{"type":"ScholarlyArticle","title":"Drug Overdose Vital-Signs Evaluator Using Machine Learning","authors":[{"name":"Anush Niranjan Lingamoorthy","slug":"anush-niranjan-lingamoorthy","given":"Anush Niranjan","family":"Lingamoorthy","affiliation":"Drexel University"},{"name":"Abhishek Kumar Mishra","slug":"abhishek-kumar-mishra","given":"Abhishek Kumar","family":"Mishra","affiliation":"Drexel University"},{"name":"Suman Kumar","slug":"suman-kumar","given":"Suman","family":"Kumar","affiliation":"Drexel University"},{"name":"David Gordon","slug":"david-gordon","given":"David","family":"Gordon","affiliation":"Thomas Jefferson University"},{"name":"Jacob Brenner","slug":"jacob-brenner","given":"Jacob","family":"Brenner","affiliation":"University of Pennsylvania"},{"name":"Nagarajan Kandasamy","slug":"nagarajan-kandasamy","given":"Nagarajan","family":"Kandasamy","affiliation":"Drexel University"},{"name":"Amanda Watson","slug":"amanda-watson","given":"Amanda","family":"Watson","affiliation":"University of Virginia"}],"abstract":"Opioid overdose is an escalating global epidemic, affecting 16 million individuals. Lack of overdose detection and slower response times are the leading causes of overdose deaths. During a fatal opioid overdose, the user exhibits motionlessness, lack of breathing, and hypoxemia (oxygen saturation drops). In this paper, we discuss the development of a shoulder-based wearable overdose detection device that monitors hypoxemia, motion, and respiration. The device's design considers the underserved socio-economic population and their psychological contexts. However, conventional approaches to detecting an overdose typically focus on a single biomarker. To address this, we have developed a robust capsule networks based machine learning (ML) model, OxyCaps that integrates oxygen saturation, respiration rate, and motion to classify different levels of hypoxemia. This also helps improve patient adherence by decreasing the chances of false positive alerts. To determine a hypoxemic state, the model considers various features like skin tone, body physiology, motion, and photoplethysmography (PPG) signals. In the absence of real-world opioid overdose data, our research leverages data collected by our device from 19 patients experiencing sleep apnea, exploiting the parallels between overdose and apnea biomarkers. Our dataset provides a novel compilation of raw PPG and motion signals detected from the shoulder. Our model classifies 3 stages of hypoxemia with an average accuracy of 92%, specifically achieving a high recall of 0.98 for the critical hypoxemic state that is crucial in determining an overdose.","doi":"10.24963/ijcai.2024/814","url":"https://ijcai.org/proceedings/2024/814","pdf":"https://ijcai.org/proceedings/2024/0814.pdf","markdown":"https://ijcai.org/proceedings/2024/814.md","bibtex":"https://ijcai.org/proceedings/2024/bibtex/814","volume":{"slug":"2024","title":"Proceedings of the Thirty-Third International Joint Conference on Artificial Intelligence","short_title":"IJCAI 2024","url":"https://ijcai.org/proceedings/2024/","year":2024,"location":"Jeju, Korea","dates":"3-9 August 2024","editors":"Kate Larson","isbn":"978-1-956792-04-1","publisher":"International Joint Conferences on Artificial Intelligence Organization","doi_prefix":"10.24963/ijcai.2024"},"section":"AI for Good","track":"AI for Good","number":814,"pages":{"first":7358,"last":7366},"keywords":["Humans and AI: General","Multidisciplinary Topics and Applications: General"],"videos":[],"references":[{"position":1,"raw":"[Aguirregomezcorta et al., 2021] Idoia Badiola Aguirre- gomezcorta, Vladimir Blazek, Steffen Leonhardt, and Christoph Hoog Antink. Learning about reflective ppg for spo2 determination using machine learning. Current Directions in Biomedical Engineering, 7(2):33-36, 2021.","title":"Learning about reflective ppg for spo2 determination using machine learning","authors":"Idoia