Predicting deterioration in dengue using a low cost wearable for continuous clinical monitoring

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 inputs to continuously forecast clinical state. A phased prediction of low-risk states (22.1%), defined by NEWS2 and CRAMS < 6, was achieved, 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 for high-risk patients in a safe ambulatory patient setting.

Damien Keng Ming, John Daniels, Ho Quang Chanh, Stefan Karolcik, Bernard Hernandez, Vasileios Manginas, Van Hao Nguyen, Quang Huy Nguyen, Tu Qui Phan, Thi Hue Tai Luong, Huynh Trung Trieu, Alison Helen Holmes, Vinh Tho Phan, Pantelis Georgiou, Sophie Yacoub