE: 2016 Service to America Award for Science and Environment), 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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]