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Updated: Apr 30, 2026

Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma
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Subphenotyping prone position responders with machine learning.

Maxime Fosset1,2,3,4, Dario von Wedel1,2,5, Simone Redaelli1,2,6,7

  • 1Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Critical Care (London, England)
|March 15, 2025
PubMed
Summary
This summary is machine-generated.

Machine learning identified three acute respiratory distress syndrome (ARDS) subphenotypes in patients undergoing prone positioning, with one group showing significantly higher mortality. However, predicting response to prone positioning was not possible with current data.

Keywords:
ARDSClusteringMachine LearningPhenotypesPrecision MedicineProne Position

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Area of Science:

  • Critical Care Medicine
  • Respiratory Medicine
  • Data Science in Healthcare

Background:

  • Acute respiratory distress syndrome (ARDS) is a complex condition with variable patient responses to treatments like prone positioning.
  • Identifying distinct patient groups within ARDS is crucial for personalized treatment strategies.

Purpose of the Study:

  • To utilize machine learning to identify subphenotypes of ARDS patients undergoing prone positioning.
  • To assess the association between these subphenotypes and mortality and response to prone positioning.

Main Methods:

  • A retrospective analysis of 353 mechanically ventilated ARDS patients who received prone positioning.
  • Unsupervised machine learning applied to respiratory mechanics, oxygenation, and demographic data from the supine position.
  • Evaluation of 28-day mortality and response to prone positioning based on key respiratory parameters.

Main Results:

  • Three distinct ARDS subphenotypes were identified.
  • Subphenotype 3 exhibited significantly higher 28-day mortality (56%) compared to others.
  • No significant differences in response to prone positioning were observed across the identified subphenotypes.

Conclusions:

  • Distinct ARDS subphenotypes with differential mortality exist in patients undergoing prone positioning.
  • Current data and methods do not allow prediction of which patients benefit from prone positioning.
  • Further research using multimodal data is needed to better characterize ARDS heterogeneity.