E. Keller

Raphael Emberger, Jens Michael Boss, Daniel Baumann et al.

Patient monitoring in intensive care units, although assisted by biosensors, needs continuous supervision of staff. To reduce the burden on staff members, IT infrastructures are built to record monitoring data and develop clinical decision support systems. These systems, however, are vulnerable to artifacts (e.g. muscle movement due to ongoing treatment), which are often indistinguishable from real and potentially dangerous signals. Video recordings could facilitate the reliable classification of biosignals using object detection (OD) methods to find sources of unwanted artifacts. Due to privacy restrictions, only blurred videos can be stored, which severely impairs the possibility to detect clinically relevant events such as interventions or changes in patient status with standard OD methods. Hence, new kinds of approaches are necessary that exploit every kind of available information due to the reduced information content of blurred footage and that are at the same time easily implementable within the IT infrastructure of a normal hospital. In this paper, we propose a new method for exploiting information in the temporal succession of video frames. To be efficiently implementable using off-the-shelf object detectors that comply with given hardware constraints, we repurpose the image color channels to account for temporal consistency, leading to an improved detection rate of the object classes. Our method outperforms a standard YOLOv5 baseline model by +1.7% mAP@.5 while also training over ten times faster on our proprietary dataset. We conclude that this approach has shown effectiveness in the preliminary experiments and holds potential for more general video OD in the future.

Elisa Vasta, Thorir Mar Ingolfsson, Andrea Cossettini et al.

Burst suppression (BS) is a clinically relevant electroencephalographic (EEG) pattern used to monitor sedation depth and brain activity in critically ill patients, particularly during induced coma in Intensive Care Units (ICUs). Automatic burst detection remains challenging because BS patterns vary substantially between patients and annotated datasets are scarce. Recently, EEG Foundation Models (FMs) have shown promise across several downstream EEG applications, but their usefulness for BS detection remains unexplored. We present the first study to evaluate EEG FMs for burst detection in reduced-montage ICU EEG without patient-specific calibration. We compare REVE-base, LUNA-large and LuMamba-Tiny with an adaptive thresholding baseline and a task-specific EEGNet baseline. Additionally, we complement conventional EEG window-based classification with event-based burst detection evaluation. This helps assessing clinically whether burst episodes are correctly detected, reducing the impact of expected annotation variability. The best model, REVE-base, achieved the highest event-based F1-score ($0.868 \pm 0.167$) and reduced burst-per-minute error by 52.1% and 36.2% compared to EEGNet and adaptive thresholding respectively, supporting FMs for scalable EEG monitoring in ICU. Ablation experiments showed that full fine-tuning was the most effective adaptation strategy with respect to frozen-backbone training, two-step fine-tuning, and LoRA-based adaptation, improving event-based F1-score over frozen-backbone training by up to $+0.102$ for LUNA-large. With reduced labeled datasets, pretrained REVE-base outperformed random initialization by $+0.723$ event-based F1 points at 25% of the cohort, demonstrating the benefit of pretraining FM representations when adapted to burst detection with limited labeled data.

Patrick Schwab, Emanuela Keller, Carl Muroi et al.

Patients in the intensive care unit (ICU) require constant and close supervision. To assist clinical staff in this task, hospitals use monitoring systems that trigger audiovisual alarms if their algorithms indicate that a patient's condition may be worsening. However, current monitoring systems are extremely sensitive to movement artefacts and technical errors. As a result, they typically trigger hundreds to thousands of false alarms per patient per day - drowning the important alarms in noise and adding to the exhaustion of clinical staff. In this setting, data is abundantly available, but obtaining trustworthy annotations by experts is laborious and expensive. We frame the problem of false alarm reduction from multivariate time series as a machine-learning task and address it with a novel multitask network architecture that utilises distant supervision through multiple related auxiliary tasks in order to reduce the number of expensive labels required for training. We show that our approach leads to significant improvements over several state-of-the-art baselines on real-world ICU data and provide new insights on the importance of task selection and architectural choices in distantly supervised multitask learning.