Benefits
- Benefit
-
Median time in hypotension fell from 32.7 to 8.0 minutes per patient
Awaiting review
- Outcome identifiers
-
Unresolved
Not reviewedUnresolved
- Category
-
Reduced Risk
Awaiting review
- Status
-
Reported benefit
Awaiting review
- Beneficiary groups
-
People.
Awaiting review
- Beneficiaries
-
Unresolved
Not reviewedUnresolved
- Reach
-
Unresolved
Not reviewedUnresolved
- Distribution and access
-
Unresolved
Not reviewedUnresolved
- Duration
-
Unresolved
Not reviewedUnresolved
- Expected?
-
Yes
Awaiting review
- Costs and harms
-
Unresolved
Not reviewedUnresolved
AI system
- System
-
Hypotension Prediction Index (HPI)
Awaiting review
- Model
-
This is an explicit unresolved assignment: the sources on record do not settle this question.
Not reviewedUnresolved
- Release
-
Unresolved
Not reviewedUnresolved
- Provider
-
Unresolved
Not reviewedUnresolved
- Role
-
Unresolved
Not reviewedUnresolved
- Configuration
-
Unresolved
Not reviewedUnresolved
- Inputs and outputs
-
Unresolved
Not reviewedUnresolved
- Autonomy
-
Unresolved
Not reviewedUnresolved
- Workflow
-
Clinicians received the index together with a hemodynamic diagnostic guidance and treatment protocol. Patients had invasive arterial blood pressure monitoring.
Awaiting review
- Human oversight
-
Unresolved
Not reviewedUnresolved
- Relation to AI
-
Patients were randomized to the early warning system with a protocol or to standard care, so the trial isolates the effect of the system and its protocol together.
Awaiting review
- AI contribution
-
Patients were randomized to the early warning system with a protocol or to standard care, so the trial isolates the effect of the system and its protocol together.
Awaiting review
Measurement
- Studies
- Study design
- Measurement
-
Study 1: Time-weighted average of mean arterial pressure below 65 mm Hg from continuous invasive monitoring. Study 2: Area and time-weighted area below the hypotension threshold from invasive monitoring. [1] [2]
- Setting and sample
-
Study 1: 68 randomized, 60 analyzed adults in elective noncardiac surgery, one tertiary center, May 2018 to March 2019. Study 2: 34 patients having esophageal or lung resection at one hospital in Zagreb, Croatia. [1] [2]
- Measures
-
Study 1: Time-weighted average of hypotension; minutes of hypotension. Study 2: Time-weighted area under the threshold of hypotension. [1] [2]
- Comparison
-
Study 1: Standard care. Study 2: Conventional pulse contour goal-directed therapy. [1] [2]
- Results
-
Study 1: 0.10 against 0.44 mm Hg; 8.0 against 32.7 minutes. Study 2: Time-weighted area 0.01 against 0.08 mmHg. [1] [2]
- Additional value from AI
-
Study 1: Median difference 0.38 mm Hg and 16.7 minutes. Study 2: Fewer and shorter hypotensive episodes. [1] [2]
- Limitations
-
Study 1: Small, unblinded, single center; physiological outcome only; funded by the developer. Study 2: Very small; underpowered for clinical outcomes; no outside funding. [1] [2]
Money
- Kind of value
-
The kind of monetary value is unclear.
Not reviewedUnresolved
- Amount
-
The monetary value is not established.
Not reviewedUnresolved
- Currency and prices
-
The currency and price basis are unclear.
Not reviewedUnresolved
- Period and unit
-
The period and unit of the monetary estimate are unclear.
Not reviewedUnresolved
- Realization
-
Whether the monetary value was realized is unclear.
Not reviewedUnresolved
- Recipients and payers
-
The recipients and payers are unclear.
Not reviewedUnresolved
- Gross or net
-
Whether the monetary figure includes costs is unclear.
Not reviewedUnresolved
- Included costs
-
The costs included in the estimate are unclear.
Not reviewedUnresolved
- Comparison
-
The financial comparison is not established.
Not reviewedUnresolved
- Method
-
The method used to calculate monetary value is unclear.
Not reviewedUnresolved
- Return and payback
-
The return on investment or payback period is not established.
Not reviewedUnresolved
People and places
- Participants
-
Developer: Edwards Lifesciences. Operator: Amsterdam UMC, location AMC.
Awaiting review
- Jurisdictions
-
Benefit: Amsterdam UMC, location AMC, Amsterdam, the
Netherlands. Developer: 
United States. Operator: Netherlands.Awaiting review
- Ownership and control
-
Unresolved
Not reviewedUnresolved
- Dependencies
-
Unresolved
Not reviewedUnresolved
- Cross-border connections
-
Unresolved
Not reviewedUnresolved
- Geopolitical implications
-
The geopolitical implications are unclear.