Badiola Aguirregomezcorta, Vladimir Blazek, Steffen Leonhardt, Christoph Hoog, Antink","year":"2021","venue":"Current Directions in Biomedical Engineering","doi":null,"url":null,"internal_url":null},{"position":2,"raw":"[Ahamad et al., 2019] Keith Ahamad, Huiru Dong, Cheyenne Johnson, Kanna Hyashi, Kora DeBeck, MJ Milloy, and Evan Wood. Factors associated with willingness to wear an electronic overdose detection device. Addiction science & clinical practice, 14(1):1-5, 2019.","title":"Factors associated with willingness to wear an electronic overdose detection device","authors":"Keith Ahamad, Huiru Dong, Cheyenne Johnson, Kanna Hyashi, Kora Debeck, Evan Milloy, Wood","year":"2019","venue":"Addiction science & clinical practice","doi":null,"url":null,"internal_url":null},{"position":3,"raw":"[Berry et al., 2012] Richard B Berry, Rita Brooks, Char- lene E Gamaldo, Susan M Harding, C Marcus, Bradley V Vaughn, et al. The aasm manual for the scoring of sleep and associated events. Rules, Terminology and Techni- cal Specifications, Darien, Illinois, American Academy of Sleep Medicine, 176:2012, 2012.","title":"The aasm manual for the scoring of sleep and associated events. Rules, Terminology and Technical Specifications","authors":"Rita Richard B Berry, Charlene E Brooks, Susan M Gamaldo, C Harding, Bradley V Marcus, Vaughn","year":"2012","venue":"American Academy of Sleep Medicine","doi":null,"url":null,"internal_url":null},{"position":4,"raw":"[Boyer, 2012a] Edward W Boyer. Management of opioid analgesic overdose. New England Journal of Medicine, 367(2):146-155, 2012.","title":"Management of opioid analgesic overdose","authors":"Edward W Boyer, Boyer","year":"2012","venue":"New England Journal of Medicine","doi":null,"url":null,"internal_url":null},{"position":5,"raw":"[Boyer, 2012b] Edward W Boyer. Management of opioid analgesic overdose. New England Journal of Medicine, 367(2):146-155, 2012.","title":"Management of opioid analgesic overdose","authors":"Edward W Boyer, Boyer","year":"2012","venue":"New England Journal of Medicine","doi":null,"url":null,"internal_url":null},{"position":6,"raw":"[Campbell et al., 2023] Anne Campbell, Sharon Millen, Li Guo, Uisce Jordan, Amanda Taylor-Beswick, Chris Rintoul, and Aisling Diamond. Reducing opioid re- lated deaths for individuals who are at high risk of death from overdose: a co-production study with people housed within prison and hostel accommodation during covid-19. Frontiers in Public Health, 11:1080629, 2023.","title":"Reducing opioid related deaths for individuals who are at high risk of death from overdose: a co-production study with people housed within prison and hostel accommodation during covid-19","authors":"Anne Campbell, Sharon Millen, Li Guo, Uisce Jordan, Amanda Taylor-Beswick, Chris Rintoul, Aisling Diamond","year":"2023","venue":"Frontiers in Public Health","doi":null,"url":null,"internal_url":null},{"position":7,"raw":"[Chan et al., 2021] Justin Chan, Vikram Iyer, Anran Wang, Alexander Lyness, Preetma Kooner, Jacob Sunshine, and Shyamnath Gollakota. Closed-loop wearable naloxone in- jector system. Scientific reports, 11(1):1-13, 2021.","title":"Closed-loop wearable naloxone injector system","authors":"Justin Chan, Vikram Iyer, Anran Wang, Alexander Lyness, Preetma Kooner, Jacob Sunshine, Shyamnath Gollakota","year":"2021","venue":"Scientific reports","doi":null,"url":null,"internal_url":null},{"position":8,"raw":"[Chang et al., 2018] Hsien-Yen Chang, Hadi Kharrazi, Dave Bodycombe, Jonathan P Weiner, and G Caleb Alexander. Healthcare costs and utilization associated with high-risk prescription opioid use: a retrospective cohort study. BMC medicine, 16(1):1-11, 2018.","title":"Healthcare costs and utilization associated with high-risk prescription opioid use: a retrospective cohort study","authors":"Hsien-Yen Chang, Hadi Kharrazi, Dave Bodycombe, Jonathan P Weiner, Caleb