The Language of Caring: Quantitating Medical Practice Patterns using Symbolic Dynamics

J. Paladino; A. M. Kaynar; P. S. Crooke; J. R. Hotchkiss

Mathematical Modelling of Natural Phenomena (2010)

  • Volume: 5, Issue: 3, page 165-172
  • ISSN: 0973-5348

Abstract

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Real-world medical decisions rarely involve binary Ðsole condition present or absent- patterns of patient pathophysiology. Similarly, provider interventions are rarely unitary in nature: the clinician often undertakes multiple interventions simultaneously. Conventional approaches towards complex physiologic derangements and their associated management focus on the frequencies of joint appearances, treating the individual derangements of physiology or elements of intervention as conceptually isolated. This framework is ill suited to capture either the integrated patterns of derangement displayed by a particular patient or the integrated patterns of provider intervention. Here we illustrate the application of a different approach-that of symbolic dynamics-in which the integrated pattern of each patients derangement, and the associated provider response, are captured by defining words based on the elements of the pattern of failure. We will use as an example provider practices in the context of mechanical ventilation- a common, potentially harmful, and complex life support technology. We also delineate other domains in which symbolic dynamics approaches might aid in quantitating practice patterns, assessing quality of care, and identifying best practices.

How to cite

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Paladino, J., et al. "The Language of Caring: Quantitating Medical Practice Patterns using Symbolic Dynamics." Mathematical Modelling of Natural Phenomena 5.3 (2010): 165-172. <http://eudml.org/doc/197681>.

@article{Paladino2010,
abstract = {Real-world medical decisions rarely involve binary Ðsole condition present or absent- patterns of patient pathophysiology. Similarly, provider interventions are rarely unitary in nature: the clinician often undertakes multiple interventions simultaneously. Conventional approaches towards complex physiologic derangements and their associated management focus on the frequencies of joint appearances, treating the individual derangements of physiology or elements of intervention as conceptually isolated. This framework is ill suited to capture either the integrated patterns of derangement displayed by a particular patient or the integrated patterns of provider intervention. Here we illustrate the application of a different approach-that of symbolic dynamics-in which the integrated pattern of each patients derangement, and the associated provider response, are captured by defining words based on the elements of the pattern of failure. We will use as an example provider practices in the context of mechanical ventilation- a common, potentially harmful, and complex life support technology. We also delineate other domains in which symbolic dynamics approaches might aid in quantitating practice patterns, assessing quality of care, and identifying best practices.},
author = {Paladino, J., Kaynar, A. M., Crooke, P. S., Hotchkiss, J. R.},
journal = {Mathematical Modelling of Natural Phenomena},
keywords = {symbol dynamics; patient care; language},
language = {eng},
month = {4},
number = {3},
pages = {165-172},
publisher = {EDP Sciences},
title = {The Language of Caring: Quantitating Medical Practice Patterns using Symbolic Dynamics},
url = {http://eudml.org/doc/197681},
volume = {5},
year = {2010},
}

TY - JOUR
AU - Paladino, J.
AU - Kaynar, A. M.
AU - Crooke, P. S.
AU - Hotchkiss, J. R.
TI - The Language of Caring: Quantitating Medical Practice Patterns using Symbolic Dynamics
JO - Mathematical Modelling of Natural Phenomena
DA - 2010/4//
PB - EDP Sciences
VL - 5
IS - 3
SP - 165
EP - 172
AB - Real-world medical decisions rarely involve binary Ðsole condition present or absent- patterns of patient pathophysiology. Similarly, provider interventions are rarely unitary in nature: the clinician often undertakes multiple interventions simultaneously. Conventional approaches towards complex physiologic derangements and their associated management focus on the frequencies of joint appearances, treating the individual derangements of physiology or elements of intervention as conceptually isolated. This framework is ill suited to capture either the integrated patterns of derangement displayed by a particular patient or the integrated patterns of provider intervention. Here we illustrate the application of a different approach-that of symbolic dynamics-in which the integrated pattern of each patients derangement, and the associated provider response, are captured by defining words based on the elements of the pattern of failure. We will use as an example provider practices in the context of mechanical ventilation- a common, potentially harmful, and complex life support technology. We also delineate other domains in which symbolic dynamics approaches might aid in quantitating practice patterns, assessing quality of care, and identifying best practices.
LA - eng
KW - symbol dynamics; patient care; language
UR - http://eudml.org/doc/197681
ER -

