Publication: Análisis de complejidad y modelos estadísticos en predicción de la fiebre. Consideración sobre la validez del concepto de fiebre en el ámbito clínico
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2017-02-28
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Universidad Complutense de Madrid
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Abstract
Introducción: Los dispositivos de monitorización continua de la temperatura permiten realizar analísis detallados de sus oscilaciones temporales, así como de los procesos de disipación y conservación de calor. Además, algunas técnicas de análisis de la complejidad de series temporales pueden aportar información precisa sobre el funcionamiento del sistema termorregulador. Estas herramientas ayudan a identificar los cambios que ocurren en la termorregulación en los minutos previos a la fiebre, lo que se podría modelizar mediante técnicas de análisis multivariante para anticipar su aparición. Por otro lado, la consideración de la fiebre en la práctica clínica habitual es poco consistente, ya que no se puede identificar un criterio único válido para cualquier paciente. Distintos médicos pueden mostrar criterios dispares cuando consideran la existencia de picos febriles sobre distintas gráficas de temperatura. Objetivos: Analizar la relación entre complejidad (medida por ApEn -entropía aproximada-) y temperatura central en un grupo de individuos sanos y pacientes con fiebre. Desarrollar modelos predictivos que permitan anticipar la aparición de un pico febril en un intervalo de unos minutos. Comparar los resultados de dichos modelos con la consideración de la fiebre por médicos con experiencia clínica. Evaluar el grado de concordancia en la consideración de la fiebre por dichos expertos...
Introduction: Devices for continuous body temperature monitoring allow for detailed analysis of changes in short and long terms. It is also possible to analyze the processes of heat conservation and dissipation that are central to the pathophysiology of fever. Moreover, information about physiological systems’ functioning may be gathered with techniques of complexity analysis of time series. These tools can help to identify changes in thermorregulation before a fever spike, which can be modelled with multivariate techniques in order to forecast the appearance of fever. Regarding the clinical value of fever, the very variability of body temperature makes its use problematic, and difficult to standardize, since no single criterion can be established for every patient. Experienced physicians may have different judgements, and even a significant intra-observer disagreement may be found. Objectives To analyze the relationship between complexity (measured by means of ApEn -Approximate Entropy-) and core body temperature, and compare the results in a group of healthy individuals and patients with fever. To develop some predictive models which allow to forecast the appearance of a fever spike in a short interval of time. To compare the results of the prediction provided by those models with the assessment of experienced physicians. To assess the degree of consistency among those experts when considering the existence of fever...
Introduction: Devices for continuous body temperature monitoring allow for detailed analysis of changes in short and long terms. It is also possible to analyze the processes of heat conservation and dissipation that are central to the pathophysiology of fever. Moreover, information about physiological systems’ functioning may be gathered with techniques of complexity analysis of time series. These tools can help to identify changes in thermorregulation before a fever spike, which can be modelled with multivariate techniques in order to forecast the appearance of fever. Regarding the clinical value of fever, the very variability of body temperature makes its use problematic, and difficult to standardize, since no single criterion can be established for every patient. Experienced physicians may have different judgements, and even a significant intra-observer disagreement may be found. Objectives To analyze the relationship between complexity (measured by means of ApEn -Approximate Entropy-) and core body temperature, and compare the results in a group of healthy individuals and patients with fever. To develop some predictive models which allow to forecast the appearance of a fever spike in a short interval of time. To compare the results of the prediction provided by those models with the assessment of experienced physicians. To assess the degree of consistency among those experts when considering the existence of fever...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 14/12/2015