Alexander","year":"2018","venue":"BMC medicine","doi":null,"url":null,"internal_url":null},{"position":9,"raw":"[Dhowan et al., 2019] Bahar Dhowan, Jongcheon Lim, Michael D MacLean, Alycia G Berman, Min Ku Kim, Qi Yang, Jacqueline Linnes, Chi Hwan Lee, Craig J Goergen, and Hyowon Lee. Simple minimally-invasive automatic antidote delivery device (a2d2) towards closed- loop reversal of opioid overdose. Journal of Controlled Release, 306:130-137, 2019.","title":"Simple minimally-invasive automatic antidote delivery device (a2d2) towards closedloop reversal of opioid overdose","authors":"Jongcheon Bahar Dhowan, Lim, Alycia G Michael D Maclean, Min Ku Berman, Qi Kim, Jacqueline Yang, Chi Hwan Linnes, Craig J Lee, Hyowon Goergen, Lee","year":"2019","venue":"Journal of Controlled Release","doi":null,"url":null,"internal_url":null},{"position":10,"raw":"[Elgendi, 2016] Mohamed Elgendi. Optimal signal quality index for photoplethysmogram signals. Bioengineering, 3(4):21, 2016.","title":"Optimal signal quality index for photoplethysmogram signals","authors":"Mohamed Elgendi","year":"2016","venue":"Bioengineering","doi":null,"url":null,"internal_url":null},{"position":11,"raw":"[Hoffman et al., 2022] Jason S Hoffman, Varun K Viswanath, Caiwei Tian, Xinyi Ding, Matthew J Thomp- son, Eric C Larson, Shwetak N Patel, and Edward J Wang. Smartphone camera oximetry in an induced hypoxemia study. NPJ Digital Medicine, 5(1):146, 2022.","title":"Smartphone camera oximetry in an induced hypoxemia study","authors":"Jason S Hoffman, K Varun, Caiwei Viswanath, Xinyi Tian, Matthew J Ding, Eric C Thompson, Shwetak N Larson, Edward J Patel, Wang","year":"2022","venue":"NPJ Digital Medicine","doi":null,"url":null,"internal_url":null},{"position":12,"raw":"[Imtiaz et al., 2021] Mohammad S Imtiaz, Charles V Ban- doian, and Thomas J Santoro. Hypoxia driven opioid tar- geted automated device for overdose rescue. Scientific Re- ports, 11(1), 2021.","title":"Hypoxia driven opioid targeted automated device for overdose rescue","authors":"Charles V Mohammad S Imtiaz, Thomas J Bandoian, Santoro","year":"2021","venue":"Scientific Reports","doi":null,"url":null,"internal_url":null},{"position":13,"raw":"[Kanter et al., 2021a] Katie Kanter, Ryan Gallagher, Fey- isope Eweje, Alexander Lee, David Gordon, Stephen Landy, Julia Gasior, Haideliza Soto-Calderon, Peter F Cronholm, Ben Cocchiaro, et al. Willingness to use a wearable device capable of detecting and reversing over- dose among people who use opioids in philadelphia. Harm reduction journal, 18(1):1-14, 2021.","title":"Willingness to use a wearable device capable of detecting and reversing overdose among people who use opioids in philadelphia","authors":"Kanter","year":"2021","venue":"Harm reduction journal","doi":null,"url":null,"internal_url":null},{"position":14,"raw":"[Kanter et al., 2021b] Katie Kanter, Ryan Gallagher, Fey- isope Eweje, Alexander Lee, David Gordon, Stephen Landy, Julia Gasior, Haideliza Soto-Calderon, Peter F Cronholm, Ben Cocchiaro, et al. Willingness to use a wearable device capable of detecting and reversing over- dose among people who use opioids in philadelphia. Harm Reduction Journal, 18(1):1-14, 2021.","title":"Willingness to use a wearable device capable of detecting and reversing overdose among people who use opioids in philadelphia","authors":"Kanter","year":"2021","venue":"Harm Reduction Journal","doi":null,"url":null,"internal_url":null},{"position":15,"raw":"Alison Knopf. Masimo \"halo\" gets fda go- ahead for otc and rx. Alcoholism & Drug Abuse Weekly, 35(16):4-5, 2023.","title":"Masimo \"halo\" gets fda goahead for otc and rx","authors":"Alison Knopf","year":"2023","venue":"Alcoholism & Drug Abuse Weekly","doi":null,"url":null,"internal_url":null},{"position":16,"raw":"[Krejčí et al., 2018] Jakub Krejčí, Michal Botek, and An- drew J McKune. Dynamics of the heart rate variability and oxygen saturation response to acute normobaric