References

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  1. R. Engbert, C. Scheffczyk, R.T. Krampe, M. Rosenblum, J. Kurths, R. Kliegl. Tempo-induced transitions in polyrhythmic hand movements. Phys. Rev. E, 56 (1997), No. 5, 5823–5833.  
  2. B. Hao. Symbolic dynamics and characterization of complexity. Physica D, 51 (1991),161–176.  
  3. R. Engbert, M. Schiek, J. Kurths, R. Krampe, R. Kliegl, F. Drepper. Symbolic dynamics of physiological synchronization: Examples from bimanual movements and cardiorespiratory interaction. Nonlin. Anal. Theor. Meth. Appl., 30 (1997), No. 2, 973–984.  
  4. U. Schwarz, A.O. Benz, J. Kurths, A. Witt. Analysis of solar spike events by means of symbolic dynamics methods. Astron. Astrophys., 277 (1993), 215–224.  
  5. X.Z. Tang, E.R. Tracy, A.D. Boozer, A. Debrauwa, R. Brown. Symbol sequence statistics in noisy chaotic signal reconstruction. Phys. Rev. E, 51 (1995), 3871–3889.  
  6. C.S. Daw, M.B. Kennel, C.E.A. Finney, F.T. Connolly. Observing and modeling nonlinear dynamics in an internal combustion engine. Phys. Rev. E, 57 (1998), No. 3, 2811–2819.  
  7. C.S. Daw, C.E.A. Finney, E.R. Tracy. A review of symbolic analysis of experimental data. Rev. Scien. Instru., 47 (2003), No. 2, 915–930.  
  8. J.R. Hotchkiss, P.S. Crooke, A.B. Adams, J.J. Marini. Implications of a biphasic two compartment model of constant flow ventilation for the clinical setting. J. Crit. Care.9 (1994), No. 2, 114–123.  
  9. P.S. Crooke, J.D. Head, J.J. Marini, J.R. Hotchkiss. Patient-ventilator interaction: A general model for non-passive mechanical ventilation. IMA J. Math. Appl. Med. Biol., 15 (1998), 321–337.  
  10. P.S. Crooke, S. Hota, J.J. Marini, J.R. Hotchkiss. A mathematical model for carbon dioxide exchange during mechanical ventilation with TGI. Math. Comp. Mod., 29 (1999), 45–61.  
  11. A.B. Adams, P. Bliss, J.R. Hotchkiss. Effects of respiratory impedance on the performance of bi-level pressure ventilators. Respir. Care, 45 (2000), No. 4, 390–400.  
  12. J.R. Hotchkiss, D.J. Dries, J.J. Marini, P.S. Crooke. Dynamical behavior during noninvasive ventilation: chaotic support?Am. J. Resp. Crit. Care Med., 163 (2001), 374–378.  
  13. J.R. Hotchkiss, A.B. Adams, M.K. Stone, D.J. Dries, J.J. Marini. Oscillations and noise: inherent instability of pressure support ventilation?Am. J. Resp. Crit. Care Med., 165 (2002), 47–53.  
  14. P.S. Crooke, J.R. Hotchkiss, J.J. Marini. Linear and nonlinear mathematical models for non-invasive, passive ventilation. Math. Comp. Mod., 35 (2002),1297–1313.  
  15. P.S. Crooke, J.R. Hotchkiss, J.J. Marini. Modeling recruitment maneuvers with a variable compliance model for pressure preset ventilation. J. Theor. Med., 43 (2002),No. 3, 197–207.  

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