The Problem of Artifacts in Patient Monitor Data During Surgery: A Clinical and Methodological Review

@article{Takla2006ThePO,
  title={The Problem of Artifacts in Patient Monitor Data During Surgery: A Clinical and Methodological Review},
  author={George F. Takla and John H. Petre and Daniel John Doyle and Mayumi Horibe and Bala Gopakumaran},
  journal={Anesthesia \& Analgesia},
  year={2006},
  volume={103},
  pages={1196-1204}
}
Artifacts are a significant problem affecting the accurate display of information during surgery. They are also a source of false alarms. A secondary problem is the inadvertent recording of artifactual and inaccurate information in automated record keeping systems. Though most of the currently available patient monitors use techniques to minimize the effect of artifacts, their success is limited. We reviewed the problem of artifacts affecting patient monitor data during surgical cases. Methods… 
View on Wolters Kluwer
ncbi.nlm.nih.gov
72 Citations
Background Citations
21
Methods Citations
7

Tables from this paper

72 Citations

Artifacts in research data obtained from an anesthesia information and management system
TLDR
Storing a median value per minute to filter capturing of vital parameter values in an AIMS database provides reliable data for heart rate and oxygen saturation and acceptable reliability for noninvasive blood pressure data.
Integrating Physiological Data Artifacts Detection With Clinical Decision Support Systems: Observational Study
TLDR
A novel AD framework for integrating AD algorithms with CDSS with features that support real-time implementation within critical care and demonstrates the framework’s utility in identifying the best possible dynamic composition to serve the clinical need for false SpO2 alarm reduction and subsequent alarm fatigue, given the limitations of a small sample size.
Causes, Characteristics, Consequences, and Correction
TLDR
Advances in processing the electrocardiographic signal may be useful to detect and eliminate artifacts, and an improved understanding of the artifacts generated by equipment, and their identifying characteristics is important to avoid misinterpretation, misdiagnosis, and iatrogenic complication.
Artifact detection and data reconciliation in multivariate ventilatory variables measured during anesthesia: A case study
TLDR
The use of the procedure of gross error detection and data reconciliation commonly used in process control, to detect highly cross-correlated artifacts in the ventilation circuit and reconcile the uncontaminated signal measurements is proposed.
Integrating Physiological Data Artifacts Detection With Clinical Decision Support Systems: Observational Study (Preprint)
TLDR
The framework features, including reusability, signal quality indicator standardization, scalability, and customizability, allow the evaluation and comparison of novel CDSS formulations and demonstrates the framework’s utility in identifying the best possible dynamic composition to serve the clinical need for false SpO2 alarm reduction and subsequent alarm fatigue.
Equipment-related Electrocardiographic Artifacts: Causes, Characteristics, Consequences, and Correction
TLDR
Advances in processing the electrocardiographic signal may be useful to detect and eliminate artifacts, and an improved understanding of the artifacts generated by equipment, and their identifying characteristics is important to avoid misinterpretation, misdiagnosis, and iatrogenic complication.
Automated anesthesia artifact analysis: can machines be trained to take out the garbage?
TLDR
This study describes a study in which two research assistants performed manual identification of AIMS data artifacts, and the research team assessed the performance of three machine learning algorithms to detect artifacts.
Implementation of Artifact Detection in Critical Care: A Methodological Review
TLDR
It is recommended that AD algorithms conform to generic input and output interfaces with commonly defined data: 1) type; 2) frequency; 3) length; and 4) SQIs.
Equipment-related Electrocardiographic Artifacts Causes, Characteristics, Consequences, and Correction
TLDR
An improved understanding of the artifacts generated by equipment, and their identifying characteristics, is important to avoid misinterpretation, misdiagnosis, and iatrogenic complication.
An Unusual Cause of Electrocardiographic Artefact: A Patient's Warming Blanket.
TLDR
A case of ECG artefacts that occur owing to a patient's warming blanket and its consequences is reported.
...
...

References

SHOWING 1-10 OF 76 REFERENCES
Automatic artifact identification in anaesthesia patient record keeping: a comparison of techniques.
Real-Time Pulse Oximetry Artifact Annotation on Computerized Anaesthetic Records
TLDR
The real-time artifact detection algorithm developed in this study was more accurate than anaesthetists who post-operatively reviewed records produced by an existing computerised anaesthesia record keeping system.
The practical management of artifact in computerised physiological data
TLDR
The results suggest that interobserver variability should have a minimal effect on values, once rules identifying the type of artifact to be removed are agreed, and may be an important consideration in the statistical analysis of computerised physiological data.
Detection of Intraoperative Incidents by Electronic Scanning of Computerized Anesthesia Records: Comparison with Voluntary Reporting
TLDR
A low level of compliance with voluntary reporting of defined intraoperative incidents was found for all anesthesiologists studied and there was a strong association between intraoper incidents and in-hospital mortality.
Artifact detection in cardiovascular time series monitoring data from preterm infants
TLDR
A method for detecting artifacts in heart-rate and mean blood-pressure data from a physiological monitoring system used in preterm infants, using a parametric artifact detector, called CVDetector.
Artifact Mistaken for Electrical Interference Recorded From a Pulmonary Artery Catheter
TLDR
A case in which the blood pressure tracing from the pulmonary artery revealed an artifact that looked at first glance like 60 cycle alternating current (AC) electrical interference, and the investigation as to its origin revealed important lessons in the analysis of human error.
Effect of adaptive motion-artifact reduction on QRS detection.
TLDR
Adaptive noise removal was applied to the ECG signal using a skin-stretch signal as the noise reference and reduced the number of false QRS detections in the records from 380 to 104, for an average reduction in false detections of 72.6%.
Noninvasive blood pressure performance: a reproducible method for quantifying motion artifact tolerance in oscillometry.
TLDR
A commercially available NIBP simulator was modified to permit the superimposition of repeatable motion artifact waveforms from a function generator onto known patient blood pressure profiles, providing a reproducible and quantifiable method by which to assess and differentiate the artifact tolerance of different N IBP technologies.
Noninvasive blood pressure performance: a reproducible method for quantifying motion artifact tolerance in oscillometry.
TLDR
A commercially available NIBP simulator was modified to permit the superimposition of repeatable motion artifact waveforms from a function generator onto known patient blood pressure profiles available in the NIBp simulator, providing a reproducible and quantifiable method by which to assess and differentiate the artifact tolerance of different N IBP technologies.
A new method for pulse oximetry possessing inherent insensitivity to artifact
TLDR
It is demonstrated that this new methodology results in a reduced sensitivity to common classes of motion artifact, while retaining the generality to be combined with conventional signal processing techniques.
...
...