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In this paper, a multi-model predictive control approach is used to automate the co-administration of propofol and remifentanil from bispectral index measurement during general anesthesia. To handle the parameter uncertainties in the…
Accurately predicting anesthetic effects is essential for target-controlled infusion systems. The traditional (PK-PD) models for Bispectral index (BIS) prediction require manual selection of model parameters, which can be challenging in…
Significant effort toward the automation of general anesthesia has been made in the past decade. One open challenge is in the development of control-ready patient models for closed-loop anesthesia delivery. Standard depth-of-anesthesia…
This paper presents a model-based control architecture. Based on the Medical Cyber-physical Systems (MCPS) concept, we construct a safe and reliable automatic anesthesia control closed-loop system. The control architecture uses the…
This paper proposes an adaptive neuro-fuzzy framework to improve drug infusion rate in closed-loop control of anesthesia. The proposed controller provides a sub-optimal propofol administration rate as input to reach the desired bispectral…
We present a non-linear dynamical system for modelling the effect of drug infusions on the vital signs of patients admitted in Intensive Care Units (ICUs). More specifically we are interested in modelling the effect of a widely used…
Pain management in intensive care usually involves complex trade-offs, since both inadequate and excessive treatment can compromise patient safety. Prior work on reinforcement learning for sedation and analgesia has explored how to optimize…
Pulse-modulated feedback is utilized in drug dosing to mimic sustained over a longer period of time manual discrete dose administration, the latter is in contrast with continuous drug infusion. The intermittent mode of dosing calls for a…
Objectives. Accurately predicting transitions to anesthetic drugs overdosage is a critical challenge in general anesthesia as it requires the identification of EEG indicators relevant for anticipating the evolution of the depth of…
This paper proposes a constrained control scheme for the control of the depth of hypnosis during induction phase in clinical anesthesia. In contrast with existing control schemes for propofol delivery, the proposed scheme guarantees…
Dynamic treatment regimes are of growing interest across the clinical sciences as these regimes provide one way to operationalize and thus inform sequential personalized clinical decision making. A dynamic treatment regime is a sequence of…
Dynamic treatment regimes or policies are a sequence of decision functions over multiple stages that are tailored to individual features. One important class of treatment policies in practice, namely multi-stage stationary treatment…
Patient's vital signs, which are displayed on monitors, make the anesthesiologist's visual attention (VA) a key component in the safe management of patients under general anesthesia; moreover, the distribution of said VA and the ability to…
Covariate-adaptive randomization schemes such as the minimization and stratified permuted blocks are often applied in clinical trials to balance treatment assignments across prognostic factors. The existing theoretical developments on…
Randomized clinical trials are the gold standard when estimating the average treatment effect. However, they are usually not a random sample from the real-world population because of the inclusion/exclusion rules. Meanwhile, observational…
The STEP 1 randomized trial evaluated the effect of taking semaglutide vs placebo on body weight over a 68 week duration. As with any study evaluating an intervention delivered over a sustained period, non-adherence was observed. This was…
Complete randomization allows for consistent estimation of the average treatment effect based on the difference in means of the outcomes without strong modeling assumptions on the outcome-generating process. Appropriate use of the…
Medication adherence is a well-known problem for pharmaceutical treatment of chronic diseases. Understanding how nonadherence affects treatment efficacy is made difficult by the ethics of clinical trials that force patients to skip doses of…
Regression adjustment is broadly applied in randomized trials under the premise that it usually improves the precision of a treatment effect estimator. However, previous work has shown that this is not always true. To further understand…
Warfarin, a commonly prescribed drug to prevent blood clots, has a highly variable individual response. Determining a maintenance warfarin dose that achieves a therapeutic blood clotting time, as measured by the international normalized…