John Mark Ansermino

Professor

Research Interests

Global Health
Physiological Monitoring
Precision Health
Mobile Health
Outcome prediction
Sepsis in children
Artificial Intellegence
Automation in healthcare

Relevant Degree Programs

 

Research Methodology

Implementation science
Decision support
Digital solutions

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Postdoctoral Fellows
Any time / year round

Global health

I support public scholarship, e.g. through the Public Scholars Initiative, and am available to supervise students and Postdocs interested in collaborating with external partners as part of their research.

Graduate Student Supervision

Doctoral Student Supervision (Jan 2008 - Mar 2019)
Monitoring sleep and sleep breathing disorders using pulse oximeter photoplethysmogram (2018)

We developed novel algorithms for monitoring sleep, sleep breathing disorder (SBD)and instantaneous respiratory rate (IRR) in children using the characterization ofpulse oximetry photoplethysmogram (PPG). To evaluate the algorithms, we recordedthe oxygen saturation (SpO₂) and PPG signals from 160 children using a phone-basedoximeter consisting of a microcontroller-based pulse oximeter module interfacinga smartphone. This mobile oximeter was further developed to perform allprocessing on the smartphone through the audio interface.We evaluated the relative impact of SBD on sympathetic and parasympatheticactivity in children through the characterization of PPG and concluded that sympatheticactivity was higher in 30-second epochs with apnea/hypopnea event(s). Welater characterized the SpO₂ pattern in SDB and then combined SpO₂ pattern characterizationand PPG analysis to design a model with two binary logistic classifiersto identify the epochs with apnea/hypopnea events.We developed a novel model for identifying the cycles of random eye movement(REM) and non-REM of the overnight sleep based on the activity of cardiorespiratorysystem using the overnight PPG. We extracted the features associated withpulse rate variability (PRV), respiratory rate (RR), vascular tone and movementfrom PPG to build a model with two binary classifiers to identify wakefulness fromsleep (wake/sleep classifier) and REM from non-REM sleep (non-REM/REM classifier).We also developed a novel algorithm for extracting the instantaneous respiratoryrate (IRR) from PPG. The algorithm was performed in three steps: extractionof three respiratory-induced variation signals from PPG, estimation of IRR fromeach extracted respiratory-induced variation signal and fusion of IRR estimates. A time-frequency transform called synchrosqueezing transform (SST) was usedto extract the respiratory-induced variation signals from PPG. Later, a second SSTwas applied to estimate IRR from respiratory-induced variation signals. To fuseIRR estimates, a novel algorithm was proposed.This study would expand the functionality of conventional pulse oximetry beyondthe measurement of heart rate and SpO₂ to monitor sleep, to screen SBDs andmeasure the respiratory rate continuously and instantly.

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The fullPIERS risk prediction model for women with pre-eclampsia : external validation, recalibration and added value of a novel biomarker (placental growth factor) (2017)

The hypertensive disorders of pregnancy (HDPs), including pre-eclampsia, complicate up to 10% of pregnancies and are leading causes of maternal and perinatal morbidity and mortality. The fullPIERS model was developed to identify and quantify the risks of developing complications for women with pre-eclampsia in high-resource settings and to aid clinicians in managing such pregnancies. Prior to introducing the model into clinical practice, it is important to assess its external validity. Recalibration, if required, and addition of new biomarkers may be helpful to improve the predictive performance of the model. The objectives of this thesis were (i) to assess the external validity of the fullPIERS risk prediction model for women with pre-eclampsia (ii) recalibrate the model if necessary, and (iii) to assess the incremental value of adding the biomarker, placental growth factor (PlGF), to the model.Using abstracted medical records of women admitted into tertiary units in four high-income countries (HICs), the fullPIERS model was assessed for geographical and temporal validity. The model’s predictive ability in women with a broader spectrum of disease including early-onset pre-eclampsia, other HDPs and low and middle-income countries was also assessed using existing cohorts. Good performance was interpreted based on discrimination (AUROCs ≥0.7) and calibration (slope ≥ 0.7). Stratification and classification accuracy of the model were also assessed. The fullPIERS model showed good discriminatory performance on temporal and geographical validity (AUROCs >0.8) and also in broader HDPs (AUROCs >0.7). Medium to high likelihood ratios were estimated (>5 to >10) at a predicted probability cut-off of ≥30% for ruling in adverse maternal outcomes. Calibration was reduced in all cohorts (
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Recent Tri-Agency Grants

The following is a selection of grants for which the faculty member was principal investigator or co-investigator. Currently, the list only covers Canadian Tri-Agency grants from years 2013/14-2016/17 and excludes grants from any other agencies.

  • VitalPAD: An intelligent monitoring and communication device to optimize safety in the pediatric intensive care unit - Canadian Institutes of Health Research (CIHR) - Project Scheme: 2016 1st Live Pilot (2016/2017)
  • Certifiably safe closed-loop control for anesthesia - Canadian Institutes of Health Research (CIHR) - Proof of Principle Phase 1 (2015/2016)
  • The fullPIERS risk prediction model for women with pre-eclampsia: External validation and added value of a novel biomarker - Canadian Institutes of Health Research (CIHR) - Operating Grant (2014/2015)
  • The Canadian STRIDER Trial: Sildenafil for dismal prognosis IUGR - Canadian Institutes of Health Research (CIHR) - Operating Grant (2014/2015)
  • LungFIT: A smartphone system for pulmonary rehabilitation - Canadian Institutes of Health Research (CIHR) - Catalyst Grant (2013/2014)
  • Closed-loop control of anesthesia - Canadian Institutes of Health Research (CIHR) - Collaborative Health Research Projects (2013/2014)
  • People and planet friendly home - Natural Sciences and Engineering Research Council of Canada (NSERC) - Collaborative Research and Development Grants - Project (2013/2014)
  • MAG-CP: Magnesium sulphate for fetal neuroprotection of the preterm infant - Canadian Institutes of Health Research (CIHR) - Operating Grant (2013/2014)
  • Preventing severe maternal morbidity - Canadian Institutes of Health Research (CIHR) - Emerging Team Grant (2013/2014)
  • Stipend: Development and evaluation of a mobile patient monitoring device for intensive care unit nurses - Canadian Institutes of Health Research (CIHR) - CIHR Fellowship (2013/2014)
  • The phone oximeter: A simple, mobile device for the management of respiratory disease in the community - Natural Sciences and Engineering Research Council of Canada (NSERC) - Collaborative Health Research Projects (2013/2014)
  • Engineers in scrubs - fostering innovation in medical technologies through deep understanding of clinical needs - Natural Sciences and Engineering Research Council of Canada (NSERC) - Collaborative Research and Training Experience (CREATE) Program (2013/2014)
 
 

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