hypoxia within the first 10 min of exposure. Clinical physiology and functional imaging, 38(1):56-62, 2018.","title":"Dynamics of the heart rate variability and oxygen saturation response to acute normobaric hypoxia within the first 10 min of exposure","authors":"Jakub Krejčí, Michal Botek, Andrew J Mckune","year":"2018","venue":"Clinical physiology and functional imaging","doi":null,"url":null,"internal_url":null},{"position":17,"raw":"[Kumar, 2024] Abhishek Kumar. Drug over- dose vital-signs evaluator using machine learn- ing. https://github.com/abhishekkumarm98/ Drug-Overdose-Vital-Signs-Evaluator, 2024.","title":"Drug overdose vital-signs evaluator using machine learning","authors":"Abhishek Kumar","year":"2024","venue":null,"doi":null,"url":"https://github.com/abhishekkumarm98/Drug-Overdose-Vital-Signs-Evaluator","internal_url":null},{"position":18,"raw":"[Lazazzera et al., 2021] Remo Lazazzera, Margot Deviaene, Carolina Varon, Bertien Buyse, Dries Testelmans, Pablo Laguna, Eduardo Gil, and Guy Carrault. Detection and classification of sleep apnea and hypopnea using ppg and spo 2 signals. IEEE Transactions on Biomedical Engineer- ing, 68(5):1496-1506, 2021.","title":"Detection and classification of sleep apnea and hypopnea using ppg and spo 2 signals","authors":"Lazazzera","year":"2021","venue":"IEEE Transactions on Biomedical Engineering","doi":null,"url":null,"internal_url":null},{"position":19,"raw":"[Lee et al., 2000] Wally W. Lee, Kurt Mayberry, Robert Crapo, and Robert L. Jensen. The accuracy of pulse oximetry in the emergency department. The American Journal of Emergency Medicine, 18(4):427-431, 2000.","title":"The accuracy of pulse oximetry in the emergency department","authors":"Wally W Lee, Kurt Mayberry, Robert Crapo, Robert L Jensen","year":"2000","venue":"The American Journal of Emergency Medicine","doi":null,"url":null,"internal_url":null},{"position":20,"raw":"[Liang et al., 2018] Yongbo Liang, Mohamed Elgendi, Zhencheng Chen, and Rabab Ward. An optimal filter for short photoplethysmogram signals. Scientific data, 5(1):1-12, 2018.","title":"An optimal filter for short photoplethysmogram signals","authors":"Yongbo Liang, Mohamed Elgendi, Zhencheng Chen, Rabab Ward","year":"2018","venue":"Scientific data","doi":null,"url":null,"internal_url":null},{"position":21,"raw":"[Lingamoorthy et al., 2023] Anush Lingamoorthy, Amanda Watson, Korey Henderson, Ayan Mandal, David Gordon, Xiaonan Ma, James Weimer, Nagarajan Kandasamy, and Jacob S Brenner. Dove: Shoulder-based opioid overdose detection and reversal device. In 2023 IEEE/ACM Con- ference on Connected Health: Applications, Systems and Engineering Technologies (CHASE), pages 56-67. IEEE, 2023.","title":"Dove: Shoulder-based opioid overdose detection and reversal device","authors":"Anush Lingamoorthy, Amanda Watson, Korey Henderson, Ayan Mandal, David Gordon, Xiaonan Ma, James Weimer, Nagarajan Kandasamy, Jacob S Brenner","year":"2023","venue":"IEEE/ACM Conference on Connected Health: Applications, Systems and Engineering Technologies (CHASE)","doi":null,"url":null,"internal_url":null},{"position":22,"raw":"[Mahmud et al., 2022] Talha Ibn Mahmud, Sheikh Asif Im- ran, and Celia Shahnaz. Res-se-convnet: A deep neural network for hypoxemia severity prediction for hospital in- patients using photoplethysmograph signal. IEEE Jour- nal of Translational Engineering in Health and Medicine, 10:1-9, 2022.","title":"Talha Ibn Mahmud, Sheikh Asif Imran, and Celia Shahnaz. Res-se-convnet: A deep neural network for hypoxemia severity prediction for hospital inpatients using photoplethysmograph signal","authors":"Mahmud","year":"2022","venue":"IEEE Journal of Translational Engineering in Health and Medicine","doi":null,"url":null,"internal_url":null},{"position":23,"raw":"[Nandakumar et al., 2019] Rajalakshmi Nandakumar, Shyamnath Gollakota, and Jacob E Sunshine. Opi- oid overdose detection using