SYMBIOSIS OF NURSE AND MACHINE THROUGH FUZZY LOGIC: IMPROVED SPECIFICITY OF A NEW NEONATAL PULSE OXIMETER ALARM.
Contributors: University of California, San Francisco.
Published: 1993
Number of pages: 157
Subjects: Health Sciences, Nursing.; Computer Science.; Artificial Intelligence.
Description: Non-invasive pulse oximeters are used by nurses to monitor oxygenation in $>$600 NICU's in the USA for $>$80% of mechanically ventilated infants. Motion causes false alarms up to 29% of the time, resulting in poor specificity. I developed a fuzzy logic computer prototype alarm system using fuzzy sets of desaturation, within limits, and artifact. The purpose of this study was to compare the new (NEW) vs. conventional (OLD) alarm systems to test the hypothesis that a neonatal pulse oximeter alarm system based on fuzzy logic will have equivalent sensitivity and improved specificity vs. the OLD alarm system. Thirty-eight infants were enrolled with a mean (range) study weight of 1495g (470-3390). Oxygen saturation signals (Nellcor N200) were collected for 1 hour per infant on a strip chart recorder and saved on a computer. Reference (REF) signals were simultaneously recorded from a second pulse oximeter and transcutaneous O$\sb2$ monitor. If an alarm persisted, each 30 second interval was considered a separate event. The NEW vs. OLD alarms were compared to the REF for 919 alarm events. There were 451 new alarm events, with a mean of 12.1 (range 1-36) new events per subject, and the others were persistent alarms. Oxygen desaturation was defined as transcutaneous $\rm PO\sb2<40$ torr and $\rm SaO\sb2$ $<$ 85% for the REF.

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The NEW alarm system had 34% fewer false positive alarms (p $<$.001). The NEW fuzzy logic alarm system has equivalent sensitivity and improved specificity vs. the OLD alarm system. When used to monitor oxygenation in infants, this system with fewer false alarms may decrease the "Cry Wolf Syndrome", and represents a symbiosis between nurse and machine.
Notes: Source: Dissertation Abstracts International, Volume: 54-03, Section: B, page: 1328.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1993.

School code: 0034.