SPAR project
Research type
Research Study
Full title
Exploration of a novel mathematical approach to assist with clinical decision making in critically ill children.
IRAS ID
226172
Contact name
Duncan Macrae
Contact email
Sponsor organisation
Guy's and St Thomas' NHS Foundation Trust, Royal Brompton and Harefield Hospitals
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
In the UK, critically ill children are cared for in Paediatric Intensive Care Units (PICU) and they are continuously monitored by bedside monitors for ECG, blood pressure and other cardiovascular parameters. These children are prone to clinical deteriorations and the earlier these deteriorations are detected and treated, the better the outcome.
Bedside monitor data, such as blood pressure, is generated as repeating waves. Bedside monitor typically capture approximately 125 data points per second (125Hertz). This huge amount of numerical data is too much for clinicians to make sense of and therefore the devices simplify it, reporting average, maximum and minimum values. Unfortunately, by doing so a potential wealth of information contained in the waveform is discarded. This waveform data has long been known to contain useful information on cardiovascular function and if suitably interpreted it may detect early deterioration.
Symmetric Projection Attractor Reconstruction (SPAR), a novel mathematical method, uses all the waveform data providing detailed information about how the shape of the waveform changes. The method converts high fidelity digital data from bedside monitors into a simpler image that can be quantified to reveal more nuanced changes in the cardiovascular system. The technique has been validated in healthy humans and now we wish to explore the application of this method on data collected from children admitted to the Royal Brompton Hospital PICU.
This is an exploratory cohort study. Routinely collected bedside monitor waveform data (Arterial BP, ECG, central venous pressure and pulse oximetry) and clinical data such as diagnosis, tests and results will be extracted from children over the period of two years. The waveforms will then be annotated with key clinical events and analysed using the novel mathematical method. Changes in the waveform will be correlated with the key events to detect deterioration.
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
21/NW/0145
Date of REC Opinion
17 May 2021
REC opinion
Unfavourable Opinion