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Computing in Anesthesia and Intensive Care (Paperback, Softcover reprint of the original 1st ed. 1983)
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Computing in Anesthesia and Intensive Care (Paperback, Softcover reprint of the original 1st ed. 1983)
Series: Developments in Critical Care Medicine and Anaesthesiology, 5
Expected to ship within 10 - 15 working days
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There is a tendency of an increasing number of signals and derived
variables to be incorporated in the monitoring of patients during
anesthesia and in intensive care units. The addition of new signals
hardly ever leads to thedeletion of other signals. This is probably
based on a feeling of insecurity. We must realize that each new
signal that is being monitored brings along its cost, in terms of
risk to the patient, investment and time. It is therefore essential
to assess the relative contribution of this new signal to the
quality of the monitoring process; i. e. given the set of signals
already in use, what is the improvement when a new signal is added?
Beyond a certain point the addition of new information leads to new
uncertainty and degrades the result (Ream, 1981) In the diagnostic
process, it is possible to evaluate "result" in an objective,
qualitative way. The changes in the sensitivity and specificity of
the diagnosis as a result of the addition or deletion of a certain
variable can be calculated on the basis of false negative, false
positive, correct negative and false negative scores. Different
methods for multiple regression analysis have been implemented on
computers (Gelsema, 1981) which can support such decision
processes. In monitoring, the situation is much more complex. Many
definitions of monitoring have been given; the common denominator
is that monitoring is a continuous diagnostic process based upon a
(semi)continuous flow of information. This makes simple assessment
methods useless.
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