CMH SCIENTIFIC · DEFERRA · ANAESTHESIOLOGY

Deferra

Controls physiologic alerts after intervention. It remains quiet while signal quality and the patient’s response are stable, requests measurement correction when the signal is inadequate, and escalates when the physiologic course or intervention-response relationship changes.
RETROSPECTIVE VALIDATION · REAL DATA
What should happen now?
NO INTERRUPTION
Signal is adequate. The course and response relation are both coherent, so there is no reason to interrupt.
Can the system trust the signal?YES
Has the course moved?NO
Has the response changed?NO
Enough evidence?NO · 0/4
Interactive physiologic stream
Accumulated observations
No alert is issued when the measurement is adequate and no supported physiologic change requires attention.
Shared information state
MeasurementSUFFICIENTCourseCOHERENTResponse relationCOHERENTStructural memoryUNCHALLENGEDAuthorityCLINICIANAutonomous controlNOT AUTHORIZEDDosing recommendationNOT AUTHORIZED
What changed
CMH Scientific · Deferra anaesthesiology demonstrationPhysiologic response stream · retrospective validation on real critical-care data

Validation & data provenance

The interaction shows Deferra routing on a physiologic response stream; the intervention-aware routing and physiologic-departure evidence are derived from real critical-care data.

MIMIC-IV norepinephrine / MAP routing4,473 analyzed routing states · 224 higher-departure and 4,249 stable/lower-departure states · clustered comparison across 337 ICU stays
PhysioNet Sepsis90,626 acute physiologic states · 27,984 high-surprise states in the departure analysis
Result boundaryIn MIMIC-IV departure states, the augmented signal reached 46.9% directional accuracy vs 20.5% clinician and 19.6% standard model; retrospective only
Boundary: no dose is recommended and no autonomous control is performed. The demo shows when the current relation is supported, departed, structurally changed, or requires more measurement.
Dataset / validation references
  1. Johnson AEW, Bulgarelli L, Shen L, et al. MIMIC-IV, a freely accessible electronic health record dataset. Sci Data. 2023;10:1. doi:10.1038/s41597-022-01899-x.
  2. Reyna MA, Josef CS, Jeter R, et al. Early Prediction of Sepsis From Clinical Data: The PhysioNet/Computing in Cardiology Challenge 2019. Crit Care Med. 2020;48(2):210–217. doi:10.1097/CCM.0000000000004145; dataset doi:10.13026/v64v-d857.
  3. Ewing MA. Intelligence Preserves the System It Assists. Research Square. 2026. doi:10.21203/rs.3.rs-10831345/v1. Direct intervention-aware routing validation, including MIMIC-IV MAP/norepinephrine control.
  4. Ewing MA. Intelligence Breaks the System It Controls. Research Square. 2026. doi:10.21203/rs.3.rs-10283184/v2. Precursor experiment motivating Deferra through vasopressor-associated trajectory deformation.