A patient state is detected with at least one classification boundary generated by a supervised machine learning technique, such as a support vector machine. In some examples, the patient state detection is used to at least one of control the delivery of therapy to a patient, to generate a patient notification, to initiate data recording, or to evaluate a patient condition. In addition, an evaluation metric can be determined based on a feature vector, which is determined based on characteristics of a patient parameter signal, and the classification boundary. Example evaluation metrics can be based on a distance between at least one feature vector and the classification boundary and/or a trajectory of a plurality of feature vectors relative to the classification boundary over time.