Predicting deterioration in dengue using a low cost wearable for continuous clinical monitoring.
Ming DK., Daniels J., Chanh HQ., Karolcik S., Hernandez B., Manginas V., Nguyen VH., Nguyen QH., Phan TQ., Luong THT., Trieu HT., Holmes AH., Phan VT., Georgiou P., Yacoub S., VITAL consortium .
Close vital signs monitoring is crucial for the clinical management of patients with dengue. We investigated performance of a non-invasive wearable utilising photoplethysmography (PPG), to provide real-time risk prediction in hospitalised individuals. We performed a prospective observational clinical study in Vietnam between January 2020 and October 2022: 153 patients were included in analyses, providing 1353 h of PPG data. Using a multi-modal transformer approach, 10-min PPG waveform segments and basic clinical data (age, sex, clinical features on admission) were used as features to continuously forecast clinical state 2 h ahead. Prediction of low-risk states (17,939/80,843; 22.1%), defined by NEWS2 and mSOFA < 6, was associated with an area under the precision-recall curve of 0.67 and an area under the receiver operator curve of 0.83. Implementation of such interventions could provide cost-effective triage and clinical care in dengue, offering opportunities for safe ambulatory patient management.