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Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review

Patient monitoring technology has been used to guide therapy and alert staff when a vital sign leaves a predefined range in the intensive care unit (ICU) for decades. However, large amounts of technically false or clinically irrelevant alarms provoke alarm fatigue in staff leading to desensitisation...

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Autores principales: Chromik, Jonas, Klopfenstein, Sophie Anne Ines, Pfitzner, Bjarne, Sinno, Zeena-Carola, Arnrich, Bert, Balzer, Felix, Poncette, Akira-Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424650/
https://www.ncbi.nlm.nih.gov/pubmed/36052315
http://dx.doi.org/10.3389/fdgth.2022.843747
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author Chromik, Jonas
Klopfenstein, Sophie Anne Ines
Pfitzner, Bjarne
Sinno, Zeena-Carola
Arnrich, Bert
Balzer, Felix
Poncette, Akira-Sebastian
author_facet Chromik, Jonas
Klopfenstein, Sophie Anne Ines
Pfitzner, Bjarne
Sinno, Zeena-Carola
Arnrich, Bert
Balzer, Felix
Poncette, Akira-Sebastian
author_sort Chromik, Jonas
collection PubMed
description Patient monitoring technology has been used to guide therapy and alert staff when a vital sign leaves a predefined range in the intensive care unit (ICU) for decades. However, large amounts of technically false or clinically irrelevant alarms provoke alarm fatigue in staff leading to desensitisation towards critical alarms. With this systematic review, we are following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist in order to summarise scientific efforts that aimed to develop IT systems to reduce alarm fatigue in ICUs. 69 peer-reviewed publications were included. The majority of publications targeted the avoidance of technically false alarms, while the remainder focused on prediction of patient deterioration or alarm presentation. The investigated alarm types were mostly associated with heart rate or arrhythmia, followed by arterial blood pressure, oxygen saturation, and respiratory rate. Most publications focused on the development of software solutions, some on wearables, smartphones, or headmounted displays for delivering alarms to staff. The most commonly used statistical models were tree-based. In conclusion, we found strong evidence that alarm fatigue can be alleviated by IT-based solutions. However, future efforts should focus more on the avoidance of clinically non-actionable alarms which could be accelerated by improving the data availability. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233461, identifier: CRD42021233461.
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spelling pubmed-94246502022-08-31 Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review Chromik, Jonas Klopfenstein, Sophie Anne Ines Pfitzner, Bjarne Sinno, Zeena-Carola Arnrich, Bert Balzer, Felix Poncette, Akira-Sebastian Front Digit Health Digital Health Patient monitoring technology has been used to guide therapy and alert staff when a vital sign leaves a predefined range in the intensive care unit (ICU) for decades. However, large amounts of technically false or clinically irrelevant alarms provoke alarm fatigue in staff leading to desensitisation towards critical alarms. With this systematic review, we are following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist in order to summarise scientific efforts that aimed to develop IT systems to reduce alarm fatigue in ICUs. 69 peer-reviewed publications were included. The majority of publications targeted the avoidance of technically false alarms, while the remainder focused on prediction of patient deterioration or alarm presentation. The investigated alarm types were mostly associated with heart rate or arrhythmia, followed by arterial blood pressure, oxygen saturation, and respiratory rate. Most publications focused on the development of software solutions, some on wearables, smartphones, or headmounted displays for delivering alarms to staff. The most commonly used statistical models were tree-based. In conclusion, we found strong evidence that alarm fatigue can be alleviated by IT-based solutions. However, future efforts should focus more on the avoidance of clinically non-actionable alarms which could be accelerated by improving the data availability. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233461, identifier: CRD42021233461. Frontiers Media S.A. 2022-08-16 /pmc/articles/PMC9424650/ /pubmed/36052315 http://dx.doi.org/10.3389/fdgth.2022.843747 Text en © 2022 Chromik, Klopfenstein, Pfitzner, Sinno, Arnrich, Balzer and Poncette. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Digital Health
Chromik, Jonas
Klopfenstein, Sophie Anne Ines
Pfitzner, Bjarne
Sinno, Zeena-Carola
Arnrich, Bert
Balzer, Felix
Poncette, Akira-Sebastian
Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
title Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
title_full Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
title_fullStr Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
title_full_unstemmed Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
title_short Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
title_sort computational approaches to alleviate alarm fatigue in intensive care medicine: a systematic literature review
topic Digital Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424650/
https://www.ncbi.nlm.nih.gov/pubmed/36052315
http://dx.doi.org/10.3389/fdgth.2022.843747
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