Automated Pediatric Delirium Recognition via Deep Learning-Powered Video Analysis

Delirium is an acute, fluctuating state of consciousness disturbance characterized by cognitive alterations and perceptual disturbances. Pediatric delirium has a notably higher incidence rate than adult delirium, and it is time-consuming and labor-intensive for clinicians to analyze, requiring effective recognition approaches. Deep learning has shown potential for the extraction of robust representations and improvement of patient outcomes. In this study, 129 video samples labeled by professional clinicians were collected from multiple hospitals, including 74 non-delirium and 55 delirium labeled samples. An 18-layer deep spatiotemporal convolutional neural network is employed, in which two-dimensional and one-dimensional convolutional filters are applied to individual video frames to extract frame-level and inter-frame-level features, respectively. The entire architecture is pretrained on a large-scale video analysis dataset, and a three-layer fully connected classification head is integrated for the delirium recognition task. The proposed model was fine-tuned with a training dataset and evaluated on a testing dataset, exploring various models and strategies. The proposed algorithm demonstrated robust classification performance, achieving an accuracy of 0.8718, precision of 0.8711, recall of 0.8730, and F1-score of 0.8715, with approximately 31.54 million model parameters. These metric results validate the clinical applicability and technical reliability of the model under various training and testing strategies. In addition, the developed delirium classification model is deployed a hospital system to enable intelligent video diagnosis. The independent test accuracy for 100 newly collected samples is 0.8800. Therefore, the proposed algorithm enables new methods for pediatric delirium recognition and cures.