Wearable Continuous Vital Sign Monitoring Study (WARD-AMS) to Detect Clinical Deterioration in Postoperative General Surgery Patients: Protocol for a Randomized Controlled Trial
Notice bibliographique
Résumé
Background: Postoperative complications remain a major challenge in health care systems, with more than 70% of postoperative in-hospital mortality occurring in general wards. Current practice relies on intermittent spot-check monitoring of vital signs guided by track-and-trigger thresholds such as early warning scores. Evidence shows that, up to 4 hours before an adverse event, abnormal vital signs can be detected in up to 60% of patients. Continuous vital sign monitoring in general wards offers the potential to detect clinical deterioration earlier. However, prospective evaluations of continuous monitoring in general wards remain limited. Objective: This study aims to prospectively evaluate the impact of continuous vital sign monitoring in adult postoperative patients in general wards. The primary objective is to determine whether continuous vital sign monitoring reduces the time from device-defined physiological deterioration to the first objective escalation event (acknowledgment or clinical action) by the health care team. Secondary objectives are to evaluate clinical outcomes, operational impact, and both staff and patient experiences. Methods: We conducted a single-center, open-label randomized controlled trial of 200 general surgical patients, receiving continuous vital signs monitoring alongside standard care. Participants were randomized 1:1 to alerting or nonalerting groups, either real-time data and alerts visible or blinded to clinicians, respectively. The primary outcome is the time from the first device-defined physiological deterioration episode to the first objective escalation event (acknowledgment or clinical action). Exploratory outcomes evaluate time to treatment initiation, rapid response team activation, escalation of care, length of stay, mortality, alarm performance, and patient and staff experience. Results: The Ward Alerting and Ambulatory Monitoring Study (WARD-AMS) trial received ethical approval in April 2024; recruitment commenced in October 2024 and was completed by December 2025 with 200 patients enrolled. Data analysis is ongoing, with results to be submitted for publication by mid-2026. Conclusions: The WARD-AMS study is among the first prospective, randomized evaluations of continuous vital sign monitoring in real-world ward settings looking at clinical outcomes and user experience. By integrating clinical outcomes, alarm analytics, and stakeholder experiences, it aims to provide a comprehensive understanding of the benefits, limitations, and implementation challenges of continuous monitoring. Findings from this study will inform strategies to optimize response to early clinical deterioration, reducing alarm fatigue and embedding new technologies into existing routine ward practice.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».