• Zheyan Tu, Sean D Jeffries, Joshua Morse, and Thomas M Hemmerling.
• Department of Surgical and Interventional Sciences, McGill University Health Center, Montreal, Canada.
• J Clin Monit Comput. 2024 Oct 29.

AbstractThis study presents a comprehensive comparison of multiple time-series models applied to physiological metric predictions. It aims to explore the effectiveness of both statistical prediction models and pharmacokinetic-pharmacodynamic prediction model and modern deep learning approaches. Specifically, the study focuses on predicting the bispectral index (BIS), a vital metric in anesthesia used to assess the depth of sedation during surgery, using datasets collected from real-life surgeries. The goal is to evaluate and compare model performance considering both univariate and multivariate schemes. Accurate BIS prediction is essential for avoiding under- or over-sedation, which can lead to adverse outcomes. The study investigates a range of models: The traditional mathematical models include the pharmacokinetic-pharmacodynamic model and statistical models such as autoregressive integrated moving average (ARIMA) and vector autoregression (VAR). The deep learning models encompass recurrent neural networks (RNNs), specifically Long Short-Term Memory (LSTM) and Gated Recurrent Units (GRU), as well as Temporal Convolutional Networks (TCNs) and Transformer models. The analysis focuses on evaluating model performance in predicting the BIS using two distinct datasets of physiological metrics collected from actual surgical procedures. It explores both univariate and multivariate prediction schemes and investigates how different combinations of features and input sequence lengths impact model accuracy. The experimental findings reveal significant performance differences among the models: In univariate prediction scenarios for predicting BIS, the LSTM model demonstrates a 2.88% improvement over the second-best performing model. For multivariate predictions, the LSTM model outperforms others by 6.67% compared to the next best model. Furthermore, the addition of Electromyography (EMG) and Mean Arterial Pressure (MAP) brings significant accuracy improvement when predicting BIS. The study emphasizes the importance of selecting and building appropriate time-series models to achieve accurate predictions in biomedical applications. This research provides insights to guide future efforts in improving vital sign prediction methodologies for clinical and research purposes. Clinically, with improvements in the prediction of physiological parameters, clinicians can be informed of interventions if an anomaly is detected or predicted.© 2024. The Author(s), under exclusive licence to Springer Nature B.V.

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