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Record W4415890419 · doi:10.1088/1361-6579/ae1b70

High-fidelity measurement of pulse arrival time in critically ill children using standard bedside monitoring equipment

2025· article· en· W4415890419 on OpenAlexaff
Ian Ruffolo, Asad Siddiqui, Binh Nguyen, William G Dixon, Azadeh Assadi, Robert W. Greer, Steven M. Schwartz, Michael Brudno, Alex Mariakakis, Ann Goodwin

Bibliographic record

VenuePhysiological Measurement · 2025
Typearticle
Languageen
FieldEngineering
TopicNon-Invasive Vital Sign Monitoring
Canadian institutionsHospital for Sick ChildrenCanada Research ChairsUniversity of Toronto
Fundersnot available
KeywordsPhotoplethysmogramWaveformCritically illStandardizationIntensive careArrival timeTemporal resolutionPulse (music)

Abstract

fetched live from OpenAlex

Abstract Objective . Pulse arrival time (PAT) is known to be correlated with blood pressure. Although PAT can be measured using electrocardiography (ECG), photoplethysmography (PPG), and other signals commonly available in clinical settings, recent literature has noted that devices recording these waveforms are often subject to many hardware-specific factors related to digital filtering, clock synchronization, temporal resolution, and latency. These factors can introduce relative timing errors between the ECG and PPG signals, resulting in a situation where traditional approaches for PAT measurement will not work as intended. Approach . In this work, we propose a methodology that accounts for these confounding factors and generates precise measurements of PAT using standard bedside monitoring equipment. This technique involves using heart rate variability to match heartbeats across waveforms and experimentally profiling the timing systems of bedside medical devices to correct various timing-related artifacts. To improve the precision of the resulting PAT measurements, we model temporal uncertainties stemming from the finite temporal resolution of the waveform samples. Main results . We apply this approach to a dataset comprising approximately 1.6 million hours of continuous ECG and PPG data from over 10 000 unique patients in a pediatric intensive care unit. After demonstrating that the observed timing artifacts are consistent across the entire dataset, we show that accounting for them results in more reasonable distributions of PAT measurements across age groups. Significance . It is our hope that this work will spur discussion around the standardization of PAT measurement using routinely collected signals in a clinical environment.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Bench or experimental · Consensus signal: Bench or experimental
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.194
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.047
GPT teacher head0.268
Teacher spread0.222 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designBench or experimental
Domainnot available
GenreEmpirical

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".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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