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Machine learning to predict poor school performance in paediatric survivors of intensive care: a population-based
Patricia Gilholm1, Kristen Gibbons1, Sarah Brüningk2,3
1Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Insights
A new machine learning model predicts poor school outcomes for children after intensive care unit (ICU) stays. This tool helps identify children needing extra support for better long-term educational success.
Area of Science:
- Pediatric critical care medicine
- Machine learning in healthcare
- Educational outcome prediction
Background:
- Improved survival rates in pediatric intensive care units (ICUs) highlight the need for tools to predict long-term outcomes.
- Current methods lack the ability to forecast educational challenges for childhood ICU survivors.
Purpose of the Study:
- To develop and validate a machine learning model for predicting poor school outcomes in children following ICU admission.
- To identify key factors contributing to educational difficulties in pediatric ICU survivors.
Main Methods:
- A population-based study analyzed data from children under 16 admitted to ICUs in Queensland, Australia (1997-2019).
- The primary outcome was failure to meet the National Minimum Standard (NMS) in the National Assessment Program-Literacy and Numeracy (NAPLAN) tests.
- Machine learning classifiers were trained and validated using routine ICU data and stratified nested cross-validation.
Main Results:
- The study included 13,957 ICU survivors with 37,200 NAPLAN tests over a median 6-year follow-up.
- The model achieved an Area Under the Receiver Operating Characteristic curve (AUROC) of 0.8, predicting NMS failure with 85% sensitivity and 51% specificity.
- Socio-economic status, illness severity, and neurological, congenital, and genetic disorders were significant predictors.
Conclusions:
- A machine learning model utilizing data available at ICU discharge can predict educational difficulties in school-aged children.
- This predictive tool can aid in prioritizing patients for follow-up care and targeted rehabilitation interventions.
- The model offers a promising approach to support the long-term well-being of pediatric ICU survivors.
Purpose:
Whilst survival in paediatric critical care has improved, clinicians lack tools capable of predicting long-term outcomes. We developed a machine learning model to predict poor school outcomes in children surviving intensive care unit (ICU).
Methods:
Population-based study of children < 16 years requiring ICU admission in Queensland, Australia, between 1997 and 2019. Failure to meet the National Minimum Standard (NMS) in the National Assessment Program-Literacy and Numeracy (NAPLAN) assessment during primary and secondary school was the primary outcome. Routine ICU information was used to train machine learning classifiers. Models were trained, validated and tested using stratified nested cross-validation.
Results:
13,957 childhood ICU survivors with 37,200 corresponding NAPLAN tests after a median follow-up duration of 6 years were included. 14.7%, 17%, 15.6% and 16.6% failed to meet NMS in school grades 3, 5, 7 and 9. The model demonstrated an Area Under the Receiver Operating Characteristic curve (AUROC) of 0.8 (standard deviation SD, 0.01), with 51% specificity to reach 85% sensitivity [relative Area Under the Precision Recall Curve (rel-AUPRC) 3.42, SD 0.06]. Socio-economic status, illness severity, and neurological, congenital, and genetic disorders contributed most to the predictions. In children with no comorbidities admitted between 2009 and 2019, the model achieved a AUROC of 0.77 (SD 0.03) and a rel-AUPRC of 3.31 (SD 0.42).
Conclusions:
A machine learning model using data available at time of ICU discharge predicted failure to meet minimum educational requirements at school age. Implementation of this prediction tool could assist in prioritizing patients for follow-up and targeting of rehabilitative measures.
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