Not reviewedUnresolved
Follow-up
- Conditions for replication
-
Clinicians must act on alerts with the protocol. Patients must have arterial waveform monitoring.
Awaiting review
- Replication attempts
-
3 follow-up entries. Benefit recurred: 2. Benefit did not recur: 1.
Awaiting review
- Later findings
-
1 December 2020. A pilot randomized trial of index guidance in moderate- to high-risk noncardiac surgery found no reduction in hypotension.
Awaiting review
- Availability
-
Unresolved
Not reviewedUnresolved
- Institutional decision
-
A relevant institutional decision has not been established.
Not reviewedUnresolved
- Grounds
-
The grounds for an institutional decision are unclear.
Not reviewedUnresolved
- Action and result
-
The result of an institutional decision is not established.
Not reviewedUnresolved
- Success criterion
-
The criterion for a successful institutional decision is unclear.
Not reviewedUnresolved
Evidence
- Source numbers
-
AIBD-0636-source-0001–0002
Awaiting review
- Citations
-
Numbered references below.
Awaiting review
- Language
-
Unresolved
Not reviewedUnresolved
- Source relationships
-
Developer, Independent
Awaiting review
- Original evidence
-
Unresolved
Not reviewedUnresolved
- Access and versions
-
Unresolved
Not reviewedUnresolved
- Supported findings
-
Unresolved
Not reviewedUnresolved
- Evidence links
-
Unresolved
Not reviewedUnresolved
- Evidence strength
-
Independently studied. Sources: one independent peer-reviewed study and the makers' peer-reviewed study. The cited evidence includes no finding by a regulator or court. [1] [2]
- Missing evidence
-
Unresolved
Not reviewedUnresolved
Grades
- Assessed benefits
-
People.
Awaiting review
- Depth
-
People: 2.
Awaiting review
- Reasons
-
People: Median time in hypotension per patient fell from 32.7 to 8.0 minutes during surgery.
Awaiting review
- Observed or intended
-
Unresolved
Not reviewedUnresolved
- Rubric
-
Unresolved
Not reviewedUnresolved
- Assessor and date
-
Unresolved
Not reviewedUnresolved
- Alternative assessments
-
Unresolved
Not reviewedUnresolved
- Fill
-
Independently studied
Awaiting review
Entry details
- Kind
-
The case describes an evaluation or a study. A randomized trial. [1]
Fully reviewed: supporting details for Kind
Review date: 29 October 2026.
Sources: [1]
- Related entries
-
No incident in the AI Incident Database snapshot of 26 October 2026 concerns the same kind of system harming the same kind of stakeholder.
Partly reviewedUnresolved: supporting details for Related entries
Compared with the incidents in the AI Incident Database snapshot of 26 October 2026.
- Field
-
Healthcare.
Awaiting review
- Purpose
-
The index was built to predict hypotension minutes before it happens so that clinicians can prevent it. Less hypotension was that purpose.
Awaiting review
- Dates
-
Observed: March 2019. Updated: 29 October 2026.
Awaiting review
- Stage
-
The system was used in a pilot. A preliminary single-center trial. [1]
Fully reviewed: supporting details for Stage
Review date: 29 October 2026.
Sources: [1]
- Version
-
SHA-256: 37d060d43cf7…
Awaiting review: supporting details for Version
SHA-256 of the public case, its assessments, and its displayed answers and notes, excluding its own identifier and the derived coverage summary.
References
- Other identifiers
-
Unresolved
Not reviewedUnresolved
- Category mappings
-
Unresolved
Not reviewedUnresolved
- Citable summary
-
Unresolved
Not reviewedUnresolved
- Revisions
-
1 revision. Latest: 29 October 2026.
Awaiting review
Sources
-
Peer-reviewed study Developer
Wijnberge M, Geerts BF, Hol L, et al. Effect of a Machine Learning-Derived Early Warning System for Intraoperative Hypotension vs Standard Care on Depth and Duration of Intraoperative Hypotension During Elective Noncardiac Surgery: The HYPE Randomized Clinical Trial. JAMA. 2020;323(11):1052-1060.
The median time of hypotension per patient was 8.0 minutes (IQR, 1.33-26.00 minutes) in the intervention group vs 32.7 minutes (IQR, 11.5-59.7 minutes) in the control group
-
Peer-reviewed study Independent author
Šribar A, Jurinjak IS, Almahariq H, et al. Hypotension prediction index guided versus conventional goal directed therapy to reduce intraoperative hypotension during thoracic surgery: a randomized trial. BMC Anesthesiol. 2023;23:101.
In the studied cohort, use of machine learning algorithm guided hemodynamic optimization (HPI) significantly reduced the number and duration of intraoperative hypotensive episodes, as well as AUT and the primary outcome-TWA of AUT.