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Pediatric Critical Care Medicine www.pccmjournal.org 691 preceding work points to the potential utility of sophisticated signal analysis for novel therapeutic guidance and risk stratification, the study by Eytan et al (8) does little to lay additional brick along this path (5–7). Further, most modern EHRs require a human to approve or “sign-off” on documented vital signs that automatically populate hourly from a bedside monitor, providing intelligent scrubbing of inaccurate representations of patient state. The authors conclude that their findings support capturing high-frequency data from patient care, although it seems more work is necessary to first determine which measures of variability and complexity have the most prescient value in patient management when compared with other common illness indicators. Numerous confounders, such as the effects of inotropes, presence of mechanical ventilation, administration of sedative-analgesic medications, and environmental stimuli such as nursing assessments, to name a few, were not accounted for in the present analyses but almost certainly had some effects on the measures of interest. That objective documentation is an incomplete representation of a patient’s state is not a particularly surprising finding. If the health record offered a sufficiently comprehensive vantage of a patient’s condition, bedside assessments by physicians would be largely unnecessary. It may be, however, that there are additional, important summary data which could lend even more insight into a patient’s physiologic state and may prove useful for nuanced treatment decisions, such as deciding between fluid administration versus vasopressor initiation for a patient with hypotension. Indeed, it may already be that intuitive recognition of such esoteric features is part of what separate master clinicians from less experienced physicians and providers. The work by Eytan et al (8) is an essential step toward explicit characterization of vital sign patterns that may further our understanding of intensive care physiology and eventually support the development of more individualized therapeutic regimens.