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Importance of textual data in multimodality monitoring

Signorini, David F. MA(Hons); Piper, Ian R. BSc, PhD; Jones, Patricia A. MAppSc, DipPhysio; Howells, Timothy P. BA, MSc

Neurologic Critical Care
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Objectives  The use of multimodality monitoring of patients in the intensive care unit (ICU) and the subsequent collection and analysis of such data are increasing. The aim of this work was to assess the importance of recording complementary textual data referring to patient care maneuvers, calibrations, and other incidents, in addition to the raw numerical values.

Design  A retrospective analysis of multimodality monitoring data, which included comments entered concurrently at the bedside, collected from head-injured patients admitted to an ICU.

Patients  One hundred forty-seven patients with a postresuscitation Glasgow Coma Scale score of <or=to12 were monitored for a total of nearly 1 million minutes on up to eight commonly used channels.

Measurements and Main Results  Approximately 13,000 comments were added to the raw data at the time of collection. The data were subsequently validated using these comments as indicators of artifactual values. The comments were classified into a surprisingly small number of important categories, with the most frequent referring to monitor calibrations and regular ICU care maneuvers. The difference between validated and unvalidated data on the quantity of secondary insult observed was in some cases nearly 50%.

Conclusions  This work demonstrates that such textual information should be recorded concurrently with the raw monitoring values to ensure proper interpretation of the data in any retrospective analysis. Furthermore, it also suggests that a small number of prespecified categories could be used in the on-line validation of such data. (Crit Care Med 1997; 25:2048-2050)

From the Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.

Supported, in part, by grants G9301951, G9301975, and G9301951 from United Kingdom Medical Research Council.

© Williams & Wilkins 1997. All Rights Reserved.