Machine learning platform helps enable early diagnosis of life-threatening infection in premature infants

October 29, 2019

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Vector Institute and Ontario Tech University supporting two hospitals in predictive analytics to detect sepsis in infants through machine learning

Toronto – Today, the Vector Institute, an independent, not-for-profit research institute focused on leading-edge machine learning, announced the latest of its series of Pathfinder Projects to implement artificial intelligence (AI) in the health sector.

The fifth Pathfinder Project uses machine learning for early detection of sepsis in infants in the neonatal intensive care unit (NICU).

Sepsis is a life-threatening condition where bacteria grows in the blood stream, resulting in a severe widespread inflammatory response. In infants, it is one of the leading causes of long-term morbidity or mortality globally.  

With support from the Vector Institute and led by Dr. Carolyn McGregor at Ontario Tech University, Artemis is a predictive analytics platform that applies machine learning to help physicians with the critical care of newborns. Artemis is being developed in partnership with McMaster Children’s Hospital and Southlake Regional Health Centre. Once fully implemented, the Artemis system will monitor infants in NICUs, alerting clinicians when sepsis develops before it would otherwise be clinically apparent. Ultimately, Artemis will reduce mortality, morbidity and average length of stay in NICUs.

“Early detection of sepsis in newborns has the potential to save many lives,” says Dr. McGregor. “Artemis data can help NICUs better manage the use of antibiotics and reduce the frequency of blood draws from patients. Our research has also developed a new understanding of a number of other conditions which will all contribute to better outcomes for these fragile infants and their families.”

Premature babies have underdeveloped immune systems making them acutely susceptible to infections, which can lead to sepsis. Symptoms appear rapidly and unpredictably and can become fatal within hours. A quarter of preterm infants will develop an episode of sepsis during their stay in the NICU. 10 per cent of all cases are fatal.

“We’ve started Artemis with the very smallest of patients,” adds Dr. Edward Pugh, clinical lead at McMaster Children’s Hospital. “But this analytics platform has the potential to be rolled out across the adult world and very much change the way that my colleagues and I work.”

“As a community and regional hospital, Southlake is passionate about the care of all our patients,” says Patrick Clifford, Director of Research and Innovation at Southlake Regional Health Centre. “The opportunity to collaborate on Artemis not only advances care for our highly vulnerable neonates, but allows hospitals like Southlake to better serve our tiniest of patients with leading edge care, closer to home.”

Pathfinder Projects are small-scale efforts designed to produce results in 12 to 18 months to guide future research and technology adoption. With technical and resource support from the Vector Institute, projects bring together a multidisciplinary research team to tackle an important health care problem or opportunity by using machine learning and AI more broadly. Each project was chosen for its potential to help identify a “path” through which world-class machine learning research translates into widespread benefits for patients.

About the Vector Institute

The Vector Institute is an independent, not-for-profit corporation dedicated to advancing AI, excelling in machine and deep learning. The Vector Institute’s vision is to drive excellence and leadership in Canada’s knowledge, creation, and use of AI to foster economic growth and improve the lives of Canadians.

The Vector Institute is funded by the Province of Ontario, the Government of Canada through the Pan-Canadian AI Strategy administered by CIFAR, and industry sponsors from across the Canadian economy.

Predicting sepsis in infants with machine learning

Behind the medical monitors in the neonatal intensive care unit (NICU) at McMaster Children’s Hospital sits a small beige box. It likely goes unnoticed by most visitors, yet its benign appearance belies its role as a gateway to a powerful tool that could save the lives of the hospital’s smallest patients.

“The box itself is very unexciting,” confirms Dr. Edward Pugh, clinical lead at McMaster. “But it very much has the potential to change the way that my colleagues and I work.”

The box in question is the bedside connection point for Artemis, a cloud-based data collection platform that uses machine learning technology to collect, store and analyze patient data. The system is currently being pilot tested in two Ontario hospitals: Southlake Regional Health Centre in Newmarket and McMaster in Hamilton. Running continuously in the background of each hospital’s NICUs, the system sends and receives data at a volume equivalent to 1,000 tweets a second per infant for approximately 1,200 patients annually. 

With support from the Vector Institute, Ontario Tech University researcher Dr. Carolyn McGregor, the project’s lead, along with Dr. Pugh, Southlake and their teams have set up Artemis to use AI to constantly monitor many streams of data and analyze changes in infant physiology. Variations in indicators like heart rate or breathing are signs a child is dealing with an infection. Should such signs occur, Artemis will alert physicians who will interpret the data and decide next steps.

“One of our main contributions is defining the patterns of other conditions that will nevertheless make a baby unstable in similar ways,” says Dr. McGregor. “By accurately identifying sepsis and other events that make a baby unstable, we will be able to minimize unnecessary antibiotics and investigations. Minimizing interventions in the NICU can improve the long-term outcome of these fragile infants and decrease the distress and burden on their families.”

Sepsis is one of the most common and devastating conditions preterm and ill term infants can develop says Dr. McGregor. It occurs when the natural chemicals that the body produces to ward off infections fall out of balance. The underdeveloped immune systems of premature babies make them particularly vulnerable — a quarter of preterm infants develop sepsis. “Symptoms appear rapidly and unpredictably and can be fatal within a few hours,” she says, noting that 10 per cent of cases are fatal.

McMaster is home to Ontario’s largest NICU, where babies from just 350 grams to as large as eight kilograms are cared for. “We’ll have babies who will stay with us for up to a year of life,” notes Dr. Pugh. “You don’t see that in many neonatal intensive cares.” The volume, acuity and wide variety of patient conditions seen across McMaster and a large community hospital like Southlake, make them ideal locations to pilot Artemis in the field.

Studies will continue through 2020. Once fully implemented, the researchers hope to expand Artemis beyond checking for sepsis and outside of the NICU. “We’re small footprint place working with the tiniest of patients,” says Dr. Pugh, “but we have huge potential for a large impact.”

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