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How the anesthesia end time was charted

The charted anesthesia end time is a mixture of 4 ways of writing a clock time (ceiling_30min, ceiling_10min, ceiling_5min, clock_minute), modelled as an offset from a device time.

Date 2026-10-18
Status current
Methods Rounding, heaping and value resolution, Clinical and laboratory times
Variables Anesthesia end time

Background

  • Anaesthesia end is a charted event time with a 1-minute chronon.
  • It is almost entirely rounded: 95% fall on a 5-minute clock mark, with clear 10-minute preference.

Data

  • Anaesthesia ends from clinical_data.csv, modelled against the recording end.
  • Excluded: the anaesthesia ends derived from an imputed op end (stored with floating-point noise), the 1900 placeholder in case 4476, and two values outside the model range, case 3980 (+720 min, probably a 12-hour clock error) and case 4959 (+1,441 min, probably a date error).
  • 2,037 anaesthesia ends (32%) fall after the end of recording. This is plausible, since monitors come off before handover, but these cannot be checked against the signals.

Method

  • Anaesthesia end = recording end + G, with G a log-spline density (K = 8).
  • Nearest, floor and ceiling anchors were compared by BIC.
  • Modes at 5, 10, 30 minutes and the clock minute were fitted. Hour of day, emergency status and department were tested as covariates.

Results

Bar chart of charted times by minute past the hour, with tall bars on multiples of five.
The minute past the hour of every charted time: the heaps on multiples of 5, and at the standard first-case times, are the rounding modes the model fits.
  • Minutes :00, :10, :20, :30, :40 and :50 have 706–872 cases each, against 192–271 at the 5s. :00 and :30 are slightly higher (872 each).
  • Rounded ends are written up to the next mark: ceiling beats nearest by 168 BIC points and floor by 782. An end charted as 11:30 means "finished by 11:30".
  • Hour, emergency status and department made no difference.
  • On average the true end is about 4 min before the charted end, so anaesthesia durations computed from charted times run long by a few minutes.
  • Since vitaldb-resolution v0.6.0 (18 October; model version 2): the two out-of-range records are excluded (not corrected), and the stored and recomputed log-likelihoods now agree: the whole gap came from those two records. The parameters are unchanged.

Discussion

  • Ceiling rounding for anaesthesia end and floor rounding for op end together inflate charted emergence by about 6–7 min.
  • Correction: an earlier fit did not exclude the derived ends, because their noise (about 10⁻⁶ s) slipped under the test threshold. The model was refitted without them and with a wider offset range; the conclusions are unchanged.
  • Before v0.6.0 the package's log-likelihood differed from the stored one by +1,381.5: the two out-of-range records had been left in the fit at probability 10⁻³⁰⁰ (−690.8 each). They are constants, so the parameters were unaffected; model version 2 excludes them and the two now agree.

Observations it supports

Observation Status Summary
Anaesthesia record times on 5-minute marks are rounded up established An anaesthesia start or end entered on a 5-minute mark was rounded up to it: the event happened in the 5 minutes before, and on average a little earlier still. Clear for anaesthesia end; for anaesthesia start the margin is small, and the value model (How the anesthesia start time was charted) prefers rounding to the nearest mark.

Limitations

  • Ends charted after the recording stops cannot be validated against the signals.

Open questions

  • Two out-of-range end times as 12-hour or date errors (weakly supported hypothesis). Two anaesthesia-end records lie at 720 and 1,441 minutes, outside the modelled range. A 12-hour clock slip and a one-day date error are the obvious explanations; neither is confirmed.

Model

Model file: …/models/aneend.model.json. Read from the pinned snapshot of vitaldb-resolution at commit bb03ddfc8a (2026-10-18).

How a true value becomes the recorded one. The rules are tried in order: a record not taken by an earlier rule is taken by this one with the probability shown (where its condition holds); the last rule takes the rest. With no conditions, the shares follow directly.

Order Rule Rounds to Probability if reached Share of records
1 ceiling_30min 30 clock minute (ceiling) 1.8 % 1.8 %
2 ceiling_10min 10 clock minute (ceiling) 52.1 % 51.1 %
3 ceiling_5min 5 clock minute (ceiling) 87.1 % 41.0 %
4 clock_minute 1 clock minute (floor) the rest 6.1 %
Recorded resolution 1 min (chronon) (modelled at 1)
True-value density reference_offset_spline
Covariates ref (recording end clock, minutes)
Fitted on 6,254 records (clinical_data.csv)
BIC 23,456
Fitted 2026-10-18

Worked examples

Example Side Status Summary
A regression that carries rounding uncertainty through value draft Acute kidney injury after surgery against intraoperative urine output (mL/kg/h), fitted once on the recorded numbers and once per draw from the true-value distributions: the rounding moves 14% of cases across the oliguria threshold, but widens the confidence interval of the cohort's regression by at most 4%.
Oliguria labels for a prediction model value draft One label per patient, oliguric or not, from three rounded numbers: 10% of labels are uncertain and 2.6% are expected to be wrong, which sets a floor under the error any model can be measured to have. A typical model is barely affected; a good one is.
Urine output in mL/kg/h as a distribution value draft Intraoperative urine output per kilogram per hour, from three rounded inputs, as a probability distribution per case: one case in ten cannot be placed confidently on either side of 0.5 mL/kg/h.

Code

Tags: generated, vitaldb-resolution