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Journal ArticleDOI

PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals.

TL;DR: The newly inaugurated Research Resource for Complex Physiologic Signals (RRSPS) as mentioned in this paper was created under the auspices of the National Center for Research Resources (NCR Resources).
Abstract: —The newly inaugurated Research Resource for Complex Physiologic Signals, which was created under the auspices of the National Center for Research Resources of the National Institutes of He...
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TL;DR: This survey tries to provide a structured and comprehensive overview of the research on anomaly detection by grouping existing techniques into different categories based on the underlying approach adopted by each technique.
Abstract: Anomaly detection is an important problem that has been researched within diverse research areas and application domains. Many anomaly detection techniques have been specifically developed for certain application domains, while others are more generic. This survey tries to provide a structured and comprehensive overview of the research on anomaly detection. We have grouped existing techniques into different categories based on the underlying approach adopted by each technique. For each category we have identified key assumptions, which are used by the techniques to differentiate between normal and anomalous behavior. When applying a given technique to a particular domain, these assumptions can be used as guidelines to assess the effectiveness of the technique in that domain. For each category, we provide a basic anomaly detection technique, and then show how the different existing techniques in that category are variants of the basic technique. This template provides an easier and more succinct understanding of the techniques belonging to each category. Further, for each category, we identify the advantages and disadvantages of the techniques in that category. We also provide a discussion on the computational complexity of the techniques since it is an important issue in real application domains. We hope that this survey will provide a better understanding of the different directions in which research has been done on this topic, and how techniques developed in one area can be applied in domains for which they were not intended to begin with.

9,627 citations

Journal ArticleDOI
TL;DR: The Medical Information Mart for Intensive Care (MIMIC-III) as discussed by the authors is a large, single-center database comprising information relating to patients admitted to critical care units at a large tertiary care hospital.
Abstract: MIMIC-III ('Medical Information Mart for Intensive Care') is a large, single-center database comprising information relating to patients admitted to critical care units at a large tertiary care hospital. Data includes vital signs, medications, laboratory measurements, observations and notes charted by care providers, fluid balance, procedure codes, diagnostic codes, imaging reports, hospital length of stay, survival data, and more. The database supports applications including academic and industrial research, quality improvement initiatives, and higher education coursework.

4,056 citations

Journal ArticleDOI
TL;DR: Application of fractal analysis may provide new approaches to assessing cardiac risk and forecasting sudden cardiac death, as well as to monitoring the aging process, and similar approaches show promise in assessing other regulatory systems, such as human gait control in health and disease.
Abstract: According to classical concepts of physiologic control, healthy systems are self-regulated to reduce variability and maintain physiologic constancy. Contrary to the predictions of homeostasis, however, the output of a wide variety of systems, such as the normal human heartbeat, fluctuates in a complex manner, even under resting conditions. Scaling techniques adapted from statistical physics reveal the presence of long-range, power-law correlations, as part of multifractal cascades operating over a wide range of time scales. These scaling properties suggest that the nonlinear regulatory systems are operating far from equilibrium, and that maintaining constancy is not the goal of physiologic control. In contrast, for subjects at high risk of sudden death (including those with heart failure), fractal organization, along with certain nonlinear interactions, breaks down. Application of fractal analysis may provide new approaches to assessing cardiac risk and forecasting sudden cardiac death, as well as to monitoring the aging process. Similar approaches show promise in assessing other regulatory systems, such as human gait control in health and disease. Elucidating the fractal and nonlinear mechanisms involved in physiologic control and complex signaling networks is emerging as a major challenge in the postgenomic era.

1,905 citations

Journal ArticleDOI
TL;DR: It is demonstrated that an end-to-end deep learning approach can classify a broad range of distinct arrhythmias from single-lead ECGs with high diagnostic performance similar to that of cardiologists.
Abstract: Computerized electrocardiogram (ECG) interpretation plays a critical role in the clinical ECG workflow1. Widely available digital ECG data and the algorithmic paradigm of deep learning2 present an opportunity to substantially improve the accuracy and scalability of automated ECG analysis. However, a comprehensive evaluation of an end-to-end deep learning approach for ECG analysis across a wide variety of diagnostic classes has not been previously reported. Here, we develop a deep neural network (DNN) to classify 12 rhythm classes using 91,232 single-lead ECGs from 53,549 patients who used a single-lead ambulatory ECG monitoring device. When validated against an independent test dataset annotated by a consensus committee of board-certified practicing cardiologists, the DNN achieved an average area under the receiver operating characteristic curve (ROC) of 0.97. The average F1 score, which is the harmonic mean of the positive predictive value and sensitivity, for the DNN (0.837) exceeded that of average cardiologists (0.780). With specificity fixed at the average specificity achieved by cardiologists, the sensitivity of the DNN exceeded the average cardiologist sensitivity for all rhythm classes. These findings demonstrate that an end-to-end deep learning approach can classify a broad range of distinct arrhythmias from single-lead ECGs with high diagnostic performance similar to that of cardiologists. If confirmed in clinical settings, this approach could reduce the rate of misdiagnosed computerized ECG interpretations and improve the efficiency of expert human ECG interpretation by accurately triaging or prioritizing the most urgent conditions. Analysis of electrocardiograms using an end-to-end deep learning approach can detect and classify cardiac arrhythmia with high accuracy, similar to that of cardiologists.

1,632 citations

Journal ArticleDOI
Leon Glass1
08 Mar 2001-Nature
TL;DR: Molecular and physical techniques combined with physiological and medical studies are addressing questions concerning the dynamics of physiological rhythms and are transforming the understanding of the rhythms of life.
Abstract: Complex bodily rhythms are ubiquitous in living organisms. These rhythms arise from stochastic, nonlinear biological mechanisms interacting with a fluctuating environment. Disease often leads to alterations from normal to pathological rhythm. Fundamental questions concerning the dynamics of these rhythmic processes abound. For example, what is the origin of physiological rhythms? How do the rhythms interact with each other and the external environment? Can we decode the fluctuations in physiological rhythms to better diagnose human disease? And can we develop better methods to control pathological rhythms? Mathematical and physical techniques combined with physiological and medical studies are addressing these questions and are transforming our understanding of the rhythms of life.

1,204 citations

References
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Journal ArticleDOI
TL;DR: Informed implementation of the appropriate degrees of anticipatory and hindsight orientations through differentially emphasizing separate sets of strategic planning activities should enable managers to exercise better strategic control and optimize the firm's short-run performance as well as long-term prospects.

2 citations

Journal ArticleDOI
24 Sep 1999-Science
TL;DR: In 2000, a Senate panel granted NASA its full $13.6 billion request for 2000, but voted only $2.08 billion for space science in 2000, $43 million less than this year's budget and a hefty $120 million shy of what was requested.
Abstract: NASALast week, a Senate panel granted NASA its full $13.6 billion request for 2000, but voted only $2.08 billion for space science in 2000, $43 million less than this year's budget and a hefty $120 million shy of what was requested. The cut was especially painful because the committee granted both NASA and the National Science Foundation the overall amounts the White House asked for--thanks to a critical decision by Senate Republican leaders to break strict budget caps.

1 citations