{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:34:48Z","timestamp":1768264488278,"version":"3.49.0"},"reference-count":38,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,7,20]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"\n Objective<\/jats:title>\n Hypoxaemia is a strong predictor of mortality in children. Early detection of deteriorating condition is vital to timely intervention. We hypothesise that measures of pulse oximetry dynamics may identify children requiring hospitalisation. Our aim was to develop a predictive tool using only objective data derived from pulse oximetry and observed respiratory rate to identify children at increased risk of hospital admission.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary-level hospital emergency department in Bangladesh.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n Children under 5\u2005years (n=3374) presenting at the facility (October 2012\u2013April 2013) without documented chronic diseases were recruited. 1-minute segments of pulse oximetry (photoplethysmogram (PPG), blood oxygen saturation (SpO\n 2<\/jats:sub>\n ) and heart rate (HR)) and respiratory rate were collected with a mobile app.\n <\/jats:p>\n <\/jats:sec>\n \n Primary outcome<\/jats:title>\n The need for hospitalisation based on expert physician review and follow-up.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Pulse rate variability (PRV) using pulse peak intervals of the PPG signal and features extracted from the SpO\n 2<\/jats:sub>\n signal, all derived from pulse oximetry recordings, were studied. A univariate age-adjusted logistic regression was applied to evaluate differences between admitted and non-admitted children. A multivariate logistic regression model was developed using a stepwise selection of predictors and was internally validated using bootstrapping.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Children admitted to hospital showed significantly (p<0.01) decreased PRV and higher SpO\n 2<\/jats:sub>\n variability compared to non-admitted children. The strongest predictors of hospitalisation were reduced PRV-power in the low frequency band (OR associated with a 0.01\u2005unit increase, 0.93; 95% CI 0.89 to 0.98), greater time spent below an SpO\n 2<\/jats:sub>\n of 98% and 94% (OR associated with 10\u2005s increase, 1.4; 95% CI 1.3 to 1.4 and 1.5; 95% CI 1.4 to 1.6, respectively), high respiratory rate, high HR, low SpO\n 2<\/jats:sub>\n , young age and male sex. These variables provided a bootstrap-corrected AUC of the receiver operating characteristic of 0.76.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Objective measurements, easily obtained using a mobile device in low-resource settings, can predict the need for hospitalisation. External validation will be required before clinical adoption.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-011094","type":"journal-article","created":{"date-parts":[[2016,8,17]],"date-time":"2016-08-17T22:34:31Z","timestamp":1471473271000},"page":"e011094","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Respiratory rate and pulse oximetry derived information as predictors of hospital admission in young children in Bangladesh: a prospective observational study"],"prefix":"10.1136","volume":"6","author":[{"given":"Ainara","family":"Garde","sequence":"first","affiliation":[{"name":"Department of Electrical & Computer Engineering, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guohai","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Statistics, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahreen","family":"Raihana","sequence":"additional","affiliation":[{"name":"Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin","family":"Dunsmuir","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Karlen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Technology, ETH Zurich, Z\u00fcrich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parastoo","family":"Dekhordi","sequence":"additional","affiliation":[{"name":"Department of Electrical & Computer Engineering, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanvir","family":"Huda","sequence":"additional","affiliation":[{"name":"Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"},{"name":"School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shams El","family":"Arifeen","sequence":"additional","affiliation":[{"name":"Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niranjan","family":"Kissoon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy A","family":"Dumont","sequence":"additional","affiliation":[{"name":"Department of Electrical & Computer Engineering, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Mark","family":"Ansermino","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,8,17]]},"reference":[{"key":"2025120518365140000_6.8.e011094.1","first-page":"1","article-title":"Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation","volume":"6736","author":"You","year":"2015","journal-title":"Lancet"},{"key":"2025120518365140000_6.8.e011094.2","unstructured":"UNICEF. 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