Artificial Intelligence Technologies for Coping with Alarm Fatigue in Hospital Environments Because of Sensory Overload: Algorithm Development and Validation
Bibliographic record
Abstract
BACKGROUND: Informed estimates claim that 80% to 99% of alarms set off in hospital units are false or clinically insignificant, representing a cacophony of sounds that do not present a real danger to patients. These false alarms can lead to an alert overload that causes a health care provider to miss important events that could be harmful or even life-threatening. As health care units become more dependent on monitoring devices for patient care purposes, the alarm fatigue issue has to be addressed as a major concern for the health care team as well as to enhance patient safety. OBJECTIVE: The main goal of this paper was to propose a feasible solution for the alarm fatigue problem by using an automatic reasoning mechanism to decide how to notify members of the health care team. The aim was to reduce the number of notifications sent by determining whether or not to group a set of alarms that occur over a short period of time to deliver them together, without compromising patient safety. METHODS: This paper describes: (1) a model for supporting reasoning algorithms that decide how to notify caregivers to avoid alarm fatigue; (2) an architecture for health systems that support patient monitoring and notification capabilities; and (3) a reasoning algorithm that specifies how to notify caregivers by deciding whether to aggregate a group of alarms to avoid alarm fatigue. RESULTS: Experiments were used to demonstrate that providing a reasoning system can reduce the notifications received by the caregivers by up to 99.3% (582/586) of the total alarms generated. Our experiments were evaluated through the use of a dataset comprising patient monitoring data and vital signs recorded during 32 surgical cases where patients underwent anesthesia at the Royal Adelaide Hospital. We present the results of our algorithm by using graphs we generated using the R language, where we show whether the algorithm decided to deliver an alarm immediately or after a delay. CONCLUSIONS: The experimental results strongly suggest that this reasoning algorithm is a useful strategy for avoiding alarm fatigue. Although we evaluated our algorithm in an experimental environment, we tried to reproduce the context of a clinical environment by using real-world patient data. Our future work is to reproduce the evaluation study based on more realistic clinical conditions by increasing the number of patients, monitoring parameters, and types of alarm.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".