Estimating patient's clinical state from multiple concurrent physiological streams plays an important role in determining if a therapeutic intervention is necessary and for triaging patients in the hospital. In this paper we construct a non-parametric learning algorithm to estimate the clinical state of a patient. The algorithm addresses several known challenges with clinical state estimation such as eliminating bias introduced by therapeutic intervention censoring, increasing the timeliness of state estimation while ensuring a sufficient accuracy, and the ability to detect anomalous clinical states. These benefits are obtained by combining the tools of non-parametric Bayesian inference, permutation testing, and generalizations of the empirical Bernstein inequality. The algorithm is validated using real-world data from a cancer ward in a large academic hospital.

Thank you for the submission. There are a few points of clinical clarity. The more targeted goal that is in line with other models in this area is to predict clinical deterioration (a shift in patient condition that requires a higher level of care). The goal of "clinical state" is less about understanding what it is but how shifts in the state drive an intervention (i.e. ICU transfer) (2) The authors should clarify the use case they describe.

Estimating patient's clinical state from multiple concurrent physiological streams plays an important role in determining if a therapeutic intervention is necessary and for triaging patients in the hospital. In this paper we construct a non-parametric learning algorithm to estimate the clinical state of a patient. The algorithm addresses several known challenges with clinical state estimation such as eliminating bias introduced by therapeutic intervention censoring, increasing the timeliness of state estimation while ensuring a sufficient accuracy, and the ability to detect anomalous clinical states. These benefits are obtained by combining the tools of non-parametric Bayesian inference, permutation testing, and generalizations of the empirical Bernstein inequality. The algorithm is validated using real-world data from a cancer ward in a large academic hospital.