smartphones. Science translational medicine, 11(474):eaau8914, 2019.","title":"Opioid overdose detection using smartphones","authors":"Rajalakshmi Nandakumar, Shyamnath Gollakota, Jacob E Sunshine","year":"2019","venue":"Science translational medicine","doi":null,"url":null,"internal_url":null},{"position":24,"raw":"[Ogeil et al., 2018] Rowan P Ogeil, Jeremy Dwyer, Lyndal Bugeja, Cherie Heilbronn, Dan I Lubman, and Belinda Lloyd. Pharmaceutical opioid overdose deaths and the presence of witnesses. International Journal of Drug Pol- icy, 55:8-13, 2018.","title":"Pharmaceutical opioid overdose deaths and the presence of witnesses","authors":"Jeremy Rowan P Ogeil, Lyndal Dwyer, Cherie Bugeja, Dan I Heilbronn, Belinda Lubman, Lloyd","year":"2018","venue":"International Journal of Drug Policy","doi":null,"url":null,"internal_url":null},{"position":25,"raw":"[Paszke et al., 2019] Adam Paszke, Sam Gross, Francisco Massa, Adam Lerer, James Bradbury, Gregory Chanan, Trevor Killeen, Zeming Lin, Natalia Gimelshein, Luca Antiga, Alban Desmaison, Andreas Kopf, Edward Yang, Zachary DeVito, Martin Raison, Alykhan Tejani, Sasank Chilamkurthy, Benoit Steiner, Lu Fang, Junjie Bai, and Soumith Chintala. Pytorch: An imperative style, high- performance deep learning library. In Advances in Neu- ral Information Processing Systems 32, pages 8024-8035.","title":"Pytorch: An imperative style, highperformance deep learning library","authors":"Adam Paszke, Sam Gross, Francisco Massa, Adam Lerer, James Bradbury, Gregory Chanan, Trevor Killeen, Zeming Lin, Natalia Gimelshein, Luca Antiga, Alban Desmaison, Andreas Kopf, Edward Yang, Zachary Devito, Martin Raison, Alykhan Tejani, Sasank Chilamkurthy, Benoit Steiner, Lu Fang, Junjie Bai, Soumith Chintala","year":null,"venue":"Advances in Neural Information Processing Systems","doi":null,"url":null,"internal_url":null},{"position":26,"raw":"Curran Associates, Inc., 2019.","title":null,"authors":"Curran Associates, Inc","year":"2019","venue":null,"doi":null,"url":null,"internal_url":null},{"position":27,"raw":"[Pimentel et al., 2016] Marco AF Pimentel, Alistair EW Johnson, Peter H Charlton, Drew Birrenkott, Peter J Watkinson, Lionel Tarassenko, and David A Clifton. To- ward a robust estimation of respiratory rate from pulse oximeters. IEEE Transactions on Biomedical Engineer- ing, 64(8):1914-1923, 2016.","title":"Toward a robust estimation of respiratory rate from pulse oximeters","authors":"A F Marco, Alistair Ew Pimentel, Johnson, Drew Peter H Charlton, Birrenkott, Lionel Peter J Watkinson, David A Tarassenko, Clifton","year":"2016","venue":"IEEE Transactions on Biomedical Engineering","doi":null,"url":null,"internal_url":null},{"position":28,"raw":"[Sabour et al., 2017] Sara Sabour, Nicholas Frosst, and Ge- offrey E Hinton. Dynamic routing between capsules. Advances in neural information processing systems, 30, 2017.","title":"Dynamic routing between capsules","authors":"Sara Sabour, Nicholas Frosst, Geoffrey E Hinton","year":"2017","venue":"Advances in neural information processing systems","doi":null,"url":null,"internal_url":null},{"position":29,"raw":"[Shuzan et al., 2023] Md Nazmul Islam Shuzan, Moaj- jem Hossain Chowdhury, Muhammad EH Chowdhury, Murugappan Murugappan, Enamul Hoque Bhuiyan, Mo- hamed Arslane Ayari, and Amith Khandakar. Machine learning-based respiration rate and blood oxygen satura- tion estimation using photoplethysmogram signals. Bio- engineering, 10(2):167, 2023.","title":"Machine learning-based respiration rate and blood oxygen saturation estimation using photoplethysmogram signals","authors":"Md Nazmul, Islam Shuzan, Moajjem Hossain Chowdhury, Muhammad Eh Chowdhury, Murugappan Murugappan, Enamul Hoque Bhuiyan, Mohamed Arslane Ayari, Amith Khandakar","year":"2023","venue":"Bioengineering","doi":null,"url":null,"internal_url":null}],"license_note":"Copyright International Joint Conferences on Artificial Intelligence."}