Evaluating the Clinical Effectiveness of "Endotracheal Tube Position Anomaly Alerting System"

Usability and user satisfaction survey with a questionnaire

Time frame: through study completion, up to 6 months

Prevalence of endotracheal tube malposition

Prevalence of endotracheal tube malposition on the first chest radiograph on ICU admission and on the second chest radiograph taken in the ICU

Time frame: through study completion, up to 6 months

ICU length of stay

Time frame: from ICU admission to ICU discharge, an estimated average of 7 days

Duration of mechanical ventilation

Time frame: from intubation to the discontinuation of mechanical ventilation, an estimated average of 5 days

Weaning rate of mechanical ventilation

Time frame: from intubation to the successful discontinuation of mechanical ventilation, assessed up to 5 months

Accuracy of the ETPAAS

The accuracy of the Endotracheal Tube Position Anomaly Alerting System (ETPAAS) will be evaluated by comparing its automated assessments of endotracheal tube (ETT) positioning with expert clinical interpretations. Accuracy will be determined based on the system's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in detecting ETT malposition. The reference standard will be assessments made by experienced intensivists.

Time frame: through study completion, up to 6 months

Precision of the ETPAAS

The precision of the Endotracheal Tube Position Anomaly Alerting System (ETPAAS) will be evaluated by assessing the consistency and reliability of its automated endotracheal tube (ETT) position anomaly detection. Precision will be measured as the proportion of correctly identified malpositioned ETT cases among all positive alerts generated by the system (i.e., positive predictive value, PPV).

Time frame: through study completion, up to 6 months

Recall of the ETPAAS

The recall of the Endotracheal Tube Position Anomaly Alerting System (ETPAAS) will be assessed by evaluating its ability to correctly identify cases of endotracheal tube (ETT) malposition. Recall will be quantified as the proportion of true positive cases detected by ETPAAS among all actual cases of ETT malposition, also known as sensitivity. A higher recall value indicates the system's effectiveness in minimizing missed detections and ensuring timely alerts for clinical intervention.

Time frame: through study completion, up to 6 months

F1 score of the ETPAAS

The F1 score of the Endotracheal Tube Position Anomaly Alerting System (ETPAAS) will be used to assess the balance between precision and recall in detecting endotracheal tube (ETT) malposition. The F1 score is the harmonic mean of precision and recall. A higher F1 score indicates that ETPAAS effectively identifies ETT malposition with both high accuracy and low false-negative and false-positive rates. This metric provides a comprehensive evaluation of the system's performance in a clinical setting.

Time frame: through study completion, up to 6 months

Area under the curve (AUC) of receiver operating characteristic (ROC) curve of the ETPAAS

The Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC) curve will be used to evaluate the overall diagnostic performance of the Endotracheal Tube Position Anomaly Alerting System (ETPAAS) in detecting endotracheal tube (ETT) malposition. The ROC curve plots the true positive rate (sensitivity) against the false positive rate (1 - specificity) at various classification thresholds. The AUC value ranges from 0 to 1, where: * AUC = 1.0 indicates perfect classification performance. * AUC = 0.5 suggests no better performance than random chance. * Higher AUC values indicate superior discriminatory ability of ETPAAS in correctly distinguishing between correctly positioned and malpositioned ETT cases. This metric provides a robust measure of the system's reliability and effectiveness in clinical decision support.

Time frame: through study completion, up to 6 months