COMPUTER analysis of routine blood tests can predict which hospital patients are likely to experience a critical event the next day, according to preliminary Australian research.
Melbourne researchers used a computer program to examine six million blood tests taken from patients in the wards and emergency department of the Austin Hospital in the past 5 years, and combined this data with hospital records of critical events.
“We wanted to see if the blood tests contained patterns of abnormalities … to predict whether a patient would, the next day, die, go to intensive care, or receive a MET [medical emergency team] call”, said Professor Rinaldo Bellomo, director of intensive care research at Austin Health.
On average, the computer analysis was able to predict a critical event 10.2 hours before it occurred in a ward patient, and 11.9 hours beforehand for an emergency patient. The analysis included blood tests for urea and electrolytes, liver function, full blood count and arterial blood gasses.
Professor Bellomo said the analysis was 85% accurate at predicting which patients would die the next day.
“It’s kind of cool, kind of creepy … but I think it’s potentially useful”, Professor Bellomo said.
He acknowledged that knowing which patients were at risk may not improve their outcomes. However, improving knowledge of the timing and severity of risks could also assist decision making, such as in end-of-life discussions with families, he said.
The research was presented recently at the Australian and New Zealand College of Anaesthetists Trials Group workshop in Queensland.
Professor Bellomo said the next step was to assess whether having the predictive information available would change practice.
“Whether doctors and nurses in the wards already knew that these people were at risk — we don’t know that yet. What we do know is that we can identify people at high risk and we can do that in a way that hasn’t been done before”, he said.
Ultimately, the data could be incorporated into an electronic decision-assistance tool.
Dr Ross Kerridge, associate professor of anaesthesia and perioperative medicine at the University of Newcastle, said the study was an interesting example of the move towards using more “engineered” processes at hospitals.
“It’s a really exciting result … it’s a tantalising glimpse of the potential of cleverly designed information systems.”
Dr Kerridge said the computerised predictions could be used as an adjunct to clinical decision making.
“It can’t replace clinical decision making, but if the computer says someone is at very high risk then it’s a prompt for doctors to look at them again”, he said.
Using such sophisticated computer systems would make the hospitals of the future “safer, more efficient, more effective and better places to work”.
However, there would also be new dangers, such as if doctors relied on computerised systems at the expense of their clinical judgement, Dr Kerridge said.
Professor Bellomo said it was difficult to predict how doctors would react to this sort of predictive information. “They may rebel, burn the beeper, call the police, I don’t know.”
“But this has established that the information obtainable from the lab every day can be harnessed to identify those at risk, and now we have a case to take that a step further”, he said.
– Sophie McNamara
Posted 22 August 2011