# US 9,433,348 B2 · Method of rendering hemodynamic instability index indicator information

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- Number: US 9,433,348 B2
- Document ID: US9433348B2
- Status: Granted
- Kind: B2
- Application number: 14/401,987
- Filed: 2013-05-06
- Published: 2015-05-28
- Granted: 2016-09-06
- Earliest claimed: 2012-05-18
- Assignees: Koninklijke Philips N.V.
- Applicants: Koninklijke Philips N.V.
- Inventors: Larry James Eshelman; Abigail Acton Flower; Brian David Gross; Joseph James Frassica; Larry Nielsen; Mohammed Saeed
- Web page: https://patentgrep.com/patent/US9433348B2

## CPC

- A61B 5/0002: {Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network (endoradiosondes A61B5/07)}
- A61B 5/7275: {Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor}
- A61B 5/7425: {Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image}
- A61B 5/746: {Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms}
- G16H 10/40: for data related to laboratory analysis, e.g. patient specimen analysis
- G16H 40/67: for remote operation
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- G16H 50/30: for calculating health indices; for individual health risk assessment
- G16H 50/70: for mining of medical data, e.g. analysing previous cases of other patients
- A61B 5/021: Measuring pressure in heart or blood vessels
- A61B 5/024: Measuring pulse rate or heart rate
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A medical system (10) and method monitor a patient. Patient data for the patient received. The patient data includes vital sign measurements and laboratory results. A vital signs instability index (VIX) regarding a physiological condition of the patient is calculated from the received vital sign measurements. A laboratory instability index (LIX) regarding the physiological condition is calculated from the received laboratory results. The VIX and the LIX are integrated into an indicator of patient deterioration.

## Claims

### Claim 1

A medical system for monitoring a patient, said system comprising:
one or more processors programmed to:
receive patient data for the patient, the patient data including vital sign measurements and laboratory results;
calculate a vital signs instability index (VIX) regarding a physiological condition of the patient from the received vital sign measurements;
calculate a laboratory instability index (LIX) regarding the physiological condition from the received laboratory results; and
integrate the VIX and the LIX into an indicator of patient deterioration, wherein the integration includes:
looking up a prevalence value in a VIX-to-prevalence table using the VIX and the LIX, the prevalence value indicating a prevalence of unstable VIX segments in a training population for differing VIX ranges and LIX bands, the VIX ranges spanning the range of possible values for the VIX in predetermined increments, the LIX bands representing differing degrees of risk with the physiological condition and including the range of possible values for the LIX, wherein the VIX segments of the training population correspond to VIX trends over a predetermined period of time; and
mapping the prevalence value to a value of the indicator by linearly adjusting the prevalence value so it scales over the range of prevalence values in the VIX-to-prevalence table.

### Claim 2 (depends on 1)

The medical system according to claim 1, wherein the LIX is calculated using a model modeling the relationship between instability of the physiological condition and the laboratory tests corresponding to the received laboratory results.

### Claim 3 (depends on 1)

The medical system according to claim 1, wherein the at least one processor is further programmed to:
filter VIX to remove outlying values using an upper baseline and a lower baseline, an upper baseline value being a maximum VIX value over a previous period of time, and a lower baseline value being a the minimum VIX value over a previous period of time.

### Claim 4 (depends on 3)

The medical system according to claim 3, wherein a VIX value is suppressed if it exceeds a predetermined fraction of corresponding upper baseline value or is less than a predetermined fraction of a corresponding lower baseline value.

### Claim 5 (depends on 1)

The medical system according to claim 1, wherein that at least one processor is further programmed to:
display the indicator using one or more of text, color coding, and a bar chart, the color codes identifying different degrees of risk of patient deterioration.

### Claim 6 (depends on 5)

The medical system according to claim 5, wherein that at least one processor is further configured to:
in response to detecting significant patient deterioration using the VIX, independent of the indicator, highlight the display of the indicator.

### Claim 7 (depends on 1)

The medical system according to claim 1, wherein that at least one processor is further programmed to:
display a trend line of selectable values of the indicator; and
upon selection of one of the selectable values, display a tool-tip including one or more of vital sign measurements, lab results, and other relevant data for the selected value.

### Claim 8

A medical method for monitoring a patient, said method being performed by at least one processor and comprising:
receiving patient data for the patient, the patient data including vital sign measurements and laboratory results;
calculating a vital signs instability index (VIX) regarding a physiological condition of the patient from the received vital sign measurements;
calculating a laboratory instability index (LIX) regarding the physiological condition from the received laboratory results; and
integrating the VIX and the LIX into an indicator of patient deterioration, wherein the integrating includes:
looking up a prevalence value in a VIX-to-prevalence table using the VIX and the LIX, the prevalence value indicating a prevalence of unstable VIX segments in a training population for differing VIX ranges and LIX bands, the VIX ranges spanning the range of possible values for the VIX in predetermined increments, the LIX bands representing differing degrees of risk with the physiological condition and including the range of possible values for the LIX, wherein the VIX segments of the training population correspond to VIX trends over a predetermined period of time; and
mapping the prevalence value to a value of the indicator by linearly adjusting the prevalence value so it scales over the range of prevalence values in the VIX-to-prevalence table.

### Claim 9 (depends on 8)

The medical method according to claim 8, wherein the LIX is calculated using a model modeling the relationship between instability of the physiological condition and the laboratory tests corresponding to the received laboratory results.

### Claim 10 (depends on 8)

The medical method according to claim 8, further including:
filtering VIX to remove outlying values using an upper baseline and a lower baseline, an upper baseline value being a maximum VIX value over a previous period of time, and a lower baseline value being a the minimum VIX value over a previous period of time.

### Claim 11 (depends on 8)

The medical method according to claim 8, wherein that at least one processor is further programmed to:
display the indicator using one or more of text, color coding, and a bar chart, the color codes identifying different degrees of risk of patient deterioration.

### Claim 12 (depends on 8)

The medical method according to claim 8, further including:
displaying a trend line of selectable values of the indicator; and
upon selection of one of the selectable values, displaying a tool-tip including one or more of vital sign measurements, lab results, and other relevant data for the selected value.

### Claim 13 (depends on 8)

At least one processors programmed to perform the method according to claim 8.

### Claim 14 (depends on 8)

A non-transitory computer readable medium carrying software which controls one or more processors to perform the method according to claim 8.