{"id":"https://openalex.org/W7225752305","doi":"https://doi.org/10.3390/diagnostics16223714","title":"Development and Internal Validation of a Nurse-Led Sepsis Risk Score Using AI-Enabled Remote Patient Monitoring Data in Adult Febrile Neutropenia: A Nested Case\u2013Control Study","display_name":"Development and Internal Validation of a Nurse-Led Sepsis Risk Score Using AI-Enabled Remote Patient Monitoring Data in Adult Febrile Neutropenia: A Nested Case\u2013Control Study","publication_year":2026,"publication_date":"2026-11-10","ids":{"openalex":"https://openalex.org/W7225752305","doi":"https://doi.org/10.3390/diagnostics16223714"},"language":"en","primary_location":{"id":"doi:10.3390/diagnostics16223714","doi":"https://doi.org/10.3390/diagnostics16223714","is_oa":true,"landing_page_url":"https://doi.org/10.3390/diagnostics16223714","pdf_url":null,"source":{"id":"https://openalex.org/S4210172076","display_name":"Diagnostics","issn_l":"2075-4418","issn":["2075-4418"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostics","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/diagnostics16223714","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161089218","display_name":"N Aswathy Asokan","orcid":"https://orcid.org/0009-0008-0020-5889","observed_orcids":["https://orcid.org/0009-0008-0020-5889"]},"institutions":[{"id":"https://openalex.org/I81556334","display_name":"Amrita Vishwa Vidyapeetham","ror":"https://ror.org/03am10p12","country_code":"IN","type":"education","lineage":["https://openalex.org/I81556334"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Aswathy Asokan","raw_affiliation_strings":["Department of Medical Surgical Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Health Sciences Campus, Kochi 682041, Kerala, India"],"raw_orcid":"https://orcid.org/0009-0008-0020-5889","affiliations":[{"raw_affiliation_string":"Department of Medical Surgical Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Health Sciences Campus, Kochi 682041, Kerala, India","institution_ids":["https://openalex.org/I81556334"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112965663","display_name":"K.L. Ajee","orcid":"https://orcid.org/0000-0001-7877-731X","observed_orcids":["https://orcid.org/0000-0001-7877-731X"]},"institutions":[{"id":"https://openalex.org/I81556334","display_name":"Amrita Vishwa Vidyapeetham","ror":"https://ror.org/03am10p12","country_code":"IN","type":"education","lineage":["https://openalex.org/I81556334"]}],"countries":["IN"],"is_corresponding":true,"raw_author_name":"Ajee Kurunjippadath Lakshmanan","raw_affiliation_strings":["Department of Medical Surgical Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Health Sciences Campus, Kochi 682041, Kerala, India"],"raw_orcid":"https://orcid.org/0000-0001-7877-731X","affiliations":[{"raw_affiliation_string":"Department of Medical Surgical Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Health Sciences Campus, Kochi 682041, Kerala, India","institution_ids":["https://openalex.org/I81556334"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160994509","display_name":"Sachin Jadhav","orcid":"https://orcid.org/0009-0003-8123-1838","observed_orcids":["https://orcid.org/0009-0003-8123-1838"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Sachin Suresh Jadhav","raw_affiliation_strings":["Department of Hematology and the BMT, Trustwell Hospitals, 5, JC Rd, Vinobha Nagar, Sudhama Nagar, Bengaluru 560002, Karnataka, India"],"raw_orcid":"https://orcid.org/0009-0003-8123-1838","affiliations":[{"raw_affiliation_string":"Department of Hematology and the BMT, Trustwell Hospitals, 5, JC Rd, Vinobha Nagar, Sudhama Nagar, Bengaluru 560002, Karnataka, India","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025703065","display_name":"Nancy Dias","orcid":"https://orcid.org/0000-0001-5918-1457","observed_orcids":["https://orcid.org/0000-0001-5918-1457"]},"institutions":[{"id":"https://openalex.org/I186335123","display_name":"East Carolina University","ror":"https://ror.org/01vx35703","country_code":"US","type":"education","lineage":["https://openalex.org/I186335123"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Nancy Dias","raw_affiliation_strings":["Department of Nurse Science, East Carolina University, 4165F Health Science Building, Greenville, NC 