Biosensors (Jan 2024)

A Comparison of Normalization Techniques for Individual Baseline-Free Estimation of Absolute Hypovolemic Status Using a Porcine Model

  • Tamara P. Lambert,
  • Michael Chan,
  • Jesus Antonio Sanchez-Perez,
  • Mohammad Nikbakht,
  • David J. Lin,
  • Afra Nawar,
  • Syed Khairul Bashar,
  • Jacob P. Kimball,
  • Jonathan S. Zia,
  • Asim H. Gazi,
  • Gabriela I. Cestero,
  • Daniella Corporan,
  • Muralidhar Padala,
  • Jin-Oh Hahn,
  • Omer T. Inan

DOI
https://doi.org/10.3390/bios14020061
Journal volume & issue
Vol. 14, no. 2
p. 61

Abstract

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Hypovolemic shock is one of the leading causes of death in the military. The current methods of assessing hypovolemia in field settings rely on a clinician assessment of vital signs, which is an unreliable assessment of hypovolemia severity. These methods often detect hypovolemia when interventional methods are ineffective. Therefore, there is a need to develop real-time sensing methods for the early detection of hypovolemia. Previously, our group developed a random-forest model that successfully estimated absolute blood-volume status (ABVS) from noninvasive wearable sensor data for a porcine model (n = 6). However, this model required normalizing ABVS data using individual baseline data, which may not be present in crisis situations where a wearable sensor might be placed on a patient by the attending clinician. We address this barrier by examining seven individual baseline-free normalization techniques. Using a feature-specific global mean from the ABVS and an external dataset for normalization demonstrated similar performance metrics compared to no normalization (normalization: R2 = 0.82 ± 0.025|0.80 ± 0.032, AUC = 0.86 ± 5.5 × 10−3|0.86 ± 0.013, RMSE = 28.30 ± 0.63%|27.68 ± 0.80%; no normalization: R2 = 0.81 ± 0.045, AUC = 0.86 ± 8.9 × 10−3, RMSE = 28.89 ± 0.84%). This demonstrates that normalization may not be required and develops a foundation for individual baseline-free ABVS prediction.

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