Show simple item record

dc.contributor.advisorLeo Anthony Celi and Stan Finkelstein.en_US
dc.contributor.authorBaker, Lawrence,S. M.(Lawrence M.)Massachusetts Institute of Technology.en_US
dc.contributor.otherMassachusetts Institute of Technology. Institute for Data, Systems, and Society.en_US
dc.contributor.otherTechnology and Policy Program.en_US
dc.date.accessioned2020-04-13T18:24:32Z
dc.date.available2020-04-13T18:24:32Z
dc.date.copyright2019en_US
dc.date.issued2019en_US
dc.identifier.urihttps://hdl.handle.net/1721.1/124577
dc.descriptionThis electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.en_US
dc.descriptionThesis: S.M. in Technology and Policy, Massachusetts Institute of Technology, School of Engineering, Institute for Data, Systems, and Society, 2019en_US
dc.descriptionCataloged from student-submitted PDF version of thesis.en_US
dc.descriptionIncludes bibliographical references (pages 121-130).en_US
dc.description.abstractPatients in intensive care routinely have their blood glucose monitored and controlled using insulin. Two decades of on-going research has attempted to establish optimal glucose targets and treatment policy for patients with hyperglycemia in the intensive care unit (ICU). These efforts rely on the assumption that health care providers can reliably meet given targets. Significant proportions of the ICU population are either hypoglycemic or hyperglycemic and poor blood glucose control may lead to adverse patient outcomes. This thesis analyses approximately 20,000 ICU stays at the Beth Israel Deaconess Medical Center (BIDMC) which occurred between 2008 and 2018. These data are used to describe the state of clinical practice in the ICU and identify areas where treatment may be suboptimal. Even at a world-renowned teaching hospital, blood sugars are not optimally managed. 41.8% of diabetics and 14.2% of non-diabetics are severely hyperglycemic (>215mg/dL) each day. Insulin boluses are given more frequently than insulin infusions, despite guidelines recommending infusions for most critical care patients. When infusions are given, rates do not follow a consistent set of rules. Blood sugar management faces several challenges, including unreliable readings. Laboratory and fingerstick measurements that were taken at the same time had an R² of only 0.63 and the fingerstick measurements read on average 10mg/dL higher. Overcoming these challenges is an important part of improving care in the ICU. It is hoped that publicly sharing the code used to extract and clean data used for analysis will encourage further research. Code can be found at https://github.com/lawbaker/MIMIC-Glucose-Managementen_US
dc.description.statementofresponsibilityby Lawrence Baker.en_US
dc.format.extent130 pagesen_US
dc.language.isoengen_US
dc.publisherMassachusetts Institute of Technologyen_US
dc.rightsMIT theses are protected by copyright. They may be viewed, downloaded, or printed from this source but further reproduction or distribution in any format is prohibited without written permission.en_US
dc.rights.urihttp://dspace.mit.edu/handle/1721.1/7582en_US
dc.subjectInstitute for Data, Systems, and Society.en_US
dc.subjectTechnology and Policy Program.en_US
dc.titleCharacterisation of glucose management in intensive careen_US
dc.typeThesisen_US
dc.description.degreeS.M. in Technology and Policyen_US
dc.contributor.departmentMassachusetts Institute of Technology. Institute for Data, Systems, and Societyen_US
dc.contributor.departmentTechnology and Policy Programen_US
dc.identifier.oclc1149091156en_US
dc.description.collectionS.M.inTechnologyandPolicy Massachusetts Institute of Technology, School of Engineering, Institute for Data, Systems, and Societyen_US
dspace.imported2020-04-13T18:24:03Zen_US
mit.thesis.degreeMasteren_US
mit.thesis.departmentESDen_US
mit.thesis.departmentIDSSen_US


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record