在重症成人中开发和验证肌素清除预测器机器学习模型
Chao-Yuan Huang1, Fabian Güiza2, Pieter Wouters2
1Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
Critical care (London, England)
|July 6, 2023
概括
机器学习模型可以准确地预测重症患者的第二天肌素清除率 (CrCl). 这一进步有助于优化药物剂量,并识别有风险的个体,以便更好地进行临床管理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 生物统计学 生物统计学
背景情况:
- 肌素清除率 (CrCl) 对于评估重症患者的淋巴膜过率至关重要.
- 在临床实践中,每日CrCl变化需要可靠的预测方法.
研究的目的:
- 在重症患者中开发和验证第二天CrCl的预测模型.
- 将这些模型的性能与当前的临床实践参考方法进行比较.
主要方法:
- 梯度提升机 (GBM) 算法用于模型开发.
- 模型以EPaNIC试验 (2825名患者) 的数据进行训练,并在M@tric数据库 (9576名患者) 上进行外部验证.
- 开发了三个模型:"核心"",核心+BGA"和"核心+BGA+监控",包含不同的数据输入.
主要成果:
- 所有开发的模型在预测CrCl.Cl方面都超过了参考方法.
- "核心+BGA+监控"模型在外部验证中显示出最低的预测误差,平均绝对误差 (MAE) 为18.1毫升/分钟,根平均平方误差 (RMSE) 为28.9毫升/分钟.
- 参考方法显示MAE为20.6毫升/分钟,RMSE为40.1毫升/分钟.
结论:
- 常规收集的ICU数据可以准确地预测第二天的CrCl.
- 这些预测模型为水友性药物剂量调整提供了潜在的好处.
- 模型可以帮助根据危险概况对重症患者进行分层.
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