Predicting deterioration in dengue using a low cost wearable for continuous clinical monitoring.

Ming, Damien Keng; Daniels, John; Chanh, Ho Quang; Karolcik, Stefan; Hernandez, Bernard; Manginas, Vasileios; Nguyen, Van Hao; Nguyen, Quang Huy et al. · NPJ Digit Med · 2024

prospective_cohort · Level II

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Abstract

Close vital signs monitoring is crucial for the clinical management of patients with dengue. We investigated performance of a non-invasive wearable utilising photoplethysmography (PPG), to provide real-time risk prediction in hospitalised individuals. We performed a prospective observational clinical study in Vietnam between January 2020 and October 2022: 153 patients were included in analyses, providing 1353 h of PPG data. Using a multi-modal transformer approach, 10-min PPG waveform segments and basic clinical data (age, sex, clinical features on admission) were used as features to continuously forecast clinical state 2 h ahead. Prediction of low-risk states (17,939/80,843; 22.1%), defined by NEWS2 and mSOFA < 6, was associated with an area under the precision-recall curve of 0.67 and an area under the receiver operator curve of 0.83. Implementation of such interventions could provide cost-effective triage and clinical care in dengue, offering opportunities for safe ambulatory patient management.