The DOI matches its Crossref record; 34 of the 36 references it cites were found in a registry or an index.
A computational approach to early sepsis detection
Open accessAbstract
Objective To develop high-performance early sepsis prediction technology for the general patient population. Methods Retrospective analysis of adult patients admitted to the intensive care unit (from the MIMIC II dataset) who were not septic at the time of admission. Results A sepsis early warning algorithm, InSight, was developed and applied to the prediction of sepsis up to three hours prior to a patient's first five hour Systemic Inflammatory Response Syndrome (SIRS) episode. When applied to a never-before-seen set of test patients, InSight predictions demonstrated a sensitivity of 0.90 (95% CI: 0.89-0.91) and a specificity of 0.81 (95% CI: 0.80-0.82), exceeding or rivaling that of existing biomarker detection methods. Across predictive times up to three hours before a sustained SIRS event, InSight maintained an average area under the ROC curve of 0.83 (95% CI: 0.80-0.86). Analysis of patient sepsis risk showed that contributions from the coevolution of multiple risk factors were more important than the contributions from isolated individual risk factors when making predictions further in advance. Conclusions Sepsis can be predicted at least three hours in advance of onset of the first five hour SIRS episode, using only nine commonly available vital signs, with better performance than methods in standard practice today. High-order correlations of vital sign measurements are key to this prediction, which improves the likelihood of early identification of at-risk patients.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“numerous models were tested on the freely accessible MIMIC database [27, 33, 52–59]”
From Machine learning for the prediction of sepsis: a systematic review and meta-analysis of diagnostic test accuracy (2020) · cites this paper as [52]
Citations
Cites
Goldberger, A. L., Amaral, L. A. N., Glass, L., Hausdorff, J. M., Ivanov, P. C., Mark, R. G., Mietus, J. E., Moody, G. B., Peng, C.-K., & Stanley, H. E. (2000) · Circulation · doi:10.1161/01.cir.101.23.e215 · Cited by 14,809
Early goal-directed therapy in the treatment of severe sepsis and septic shock
Rivers, E., Nguyen, B., Havstad, S., Ressler, J., Muzzin, A., Knoblich, B., Peterson, E., & Tomlanovich, M. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010307 · Cited by 10,743
Angus, D. C., Linde-Zwirble, W. T., Lidicker, J., Clermont, G., Carcillo, J., & Pinsky, M. R. (2001) · Critical Care Medicine · doi:10.1097/00003246-200107000-00002 · Cited by 8,503
Kumar, A., Roberts, D., Wood, K. E., Light, B., Parrillo, J. E., Sharma, S., Suppes, R., Feinstein, D., Zanotti, S., Taiberg, L., et al. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000217961.75225.e9 · Cited by 6,109
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
Conference, F. T. I. S. D., Levy, M. M., Fink, M. P., Marshall, J. C., Abraham, E. H., Angus, D. C., Cook, D., Cohen, J., Opal, S. M., Vincent, J., et al. (2003) · Intensive Care Medicine · doi:10.1007/s00134-003-1662-x · Cited by 2,877
A randomized trial of protocol-based care for early septic shock.
The ProCESS Investigators (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1401602 · Cited by 2,414
Goal-Directed Resuscitation for Patients with Early Septic Shock
The ARISE Investigators and the ANZICS Clinical Trials Group (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1404380 · Cited by 2,055
Regional Variation in Out-of-Hospital Cardiac Arrest Incidence and Outcome
Nichol, G. (2008) · JAMA · doi:10.1001/jama.300.12.1423 · Cited by 1,979
Validation of a modified Early Warning Score in medical admissions
Subbe, C. P. (2001) · QJM · doi:10.1093/qjmed/94.10.521 · Cited by 1,788
Trial of early, goal-directed resuscitation for septic shock.
