New England Medical Center Hospitals. Inc.

Other

Duke University

Tufts University

New England Center Hospitals, Inc.

Harry P Selker

John L Griffith

Robert M Califf

W Douglas Weaver

Madhab Ray

Joni R Beshansky

Galen S Wagner

A purpose-made predictive instrument for the administration of cardiac metabolic support for acute coronary syndromes (ACS, which include unstable angina and acute myocardial infarction) that particularly identifies those most likely to benefit from treatment. In some examples, such a predictive instrument is used for real-time decision support for the administration of treatments such as glucoseinsulin-potassium (GIK).

Predictive instrument to identify patients for use of pharmacological cardiac metabolic support

A randomization mechanism for enabling randomization of a patient to one of two treatment options having different time-to-treatments is presented. Data is received for a patient experiencing symptoms of the type treatable by either of the two treatment options. The received data is used to compute for a first treatment option of the two treatment options at its associated time-to-treatment a benefit value. Assuming a benefit value for the second treatment option is an estimate of the computed first benefit value, the received data and computed benefit value are used to compute a maximum allowable delay time during which the benefit value for the second treatment option is no less than the benefit value computed for the first treatment option. When provided a given delay time by which the time-to-treatment of the second treatment option lags the first treatment option time-to-treatment, the mechanism determines if the given delay time is less than or equal to the allowable delay time. If the given delay time is determined to be less than or equal to the allowable delay time, then the patient is eligible for randomization.

Method of randomizing patients in a clinical trial

A method for evaluating a medical condition of a patient including the steps of monitoring one or more clinical features of a patient; based on the monitored features, computing a primary probability of a medical outcome or diagnosis; computing a plurality of conditional probabilities for a selected diagnostic test, the computed conditional probabilities including a first probability of the medical outcome or diagnosis assuming the selected diagnostic test produces a first outcome and a second probability of the medical outcome or diagnosis assuming the selected diagnostic test produces a second outcome; and displaying the computed primary probability as well as the plurality of computed conditional probabilities to a user as an aid to determining whether to administer the selected diagnostic test to the patient.

Diagnostic tool using a predictive instrument

A method for continuously monitoring the medical condition of a patient, the method including the steps of continuously monitoring one or more clinical features of the patient; periodically computing a probability of a medical outcome or diagnosis based upon the continuously monitored one or more clinical features; from the periodically computed probability of a medical outcome or diagnosis, computing a change-of-condition measure; periodically comparing the change-in-condition measure to a threshold value; and if any computed change-in-condition measure exceeds the threshold value, generating an alarm notification.

Continuous monitoring using a predictive instrument

An instrument for continuously monitoring the condition of a patient who has a cardiovascular disease, the instrument including an electrocardiograph; a waveform analyzer which analyzes a current segment of an ECG waveform; a computer receiving output from the waveform analyzer; and a control module. The computer is programmed to complete a monitoring cycle in which the computer uses the output from the waveform analyzer to compute a probability of a life threatening cardiac condition based upon the current segment of the patient's ECG waveform. The control module causes the computer to periodically repeat the monitoring cycle and for each repetition of said monitoring cycle to compute a change-of-condition measure, wherein the change-of-condition measure is calculated by subtracting a computed probability for a previous monitoring cycle from the computed probability for the current monitoring cycle. The computer is also programmed to compare during each monitoring cycle the computed change-of-condition measure for that monitoring cycle to a threshold value and if in excess of the threshold value to generate an alarm notification.

A clinical information reporting system for use with an electronic database for a health care facility, the electronic database containing records for a group of patients and operational information which is accessed and used during the course of operation of the facility, the records containing clinical information for said group of patients, the reporting system including an electrocardiograph which generates ECG-related data for the group of patients; database application logic for incorporating the ECG-related data for the group of patients into the database; and report generating logic for generating a process of care report from the information stored in the database, the process of care report presenting selected process of care information derived from the database as a function of a clinically meaningful class of the group of patients, wherein the clinically meaningful class is defined at least in part in terms of the ECG-related data supplied by the electrocardiograph and stored within the database.

Clinical information reporting system

A risk management system for use in a health care facility which receives patients who may be experiencing cardiac problems, the system including a first input port for receiving inputs derived from electrocardiograph measurements of a patient; a predictive instrument for using the inputs to compute a probability of the patient having a particular heart condition; a printer for generating a risk management form reporting the computed probability for the patient as well as other clinical and ECG-related observations for the patient, the form also containing categories requiring a person who is evaluating the patient to enter additional information relating to the evaluation of the patient, the computed probability triggering the printer to generate the form only when the computed probability falls within a preselected range which is less than the total range of possible values for the computed probability.

Risk management system for use with cardiac patients

An instrument for predicting the benefit of using thrombolytic therapy to treat a patient with a heart condition including a first input port for receiving inputs derived from electrocardiograph measurements of the patient's condition, and a processor for computing an estimate of said benefit based upon the electrocardiograph-derived inputs.

Thrombolysis predictive instrument

A device for determining the probability of death in cardiovascular patients including an electrocardiograph adapted to deliver a signal in the form of an electrical waveform containing information about the condition of the patient's heart; a waveform recognition and measurement device adapted to analyze the waveform and generate output based on the analysis; and a computer adapted to receive the output and calculate a numerical value representing the probability based on the output. Also provided is a method for assessing cardiovascular mortality risk at a health care facility or provider using this device.

Growing community of inventors

Wellesley, MA, United States of America

Harry P Selker