Postoperative Pain Assessment Model Based on Pulse Contour Characteristics Analysis

This study aims to develop a new postoperative pain assessment model based on pulse contour analysis and to evaluate its effectiveness in postoperative pain assessment. We derived candidate features from photoplethysmography (PPG) and developed an assessment model based on multiple logistic regressi...

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Bibliographic Details
Published in:IEEE journal of biomedical and health informatics 2019-11, Vol.23 (6), p.2317-2324
Main Authors: Seok, Hyeon Seok, Choi, Byung-Moon, Noh, Gyu-Jeong, Shin, Hangsik
Format: Article
Language:English
Subjects:
Adult
Algorithms
Amplitudes
Area Under Curve
Blood
Classification
Contours
Feature extraction
Female
Humans
Indexes
Male
Middle Aged
Optimization
Pain
pain assessment
Pain Measurement - methods
Pain, Postoperative - diagnosis
Photoplethysmography
Photoplethysmography - methods
postoperative pain
Postoperative period
Regression analysis
Shape
Signal Processing, Computer-Assisted
Surgery
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Summary:This study aims to develop a new postoperative pain assessment model based on pulse contour analysis and to evaluate its effectiveness in postoperative pain assessment. We derived candidate features from photoplethysmography (PPG) and developed an assessment model based on multiple logistic regressions with a combination of features. This study also includes investigations into the optimal unit of analysis and number of features. For model development, PPGs obtained from 78 surgical patients with a six-min duration in preand post-operation conditions, including a training set of 56 pairs and a test set of 22 pairs, were used. We tested models with 5, 10, 20, 30, 40, 50, 60, 70, and 80 beats as an analysis unit, and with 1 to 8 of features for optimization, then determined 20 beats and three features to be the simplest optimal unit of analysis and number of features, respectively. The selected features were RMSSD-ACV onset /ACA bl , AV-A sys /A total , and SD-RS, where RMSSD-ACV onset /ACA bl is the root mean square of the successive difference of the ratio of pulse onset amplitude to the pulse onset-to-peak amplitude, AV-A sys /A total is the average value of a normalized systolic area of a pulse with a total pulse area, and SD-RS is the standard deviation of a rising slope of a pulse. The accuracy (AC) and the area under the curve (AUC) of the proposed model were 0.793 and 0.872 in the development set (N = 56), respectively, which were superior to those of SPI (AC: 0.643, AUC: 0.716) and ANI (AC: 0.633 AUC: 0.671). In the test set (N = 22), the AC and AUC of the proposed model were 0.712 and 0.808, respectively, which were superior to those of SPI (AC: 0.640, AUC: 0.709) and ANI (AC: 0.640, AUC: 0.680).
ISSN:2168-2194
2168-2208
DOI:10.1109/JBHI.2018.2890482