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Predictive informatics monitoring in the Neonatal Intensive Care Unit

Award Number: R01HD072071
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/10/2014
PERIOD OF PERFORMANCE END DATE: 04/30/2027

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Predictive informatics monitoring in the Neonatal Intensive Care Unit - PROJECT SUMMARY/ABSTRACT Significance: Premature very low birth weight (VLBW) infants in the Neonatal ICU continue to suffer morbidity and mortality from sepsis and necrotizing enterocolitis (NEC), and early detection and treatment of these illnesses has been shown to improve survival and outcomes. Continuously monitored vital signs contain subtle changes in the early stage of sepsis and NEC, but these physiological markers are invisible with current technology, even for the most sophisticated monitors and experienced clinicians. Our group continues to build on experience and collaboration to develop early warning systems through advanced time series and machine learning data analytics that will improve outcomes for premature infants. Progress: Our first such early warning system, the HeRO monitor, alerts clinicians to abnormal heart rate characteristics and was shown to reduce sepsis-associated mortality by 40% in a randomized trial of 3003 VLBW infants. The past 7 years of NIH support produced several important discoveries, including 1) Adding pulse oximetry oxygenation data (SpO2) to electrocardiogram data improves sepsis and NEC prediction; 2) Center-specific differences in patient demographics and care practices impact algorithm performance; 3) High cross-correlation of heart rate and SpO2 reflects increased apnea and sepsis risk across multiple sites. Innovation: The proposed work represents a paradigm shift in patient care – monitors that report trends of development of health and illness rather than fleeting values, leading to improved outcomes of preterm infants in the NICU. Approach: In the current proposal we are adding a fourth large NICU to accomplish the following aims: Aim 1: Use advanced time series analytics and machine learning to refine and expand predictive monitoring algorithms for sepsis and NEC; Aim 2: Determine the impact of demographics and center on outcomes and algorithm performance; Aim 3: Share multi-center data and analytics globally by building on an existing platform. Investigators: Co-PI's Fairchild and Moorman have a longstanding collaboration and have led successful multicenter clinical and analytical research for the life of this grant and have strengthened the team by adding new collaborators and centers. Environment: The centers involved in this proposal are unique in their ability to collect and analyze large vital sign and clinical data sets, made possible by robust institutional research and computing support.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $657,345 )
2025	2025	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	001	11	5/2/2025	NON-COMPETING CONTINUATION	$657,345
2025	2024	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	10	10/10/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $657,345

Issue Date FY: 2024 ( Subtotal = $653,486 )
2024	2024	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	10	5/1/2024	NON-COMPETING CONTINUATION	$653,486
														Subtotal = $653,486

Issue Date FY: 2023 ( Subtotal = $661,672 )
2023	2023	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	9	4/21/2023	NON-COMPETING CONTINUATION	$661,672
2023	2022	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	002	8	7/25/2023	COMPETING CONTINUATION	$209,601
2023	2021	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	001	7	7/25/2023	NON-COMPETING CONTINUATION	-$209,601
														Subtotal = $661,672

Issue Date FY: 2022 ( Subtotal = $709,239 )
2022	2022	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	001	8	6/29/2022	COMPETING CONTINUATION	$709,239
2022	2021	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	7	6/29/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $709,239

Issue Date FY: 2021 ( Subtotal = $629,494 )
2021	2021	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	7	8/5/2021	NON-COMPETING CONTINUATION	$629,494
														Subtotal = $629,494

Issue Date FY: 2020 ( Subtotal = $652,723 )
2020	2020	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	6	7/29/2020	NON-COMPETING CONTINUATION	$652,723
														Subtotal = $652,723

Issue Date FY: 2019 ( Subtotal = $662,629 )
2019	2019	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	002	5	7/12/2019	NON-COMPETING CONTINUATION	$662,629
2019	2018	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	001	4	10/24/2018	COMPETING CONTINUATION	$19,772
2019	2016	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	3	10/24/2018	NON-COMPETING CONTINUATION	-$19,772
														Subtotal = $662,629

Issue Date FY: 2018 ( Subtotal = $718,813 )
2018	2018	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	4	8/13/2018	COMPETING CONTINUATION	$718,813
														Subtotal = $718,813

Issue Date FY: 2016 ( Subtotal = $455,905 )
2016	2016	UNIVERSITY OF VIRGINIA	P.O. BOX 400195	CHARLOTTESVILLE	VA	22904	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	3	6/16/2016	NON-COMPETING CONTINUATION	$455,905
														Subtotal = $455,905

Issue Date FY: 2015 ( Subtotal = $507,611 )
2015	2015	UNIVERSITY OF VIRGINIA	P.O. BOX 400195	CHARLOTTESVILLE	VA	22904	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	2	6/19/2015	NON-COMPETING CONTINUATION	$507,611
														Subtotal = $507,611

Issue Date FY: 2014 ( Subtotal = $621,571 )
2014	2014	UNIVERSITY OF VIRGINIA	P.O. BOX 400195	CHARLOTTESVILLE	VA	22904	CHARLOTTESVILLE CITY	USA	Child Health and Human Development Extramural Research	000	1	7/3/2014	NEW	$621,571
														Subtotal = $621,571

Grand Total All Awards = $6,930,488

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Predictive informatics monitoring in the Neonatal Intensive Care Unit

Award Number: R01HD072071

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/10/2014

PERIOD OF PERFORMANCE END DATE: 04/30/2027

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