Mouncey, P. R., Osborn, T. M., Power, G. S., Harrison, D. A., Sadique, M. Z., Grieve, R. D., Jahan, R., Harvey, S. E., Bell, D., Bion, J. F., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1500896 · Cited by 1,604
Early lactate clearance is associated with improved outcome in severe sepsis and septic shock*
Nguyen, H. B., Rivers, E. P., Knoblich, B., Jacobsen, G., Muzzin, A., Ressler, J. A., & Tomlanovich, M. C. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000132904.35713.a7 · Cited by 1,236
Procalcitonin as a diagnostic marker for sepsis: A systematic review and meta-analysis.
Wacker, C., Prkno, A., Brunkhorst, F. M., & Schlattmann, P. (2013) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70323-7 · Cited by 1,198
Treating Patients with Severe Sepsis
Wheeler, A. P., & Bernard, G. R. (1999) · New England Journal of Medicine · doi:10.1056/nejm199901213400307 · Cited by 992
National Vital Statistics Reports NCHS.pdf
Hoyert, D. (2012) · Medical Entomology and Zoology · Cited by 982
Two Decades of Mortality Trends Among Patients With Severe Sepsis
Stevenson, E. K., Rubenstein, A. R., Radin, G. T., Wiener, R. S., & Walkey, A. J. (2013) · Critical Care Medicine · doi:10.1097/ccm.0000000000000026 · Cited by 667
Nguyen, H. B., Corbett, S. W., Steele, R., Banta, J., Clark, R. T., Hayes, S. R., Edwards, J., Cho, T. W., & Wittlake, W. A. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000259463.33848.3d · Cited by 555
Inpatient care for septicemia or sepsis: a challenge for patients and hospitals.
Hall, M. J., Williams, S. N., DeFrances, C. J., & Golosinskiy, A. (2011) · PubMed · Cited by 465
National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011
Torio, C. M., & Andrews, R. M. (2013) · Cited by 413
Hoyert, D. L., Heron, M. P., Murphy, S. L., & Kung, H.-C. (2006) · PsycEXTRA Dataset · doi:10.1037/e518032006-001 · Cited by 362
Pittet, D., Rangel-Frausto, S., Li, N., Tarara, D. T., Costigan, M., Rempe, L., JEBSON, P. J. R., & Wenzel, R. P. (1995) · Intensive Care Medicine · doi:10.1007/bf01705408 · Cited by 330
Development, implementation, and impact of an automated early warning and response system for sepsis
Umscheid, C. A., Betesh, J., VanZandbergen, C., Hanish, A., Tait, G., Mikkelsen, M. E., French, B. C., & Fuchs, B. D. (2014) · Journal of Hospital Medicine · doi:10.1002/jhm.2259 · Cited by 173
Garnacho‐Montero, J., Huici-Moreno, M. J., Gutiérrez-Pizarraya, A., López, I., Márquez-Vácaro, J. A., Macher, H. C., Guerrero, J. M., & Puppo-Moreno, A. M. (2014) · Critical Care · doi:10.1186/cc13908 · Cited by 147
Prospective Trial of Real-Time Electronic Surveillance to Expedite Early Care of Severe Sepsis
Nelson, J. L., Smith, B. L., Jared, J. D., & Younger, J. G. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2010.12.008 · Cited by 122
Singer, A. J., Taylor, M., Domingo, A., Ghazipura, S., Khorasonchi, A., Thode, H. C., & Shapiro, N. I. (2014) · Academic Emergency Medicine · doi:10.1111/acem.12444 · Cited by 88
Morgenthaler, N. G., Struck, J., Fischer-Schulz, C., Seidel-Mueller, E., Beier, W., & Bergmann, A. (2002) · PubMed · Cited by 88
Wu, J.-Y., Lee, S., Shen, C., Hsieh, Y.-C., Yo, P.-H., Cheng, H., Chan, R., Lee, C., & Chang, S. (2012) · Arthritis & Rheumatism · doi:10.1002/art.34512 · Cited by 70
Herasevich, V., Pieper, M. S., Pulido, J. N., & Gajic, O. (2011) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2011-000228 · Cited by 69
Automated electronic medical record sepsis detection in the emergency department