27858, USA"],"raw_orcid":"https://orcid.org/0000-0001-5918-1457","affiliations":[{"raw_affiliation_string":"Department of Nurse Science, East Carolina University, 4165F Health Science Building, Greenville, NC 27858, USA","institution_ids":["https://openalex.org/I186335123"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017904569","display_name":"B. Premjith","orcid":"https://orcid.org/0000-0003-1188-1838","observed_orcids":["https://orcid.org/0000-0003-1188-1838"]},"institutions":[{"id":"https://openalex.org/I81556334","display_name":"Amrita Vishwa Vidyapeetham","ror":"https://ror.org/03am10p12","country_code":"IN","type":"education","lineage":["https://openalex.org/I81556334"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Premjith Bhavukam","raw_affiliation_strings":["Department of Artificial Intelligence, Amrita School of Artificial Intelligence, Amrita Vishwa Vidyapeetham, Coimbatore 641112, Tamil Nadu, India"],"raw_orcid":"https://orcid.org/0000-0003-1188-1838","affiliations":[{"raw_affiliation_string":"Department of Artificial Intelligence, Amrita School of Artificial Intelligence, Amrita Vishwa Vidyapeetham, Coimbatore 641112, Tamil Nadu, India","institution_ids":["https://openalex.org/I81556334"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049209869","display_name":"Renjitha Bhaskaran","orcid":"https://orcid.org/0000-0001-5630-5776","observed_orcids":["https://orcid.org/0000-0001-5630-5776"]},"institutions":[{"id":"https://openalex.org/I1282879092","display_name":"Amrita Institute of Medical Sciences and Research Centre","ror":"https://ror.org/05ahcwz21","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I1282879092"]},{"id":"https://openalex.org/I81556334","display_name":"Amrita Vishwa Vidyapeetham","ror":"https://ror.org/03am10p12","country_code":"IN","type":"education","lineage":["https://openalex.org/I81556334"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Renjitha Bhaskaran","raw_affiliation_strings":["Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi 682041, Kerala, India"],"raw_orcid":"https://orcid.org/0000-0001-5630-5776","affiliations":[{"raw_affiliation_string":"Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi 682041, Kerala, India","institution_ids":["https://openalex.org/I1282879092","https://openalex.org/I81556334"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5103704298","display_name":"KT Moly","orcid":"https://orcid.org/0000-0003-3664-1718","observed_orcids":["https://orcid.org/0000-0003-3664-1718"]},"institutions":[{"id":"https://openalex.org/I81556334","display_name":"Amrita Vishwa Vidyapeetham","ror":"https://ror.org/03am10p12","country_code":"IN","type":"education","lineage":["https://openalex.org/I81556334"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Kaippaplakal Thamikkutty Moly","raw_affiliation_strings":["Department of Medical Surgical Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Health Sciences Campus, Kochi 682041, Kerala, India"],"raw_orcid":"https://orcid.org/0000-0003-3664-1718","affiliations":[{"raw_affiliation_string":"Department of Medical Surgical Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Health Sciences Campus, Kochi 682041, Kerala, India","institution_ids":["https://openalex.org/I81556334"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5112965663"],"corresponding_institution_ids":["https://openalex.org/I81556334"],"apc_list":{"value":2600,"currency":"CHF","value_usd":3137},"apc_paid":{"value":2600,"currency":"CHF","value_usd":3137},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"16","issue":"22","first_page":"3714","last_page":"3714"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12172","display_name":"Neutropenia and Cancer Infections","score":0.7153000235557556,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12172","display_name":"Neutropenia and Cancer Infections","score":0.7153000235557556,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.2791000008583069,"subfield":{"id":"https://openalex.org/subfields/2706","display_name":"Critical Care and Intensive Care Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11961","display_name":"Neonatal and Maternal Infections","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7983999848365784},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.680899977684021},{"id":"https://openalex.org/C58471807","wikidata":"https://www.wikidata.org/wiki/Q327120","display_name":"Receiver