845 resultados para Therapeutic drug monitoring
Resumo:
The high morbidity and mortality associated with atherosclerotic coronary vascular disease (CVD) and its complications are being lessened by the increased knowledge of risk factors, effective preventative measures and proven therapeutic interventions. However, significant CVD morbidity remains and sudden cardiac death continues to be a presenting feature for some subsequently diagnosed with CVD. Coronary vascular disease is also the leading cause of anaesthesia related complications. Stress electrocardiography/exercise testing is predictive of 10 year risk of CVD events and the cardiovascular variables used to score this test are monitored peri-operatively. Similar physiological time-series datasets are being subjected to data mining methods for the prediction of medical diagnoses and outcomes. This study aims to find predictors of CVD using anaesthesia time-series data and patient risk factor data. Several pre-processing and predictive data mining methods are applied to this data. Physiological time-series data related to anaesthetic procedures are subjected to pre-processing methods for removal of outliers, calculation of moving averages as well as data summarisation and data abstraction methods. Feature selection methods of both wrapper and filter types are applied to derived physiological time-series variable sets alone and to the same variables combined with risk factor variables. The ability of these methods to identify subsets of highly correlated but non-redundant variables is assessed. The major dataset is derived from the entire anaesthesia population and subsets of this population are considered to be at increased anaesthesia risk based on their need for more intensive monitoring (invasive haemodynamic monitoring and additional ECG leads). Because of the unbalanced class distribution in the data, majority class under-sampling and Kappa statistic together with misclassification rate and area under the ROC curve (AUC) are used for evaluation of models generated using different prediction algorithms. The performance based on models derived from feature reduced datasets reveal the filter method, Cfs subset evaluation, to be most consistently effective although Consistency derived subsets tended to slightly increased accuracy but markedly increased complexity. The use of misclassification rate (MR) for model performance evaluation is influenced by class distribution. This could be eliminated by consideration of the AUC or Kappa statistic as well by evaluation of subsets with under-sampled majority class. The noise and outlier removal pre-processing methods produced models with MR ranging from 10.69 to 12.62 with the lowest value being for data from which both outliers and noise were removed (MR 10.69). For the raw time-series dataset, MR is 12.34. Feature selection results in reduction in MR to 9.8 to 10.16 with time segmented summary data (dataset F) MR being 9.8 and raw time-series summary data (dataset A) being 9.92. However, for all time-series only based datasets, the complexity is high. For most pre-processing methods, Cfs could identify a subset of correlated and non-redundant variables from the time-series alone datasets but models derived from these subsets are of one leaf only. MR values are consistent with class distribution in the subset folds evaluated in the n-cross validation method. For models based on Cfs selected time-series derived and risk factor (RF) variables, the MR ranges from 8.83 to 10.36 with dataset RF_A (raw time-series data and RF) being 8.85 and dataset RF_F (time segmented time-series variables and RF) being 9.09. The models based on counts of outliers and counts of data points outside normal range (Dataset RF_E) and derived variables based on time series transformed using Symbolic Aggregate Approximation (SAX) with associated time-series pattern cluster membership (Dataset RF_ G) perform the least well with MR of 10.25 and 10.36 respectively. For coronary vascular disease prediction, nearest neighbour (NNge) and the support vector machine based method, SMO, have the highest MR of 10.1 and 10.28 while logistic regression (LR) and the decision tree (DT) method, J48, have MR of 8.85 and 9.0 respectively. DT rules are most comprehensible and clinically relevant. The predictive accuracy increase achieved by addition of risk factor variables to time-series variable based models is significant. The addition of time-series derived variables to models based on risk factor variables alone is associated with a trend to improved performance. Data mining of feature reduced, anaesthesia time-series variables together with risk factor variables can produce compact and moderately accurate models able to predict coronary vascular disease. Decision tree analysis of time-series data combined with risk factor variables yields rules which are more accurate than models based on time-series data alone. The limited additional value provided by electrocardiographic variables when compared to use of risk factors alone is similar to recent suggestions that exercise electrocardiography (exECG) under standardised conditions has limited additional diagnostic value over risk factor analysis and symptom pattern. The effect of the pre-processing used in this study had limited effect when time-series variables and risk factor variables are used as model input. In the absence of risk factor input, the use of time-series variables after outlier removal and time series variables based on physiological variable values’ being outside the accepted normal range is associated with some improvement in model performance.
Resumo:
Structural health is a vital aspect of infrastructure sustainability. As a part of a vital infrastructure and transportation network, bridge structures must function safely at all times. However, due to heavier and faster moving vehicular loads and function adjustment, such as Busway accommodation, many bridges are now operating at an overload beyond their design capacity. Additionally, the huge renovation and replacement costs are a difficult burden for infrastructure owners. The structural health monitoring (SHM) systems proposed recently are incorporated with vibration-based damage detection techniques, statistical methods and signal processing techniques and have been regarded as efficient and economical ways to assess bridge condition and foresee probable costly failures. In this chapter, the recent developments in damage detection and condition assessment techniques based on vibration-based damage detection and statistical methods are reviewed. The vibration-based damage detection methods based on changes in natural frequencies, curvature or strain modes, modal strain energy, dynamic flexibility, artificial neural networks, before and after damage, and other signal processing methods such as Wavelet techniques, empirical mode decomposition and Hilbert spectrum methods are discussed in this chapter.
Resumo:
This thesis discusses various aspects of the integrity monitoring of GPS applied to civil aircraft navigation in different phases of flight. These flight phases include en route, terminal, non-precision approach and precision approach. The thesis includes four major topics: probability problem of GPS navigation service, risk analysis of aircraft precision approach and landing, theoretical analysis of Receiver Autonomous Integrity Monitoring (RAIM) techniques and RAIM availability, and GPS integrity monitoring at a ground reference station. Particular attention is paid to the mathematical aspects of the GPS integrity monitoring system. The research has been built upon the stringent integrity requirements defined by civil aviation community, and concentrates on the capability and performance investigation of practical integrity monitoring systems with rigorous mathematical and statistical concepts and approaches. Major contributions of this research are: • Rigorous integrity and continuity risk analysis for aircraft precision approach. Based on the joint probability density function of the affecting components, the integrity and continuity risks of aircraft precision approach with DGPS were computed. This advanced the conventional method of allocating the risk probability. • A theoretical study of RAIM test power. This is the first time a theoretical study on RAIM test power based on the probability statistical theory has been presented, resulting in a new set of RAIM criteria. • Development of a GPS integrity monitoring and DGPS quality control system based on GPS reference station. A prototype of GPS integrity monitoring and DGPS correction prediction system has been developed and tested, based on the A USN A V GPS base station on the roof of QUT ITE Building.