Integrated monitoring and analysis for early warning of patient deterioration

Br J Anaesth. 2006 Jul;97(1):64-8. doi: 10.1093/bja/ael113. Epub 2006 May 17.


Recently there has been an upsurge of interest in strategies for detecting at-risk patients in order to trigger the timely intervention of a Medical Emergency Team (MET), also known as a Rapid Response Team (RRT). We review a real-time automated system, BioSign, which tracks patient status by combining information from vital signs monitored non-invasively on the general ward. BioSign fuses the vital signs in order to produce a single-parameter representation of patient status, the Patient Status Index. The data fusion method adopted in BioSign is a probabilistic model of normality in five dimensions, previously learnt from the vital sign data acquired from a representative sample of patients. BioSign alerts occur either when a single vital sign deviates by close to +/-3 standard deviations from its normal value or when two or more vital signs depart from normality, but by a smaller amount. In a trial with high-risk elective/emergency surgery or medical patients, BioSign alerts were generated, on average, every 8 hours; 95% of these were classified as 'True' by clinical experts. Retrospective analysis has also shown that the data fusion algorithm in BioSign is capable of detecting critical events in advance of single-channel alerts.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Critical Care / methods*
  • Health Status Indicators*
  • Humans
  • Monitoring, Physiologic / methods*
  • Patients' Rooms
  • Signal Processing, Computer-Assisted