operating characteristic","level":2,"score":0.6582000255584717},{"id":"https://openalex.org/C2777671062","wikidata":"https://www.wikidata.org/wiki/Q6889402","display_name":"Early warning score","level":2,"score":0.6520000100135803},{"id":"https://openalex.org/C2778384902","wikidata":"https://www.wikidata.org/wiki/Q183134","display_name":"Sepsis","level":2,"score":0.48429998755455017},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.45249998569488525},{"id":"https://openalex.org/C11783203","wikidata":"https://www.wikidata.org/wiki/Q5478027","display_name":"Framingham Risk Score","level":3,"score":0.4348999857902527},{"id":"https://openalex.org/C76318530","wikidata":"https://www.wikidata.org/wiki/Q16833590","display_name":"Area under the curve","level":2,"score":0.43050000071525574},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.4025999903678894},{"id":"https://openalex.org/C48921125","wikidata":"https://www.wikidata.org/wiki/Q10861030","display_name":"Linear regression","level":2,"score":0.3894999921321869},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3772999942302704},{"id":"https://openalex.org/C2776376669","wikidata":"https://www.wikidata.org/wiki/Q5094647","display_name":"Intensive care unit","level":2,"score":0.3303000032901764},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.32499998807907104},{"id":"https://openalex.org/C198433322","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value of tests","level":2,"score":0.3118000030517578},{"id":"https://openalex.org/C8213797","wikidata":"https://www.wikidata.org/wiki/Q754250","display_name":"Respiratory rate","level":4,"score":0.3075000047683716},{"id":"https://openalex.org/C35785553","wikidata":"https://www.wikidata.org/wiki/Q756720","display_name":"Ambulatory","level":2,"score":0.2915000021457672},{"id":"https://openalex.org/C84393581","wikidata":"https://www.wikidata.org/wiki/Q82642","display_name":"Blood pressure","level":2,"score":0.2896000146865845},{"id":"https://openalex.org/C45804977","wikidata":"https://www.wikidata.org/wiki/Q7239673","display_name":"Predictive modelling","level":2,"score":0.2718000113964081},{"id":"https://openalex.org/C2781381097","wikidata":"https://www.wikidata.org/wiki/Q5133843","display_name":"Clinical prediction rule","level":2,"score":0.26260000467300415},{"id":"https://openalex.org/C119043178","wikidata":"https://www.wikidata.org/wiki/Q320723","display_name":"Covariate","level":2,"score":0.2597000002861023},{"id":"https://openalex.org/C83546350","wikidata":"https://www.wikidata.org/wiki/Q1139051","display_name":"Regression","level":2,"score":0.25929999351501465},{"id":"https://openalex.org/C27181475","wikidata":"https://www.wikidata.org/wiki/Q541014","display_name":"Cross-validation","level":2,"score":0.2524000108242035}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/diagnostics16223714","doi":"https://doi.org/10.3390/diagnostics16223714","is_oa":true,"landing_page_url":"https://doi.org/10.3390/diagnostics16223714","pdf_url":null,"source":{"id":"https://openalex.org/S4210172076","display_name":"Diagnostics","issn_l":"2075-4418","issn":["2075-4418"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostics","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/diagnostics16223714","doi":"https://doi.org/10.3390/diagnostics16223714","is_oa":true,"landing_page_url":"https://doi.org/10.3390/diagnostics16223714","pdf_url":null,"source":{"id":"https://openalex.org/S4210172076","display_name":"Diagnostics","issn_l":"2075-4418","issn":["2075-4418"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Diagnostics","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":33,"referenced_works":["https://openalex.org/W1985383810","https://openalex.org/W2028896946","https://openalex.org/W2059121696","https://openalex.org/W2064799866","https://openalex.org/W2123859227","https://openalex.org/W2129964772","https://openalex.org/W2280404143","https://openalex.org/W2324602138","https://openalex.org/W2400385987","https://openalex.org/W2554805785","https://openalex.org/W2897716519","https://openalex.org/W2945806301","https://openalex.org/W2983306000","https://openalex.org/W2986923540","https://openalex.org/W2998075038","https://openalex.org/W3006918655","https