University of Twente Student Theses


Missing data in continuously monitored vital signs of high-risk surgical patients

Paalvast, A.S. (2022) Missing data in continuously monitored vital signs of high-risk surgical patients.

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Abstract:Continuous monitoring of vital signs on a surgical ward could lead to early detection of clinical deterioration, but due to challenges including data loss, wireless monitoring systems are not yet implemented.
 In 24 patients undergoing esophagectomy of gastrectomy, vital signs were continuously monitored from their postoperative ICU admission throughout their hospital stay. Data loss was quantified, observations by researchers were screened for causes of data loss and patient cases with adverse events were studied to identify types of data loss in this clinical context. 
Temperature and body position recordings showed least data loss, followed by heart and respiration rate. Blood pressure and oxygen saturation had the highest occurrence of data loss, even up to 100%. Most data loss causes were related to usability. Prior to adverse events in four patients, data loss segments that were most likely missing not at random (MNAR) were found. Data loss in continuous monitoring is inevitable and patterns vary greatly between vital signs and patients. Standard missing data methods are not suitable for dealing with MNAR data gaps. Future research should focus on increasing knowledge of the clinical context, building imputation models around MNAR data and validating these models in clinical practice.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:30 exact sciences in general, 44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
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