— Living knowledge base

Road to CEPAS 2026

A 26-week public series on AI and neonatal sepsis prediction, built toward a 20-minute talk in Lyon on 31 October 2026. Twelve essays. One growing literature base. One honest argument.

Episode 04 of 12 · Updated 17 Jun 2026
— The argument

Prediction is not the same as clinical utility.

The field can predict late-onset sepsis in preterm neonates reasonably well. It has been able to for years. There is no shortage of models with respectable ROC curves, and our group has contributed to that pile.

What no one has done is build the bridge from prediction to clinical utility. We have models. We do not have validated response protocols. We do not have implementation data at scale. We do not have answers to the question that follows every alarm: now what?

That gap is the subject of this series, and the central argument of the talk in Lyon.

— The series

Twelve essays through October. One postscript from Lyon.

01
Framing & argument · the gap between prediction and action
02
Live PubMed search with Claude · queries archived · seven-group field map · methodology log
03
Four anchor papers, eight-dimension cross-study comparison · comparison grid
04
Critical self-appraisal of the 2023 LOS prediction paper · signal stack, alarm policy, and the proxy at the centre · methodology log
05
The Model Leaves the Lab
EU MDR/IVDR · what European medical-device regulation requires of a system like this
Upcoming
06
The Omics Layer
Literature synthesis · where omics meets ML in NICU sepsis
Upcoming
07
Doing a Mini Systematic Review with AI
Full PICO → search → screen → extract → synthesize pipeline
Upcoming
08
Big Data in the NICU — What Actually Exists
Data landscape mapping · registries, EHRs, monitor streams
Upcoming
09
HeRO and Friends — The Commercial Reality
MDR/CE marking, regulatory landscape, what's on the market
Upcoming
10
Building the Evidence Website
How this knowledge base was built · the meta-episode
Upcoming
11
The Presentation Takes Shape
Slide logic, narrative structure, the final argument
Upcoming
12
See You in Lyon
Final teaser · what to expect on stage
Upcoming
13
From the Stage
Slides, recording, audience Q&A · post-congress
After CEPAS
— Literature base

Every search, every paper, every choice — archived here.

From Episode 02 onwards, the evidence work behind every essay lives on this page. PubMed queries with their results. Extraction tables with their data. Methodological choices with their reasoning. By the time of the talk, you should be able to see the full chain of reasoning from raw literature to final slide — and copy the workflow if it helps you.

Episode 02 added: the seven academic groups doing continuous-physiology machine-learning work on late-onset sepsis prediction in preterm infants, plus the two systematic reviews that frame the field. Full methodology log with verbatim PubMed queries is on the Episode 02 search page.

Episode 03 added: the eight-dimension comparative deep-read of the four anchor papers — Berg 2023, Kausch 2023, Yang 2024, Meeus 2024 — across cohort design, signal stack, ML methodology, validation, performance, alarm policy, limitations, and contributions. The full grid, with the three supporting-cast papers and licensing notes, is on the Episode 03 comparison page.

Episode 04 added: the same two decisions — signal stack and alarm policy — turned onto our own paper, Berg 2023, read against its supplement. The detection-fraction-versus-precision framing, the sensitivity of the headline recall to the refractory period and true-positive window (supplement Tables S3, S7, S8), the blood-culture-time proxy, and an unresolved supplementary CRP discrepancy are set out on the Episode 04 methodology log.

— Branch A · Continuous-physiology ML for LOS in preterm infants
UVA / Med Predictive Science US
Kausch SL et al. 2023, Pediatric Research. 10.1038/s41390-022-02444-7
The HeRO heritage. Only multi-NICU external validation in the field — trained on UVA, validated at Columbia and Washington University. Pulse-rate-equals-ECG finding makes the model deployable on a standalone oximeter.
WKZ Utrecht NL
van den Berg M et al. 2023, Computers in Biology and Medicine. 10.1016/j.compbiomed.2023.107156
Largest single-center matched cohort in the field (292 LOS / 1,497 control). Alarm-fatigue framework with 8-hour shift-length refractory period and multi-threshold escalation, since adopted by Yang 2024 and Meeus 2024. Our paper.
Eindhoven / Máxima MC NL
Yang M et al. 2024, Computer Methods and Programs in Biomedicine. 10.1016/j.cmpb.2024.108335
Most thorough feature ablation in the field — tested raw waveforms vs 1 Hz vs 1/min vs 1/hour sampling, and HR alone vs HR+RR+SpO2 combinations. Sino-Dutch collaboration (Southeast University Nanjing on methodology, Máxima MC on data).
Antwerp / Innocens BV BE
Meeus M et al. 2024, Journal of Pediatrics. 10.1016/j.jpeds.2023.113869
Joint LOS and NEC prediction. Only commercial spinoff in the field (Innocens BV), currently navigating European MDR/CE certification.
Karolinska Institutet / KTH Stockholm SE
Honoré A et al. 2023, Acta Paediatrica. 10.1111/apa.16660
Bridges both branches — Naive Bayes combining heart-rate characteristics, respiratory and oxygenation signals, and clinical features. Senior co-authors wrote the Persad 2021 systematic review.
Rennes FR
Leon C et al. 2021, IEEE Journal of Biomedical and Health Informatics. 10.1109/JBHI.2020.3021662
Visibility-graph analysis of heart rate variability. Methodologically distinctive in the field — exploits non-linear graph properties rather than time-domain statistics.
Lausanne CH
Rio L et al. 2022, Pediatric Research. 10.1038/s41390-021-01913-9
The only independent real-world evaluation of the commercial HeRO score outside the US. Showed strong gestational-age-dependent performance — sensitivity 76% below 28 weeks, falling to 25% above 32 weeks.
— Systematic reviews
Koppens 2023 NL
Koppens HJ et al. 2023, Neonatology. 10.1159/000531118
Branch A systematic review (HRC monitoring for LOS in preterm). 15 papers, 8,230 infants. Concludes: "methodological weaknesses and limited generalizability do not justify implementation of HRC in clinical care. A large international RCT is warranted." This is the field's own policy verdict.
Kainth 2024 IN
Kainth D, Prakash S, Sankar MJ. 2024, Pediatric Infectious Disease Journal. 10.1097/INF.0000000000004409
Branch B systematic review (clinical and laboratory features). 19 studies, 76 ML models. Pooled AUROC 0.94 but 18 of 19 studies at high risk of bias, no external validation, almost all from high-income settings. Explicitly excludes vital-signs-only studies — the methodological line that separates the two branches.
— How this is built

A research method, made visible.

The series is built with Claude as a research and writing partner. Not as decoration — as the actual working method. PubMed searches, paper extraction, evidence tables, regulatory mapping, slide logic.

Every essay includes a "How I used Claude" section showing exactly where the AI helped and where it didn't. The methodology is the second deliverable. If you want to replicate it for your own field, everything you need will be here by October. The Episode 02 methodology log is the first full receipt.

— Destination

Lyon, 31 October 2026.

— The talk

Big data, AI and sepsis prediction opportunities in the NICU

A 20-minute talk for the Omics in Sepsis session at CEPAS 2026 — the first Congress of the European Paediatric Academic Societies.

Congress CEPAS 2026 · 1st of its kind
Dates 28–31 October 2026
Venue Centre de Congrès, Lyon
Session Omics in Sepsis · Sat 31 Oct, 10:30–11:30 CET
© 2026 Daniel Vijlbrief · Utrecht, NL