://openalex.org/W3009112053","https://openalex.org/W3012413426","https://openalex.org/W3023757607","https://openalex.org/W3030319168","https://openalex.org/W3047402734","https://openalex.org/W3216608404","https://openalex.org/W4205111439","https://openalex.org/W4210993322","https://openalex.org/W4224865966","https://openalex.org/W4256618988","https://openalex.org/W4392000903","https://openalex.org/W4402017447","https://openalex.org/W4402062503","https://openalex.org/W4403380926","https://openalex.org/W4410464754","https://openalex.org/W4412033881","https://openalex.org/W7167932196"],"related_works":[],"abstract_inverted_index":{"Background/Objectives:":[0],"Febrile":[1],"neutropenia":[2],"(FN)":[3],"in":[4,62,69,267],"hematologic":[5],"malignancies":[6],"carries":[7],"a":[8,15,19,63,98,190],"high":[9],"risk":[10,23],"of":[11,56,101,187,193,205,208,213,275],"sepsis.":[12],"We":[13],"developed":[14],"regression":[16,116,172],"model":[17,173],"and":[18,34,37,76,90,109,120,137,145,165,189,198,210,237,246,257],"simplified":[20],"nurse-led":[21],"sepsis":[22],"score":[24],"using":[25,94],"artificial":[26],"intelligence":[27],"(AI)-enabled":[28],"remote":[29],"patient":[30],"monitoring":[31],"(RPM)":[32],"measurements":[33,103],"routine":[35],"clinical":[36,252],"laboratory":[38],"variables.":[39],"Methods:":[40],"A":[41],"nested":[42],"case\u2013control":[43],"study":[44],"included":[45],"120":[46],"adult":[47],"FN":[48,57],"episodes":[49],"(40":[50],"Sepsis-3-defined":[51],"cases":[52],"within":[53],"14":[54],"days":[55],"onset;":[58],"80":[59],"matched":[60],"controls)":[61],"hematology/bone":[64],"marrow":[65],"transplantation":[66],"unit":[67],"(BMT)":[68],"India":[70,276],"(December":[71],"2021\u2013December":[72],"2024).":[73],"Heart":[74],"rate":[75,78],"respiratory":[77],"were":[79,92,112,260],"obtained":[80,93],"by":[81],"ballistocardiography;":[82],"blood":[83],"pressure":[84],"(BP),":[85],"peripheral":[86],"oxygen":[87],"saturation":[88],"(SpO2),":[89],"temperature":[91],"connected":[95],"probes.":[96],"Only":[97],"single":[99],"set":[100],"FN-onset":[102],"was":[104,150,182,219],"analyzed;":[105],"longitudinal":[106],"RPM":[107],"trends":[108],"platform-generated":[110],"alerts":[111],"excluded.":[113],"Conditional":[114],"logistic":[115],"identified":[117],"independent":[118,248],"predictors":[119,138],"supplied":[121],"coefficients":[122],"for":[123,234,244],"an":[124,168,202],"integer-weighted":[125],"score.":[126,170],"Regression-model":[127,228],"validation":[128,250,264],"used":[129],"two":[130],"1000-resample":[131],"bootstrap":[132],"analyses:":[133],"one":[134],"holding":[135],"cut-offs":[136],"fixed,":[139],"the":[140,176],"other":[141],"repeating":[142],"cut-off":[143,196,235],"determination":[144,197,236],"backward":[146],"selection.":[147,239],"Integer-score":[148,240],"discrimination":[149,229],"assessed":[151],"separately.":[152],"Results:":[153],"Six":[154],"predictors\u2014tachycardia,":[155],"hypotension,":[156],"\u22652":[157],"comorbidities,":[158],"absolute":[159],"neutrophil":[160],"count":[161],"<99.5":[162],"cells/\u03bcL,":[163],"chills,":[164],"elevated":[166],"procalcitonin\u2014formed":[167],"8-point":[169],"The":[171,215],"area":[174],"under":[175],"receiver":[177],"operating":[178],"characteristic":[179],"curve":[180],"(AUC)":[181],"0.847,":[183],"with":[184],"fixed-specification":[185],"optimism":[186,207,225,245],"0.028":[188],"corrected":[191,211],"AUC":[192,204,212,218],"0.819.":[194,214],"Repeating":[195],"predictor":[199,238],"selection":[200],"yielded":[201],"apparent":[203,217],"0.855,":[206],"0.036,":[209],"integer-score":[216],"0.654":[220],"(95%":[221],"CI":[222],"0.567\u20130.740),":[223],"without":[224],"correction.":[226],"Conclusions:":[227],"remained":[230],"similar":[231],"after":[232],"accounting":[233],"performance":[241],"remains":[242],"uncorrected":[243],"requires":[247],"temporal":[249],"before":[251],"use.":[253],"RPM\u2019s":[254],"AI":[255],"functions":[256],"continuous-monitoring":[258],"benefits":[259],"not":[261],"evaluated.":[262],"Temporal":[263],"is":[265],"planned":[266],"Phase":[268],"II.":[269],"Trial":[270],"registration:":[271],"Clinical":[272],"Trials":[273],"Registry":[274],"(CTRI/2025/06/088290).":[277]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-11T00:00:00"}