Early neurological deterioration detection with a transformer convolutional auto-encoder model

Abstract

This paper proposes an improved transformer convolutional auto-encoder model combined with the exponentially weighted moving average (EWMA) control chart to detect early neurological deterioration (END) of ischemic stroke patients after endovascular therapy in advance. In the proposed method, the transformer convolutional auto-encoder is used to extract crucial features of multivariate clinical monitoring time series data and obtain the reconfiguration loss while EWMA control chart is utilized to monitor the derived reconfiguration loss and identify anomalies. To verify the feasibility and effectiveness of the proposed END detection approach, multivariate clinical monitoring time series data of ischemic stroke patients in the neurocritical care unit from Beijing Tiantan hospital are collected. Meanwhile, the proposed approach is benchmarked with seven state-of-the-art models. The computation results show that the proposed approach achieves the best performance with the lowest false alarm rate and the highest detection rate. Therefore, the proposed END detection model is practical to guide doctors in conducting clinical interventions in advance to prevent deterioration in patients with ischemic stroke.