Nguyen, S. Q., Mwakalindile, E., Booth, J. S., Hogan, V., Morgan, J., Prickett, C. T., Donnelly, J. P., & Wang, H. E. (2014) · PeerJ · doi:10.7717/peerj.343 · Cited by 68
Septic shock : providing early warnings through multivariate logistic regression models
Shavdia, D. (2007) · DSpace@MIT (Massachusetts Institute of Technology) · Cited by 27
Deaths: final data for 2003, United States
Hoyert, D. L., Heron, M. P., Murphy, S. L., & Kung, H.-C. (2006) · National vital statistics reports · Cited by 21
Ferreras, J. M., Júdez, D., Tirado, G., Aspíroz, C., Martínez-Álvarez, R., Dorado, P., Galindo, A. I. E., Marrón, R., Gargallo, B., & Herranz, C. (2015) · Enfermedades Infecciosas y Microbiología Clínica · doi:10.1016/j.eimc.2015.01.002 · Cited by 16
Discharge recommendation based on a novel technique of homeostatic analysis
Calvert, J. S., Price, D. A., Barton, C. W., Chettipally, U. K., & Das, R. (2016) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocw014 · Cited by 15
Self-citationFerreras, J. M., Dorado, P., Aspíroz, C., & Martínez, R. (2016) · Enfermedades Infecciosas y Microbiología Clínica · doi:10.1016/j.eimc.2015.11.014 · Cited by 9
(2013) · PubMed
Cited by
Sorted by citations
Artificial intelligence, bias and clinical safety
Challen, R., Denny, J., Pitt, M., Gompels, L., Edwards, T., & Tsaneva-Atanasova, K. (2019) · BMJ Quality & Safety · doi:10.1136/bmjqs-2018-008370 · Cited by 956
Fleuren, L. M., Klausch, T. L. T., Zwager, C. L., Schoonmade, L. J., Guo, T., Roggeveen, L. F., Swart, E. L., Girbes, A. R. J., Thoral, P., Ercole, A., et al. (2020) · Intensive Care Medicine · doi:10.1007/s00134-019-05872-y · Cited by 755
Peiffer-Smadja, N., Rawson, T. M., Ahmad, R., Buchard, A., Georgiou, P., Lescure, F.-X., Birgand, G., & Holmes, A. H. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2019.09.009 · Cited by 561
Desautels, T., Calvert, J., Hoffman, J., Jay, M., Kerem, Y., Shieh, L., Shimabukuro, D., Chettipally, U., Feldman, M. D., Barton, C., et al. (2016) · JMIR Medical Informatics · doi:10.2196/medinform.5909 · Cited by 509
Self-citationLauritsen, S. M., Kristensen, M., Olsen, M. V., Larsen, M. S., Lauritsen, K. M., Jørgensen, M. J., Lange, J., & Thiesson, B. (2020) · Nature Communications · doi:10.1038/s41467-020-17431-x · Cited by 448
Metadata
- Authors
- Calvert, J. S., Price, D. A., Chettipally, U. K., Barton, C. W., Feldman, M. D., Hoffman, J. L., Jay, M., & Das, R.
- Affiliations
- Dascena (United States) (US)
- University of California, San Francisco (US)
- Corresponding author
- Hoffman, Jana L.
- Venue
- Computers in Biology and Medicine
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 74
- Pages
- 69-73
- ISSN
- 0010-4825 (ISSN-L)
- OpenAlex
- W2372800617
- Cited by
- 244
- References
- 36
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 24 · 2023: 21 · 2022: 24 · 2021: 39 · 2020: 35 · 2019: 38 · 2018: 11 · 2017: 15 · 2016: 6
- FWCI
- 21.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Computers in Biology and Medicine (acceptedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation (1549867)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- sepsis prediction, early sepsis detection, systemic inflammatory response syndrome, vital signs, intensive care unit patients, higher-order correlations, insight
- MeSH terms
- Adult, Critical Care, Diagnosis, Computer-Assisted, Female, Humans, Male, Retrospective Studies, Time Factors, Biomarkers, Sepsis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
