System and method for facilitating clinical decision making

• US 6,338,713 B1
• Filed: 08/18/1998
• Issued: 01/15/2002
• Est. Priority Date: 08/18/1998
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Aspect Medical Systems, Inc. (Medtronic Plc)
• Inventors: Chamoun, Nassib G., Devlin, Philip H.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US09/135,931
• Time in Patent Office: 1,246 Days
• Field of Search: 603/00, 604/75, 605/08, 605/09, 605/34
• US Class Current: 600/300
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence

Abstract

Disclosed is a system and method for providing information to the user of a medical monitoring or diagnostic device to aid in the clinical decision making process. The preferred embodiment uses two estimators or predictors of the same physiological quantity, with each of the estimators being designed to detect specific states or artifacts in the estimated parameter and thus operating at a different point on its respective ROC curve; one chosen to provide high sensitivity, the other chosen to provide high specificity. The divergence between the estimators is indicated by the use of a shaded region between their respective time trends. The use of 2 estimators of the same parameters with different performance characteristics allows the system and method of the present invention to derive additional information about the underlying physiologic process over and above that which would be available from a single estimator. The system and method of the present invention can derive information from not only the instantaneous values of the estimators and the difference between them, but also from the time trend of the difference.

Claims

1. A system for evaluating values of physiological parameters, said system comprising:

a signal acquisition device for obtaining physiological signals from a human body;

a processor for deriving, from said physiological signals, values of two or more independently-calculated estimators of a pre-selected physiological parameter and for computing relationships between said estimators;

a display for displaying information concerning said relationships between said independently-calculated estimators.

2. The system for evaluating values of physiological parameters of claim 1, wherein one estimator is derived using one physical or computational method and wherein at least one other estimator is derived using a different physical or computational method.

3. The system for evaluating values of physiological parameters of claim 1, wherein said relationships computed by said processor are instantaneous differences between the values of each estimator.

4. The system for evaluating values of physiological parameters of claim 1, in which said processor uses an instantaneous value of a relationship between estimators to determine the width of an identifiable region about, below, or above an instantaneous value of the first estimator displayed by said display.

5. The system for evaluating values of physiological parameters of claim 1, in which said processor uses an instantaneous value of a relationship between estimators to determine graphical attributes of instantaneous values of a first estimator displayed by said display.

6. The system for evaluating values of physiological parameters of claim 1, in which said processor uses a measure independent of a first estimator of a parameter of interest to determine the width of an identifiable region about, below or above a first estimator displayed by said display.

7. The system for evaluating values of physiological parameters of claim 1, in which said processor uses a measure independent of a first estimator of a parameter of interest to determine graphical attributes of instantaneous values of a first estimator displayed by said display.

8. A system for evaluating values of physiological parameters, said system comprising:

a signal acquisition device for obtaining physiological signals from a human body;

a processor for deriving from said physiological signals, values of two or more independently-calculated estimators of a pre-selected physiological parameter;

a display for displaying said independently-calculated estimators.

9. The system for evaluating values of physiological parameters of claim 8, wherein one estimator is derived using one physical or computational method and wherein at least one other estimator is derived using a different physical or computational method.

10. The system for evaluating values of physiological parameters of claim 8, wherein said processor also computes relationships between said estimators and wherein said relationships are instantaneous differences between the values of each estimator.

11. The system for evaluating values of physiological parameters of claim 8, in which said processor uses an instantaneous value of a relationship between estimators to determine the width of an identifiable region about, below, or above an instantaneous value of the first estimator displayed by said display.

12. The system for evaluating values of physiological parameters of claim 8, in which said processor uses an instantaneous value of a relationship between estimators to determine graphical attributes of instantaneous values of a first estimator displayed by said display.

13. The system for evaluating values of physiological parameters of claim 8, in which said processor uses a measure independent of a first estimator of a parameter of interest to determine the width of an identifiable region about, below or above a first estimator displayed by said display.

14. The system for evaluating values of physiological parameters of claim 8, in which said processor uses a measure independent of a first estimator of a parameter of interest to determine graphical attributes of instantaneous values of a first estimator displayed by said display.

15. A method for evaluating values of physiological parameters, said method comprising the steps of:

obtaining physiological signals from a human body;

deriving, from said physiological signals, values of two or more independently-calculated estimators of a pre-selected physiological parameter and computing relationships between said estimators;

displaying information concerning said relationships between said independently-calculated estimators.

16. The method for evaluating values of physiological parameters of claim 15, wherein one estimator is derived using one physical or computational method and wherein at least one other estimator is derived using a different physical or computational method.

17. The method for evaluating values of physiological parameters of claim 15, wherein said relationships are instantaneous differences between different estimators and instantaneous values of each estimator.

18. The method for evaluating values of physiological parameters of claim 15, in which an instantaneous value of a relationship between estimators is used to determine the width of an identifiable region about, below, or above an instantaneous value of the first estimator displayed by said display.

19. The method for evaluating values of physiological parameters of claim 15, in which an instantaneous value of a second estimator or a relationship between estimators is used to determine graphical attributes of an instantaneous values of a first estimator displayed by said display.

20. The method for evaluating values of physiological parameters of claim 15, in which a measure independent of a first estimator of a parameter of interest is used to determine the width of an identifiable region about, below or above a first estimator displayed by said display.

21. The method for evaluating values of physiological parameters of claim 15, in which a measure independent of a first estimator of a parameter of interest is used to determine graphical attributes of instantaneous values of a first estimator displayed by said display.

22. A method for evaluating values of physiological parameters, said method comprising the steps of:

obtaining physiological signals from a human body;

deriving, from said physiological signals, values of two or more independently-calculated estimators of a pre-selected physiological parameter;

displaying said independently-calculated estimators.

23. The method for evaluating values of physiological parameters of claim 22, wherein one estimator is derived using one physical or computational method and wherein at least one other estimator is derived using a different physical or computational method.

24. The method for evaluating values of physiological parameters of claim 22, further comprising the steps of computing relationships between said estimators and wherein said relationships are instantaneous differences between different estimators and instantaneous values of each estimator.

25. The method for evaluating values of physiological parameters of claim 22, in which an instantaneous value of a relationship between estimators is used to determine the width of an identifiable region about, below, or above an instantaneous value of the first estimator displayed by said display.

26. The method for evaluating values of physiological parameters of claim 22, in which an instantaneous value of a relationship between estimators is used to determine graphical attributes of an instantaneous values of a first estimator displayed by said display.

27. The method for evaluating values of physiological parameters of claim 22, in which a measure independent of a first estimator of a parameter of interest is used to determine the width of an identifiable region about, below or above a first estimator displayed by said display.

28. The method for evaluating values of physiological parameters of claim 22, in which a measure independent of a first estimator of a parameter of interest is used to determine graphical attributes of instantaneous values of a first estimator displayed by said display.