深度学习模型预测运动压力测试结果:优化诊断测试选择策略,减少疑似冠状动脉疾病患者的浪费
Juan Lu1, Jonathon Stewart2, Mohammed Bennamoun3
1Department of Computer Science and Software Engineering, The University of Western Australia, Australia; Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia.
机器学习模型可以使用患者数据预测不确定的心脏炼应力测试 (EST) 结果. 这种方法有助于识别可能需要进行非诊断测试的患者,优化冠状动脉疾病 (CAD) 的诊断策略.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 机器学习 机器学习
背景情况:
- 心脏运动压力测试 (EST) 对于管理疑似冠状动脉疾病 (CAD) 至关重要.
- 很大一部分 (高达30%) 的 EST 结果是不确定的或非诊断性的,导致医疗资源被浪费.
- 预先预测这些非诊断结果对于有效的患者管理至关重要.
研究的目的:
- 开发能够预测EST结果的机器学习 (ML) 模型,包括不确或非诊断结果.
- 为了预测,利用现有的患者人口统计和预测临床信息.
- 为了确定可能在手术前进行不确定的测试的患者.
主要方法:
- 分析了30710名患者的大型队列.
- 患者的人口统计数据 (年龄,性别) 和测试前的临床信息被用作输入变量.
- 构建了各种ML模型并使用受体运行特征曲线 (AUC) 下的面积用于分辨功率进行比较.
主要成果:
- 一个遗忘决策树模型网络实现了最高的分辨力,AUC为0.83.
- 最好的模型显示了69%的灵敏度和0.78%的特异性,用于预测不确定的EST结果.
- 该模型在测试组中正确识别了2010年的不确定的EST.
结论:
- 使用人口统计和预测临床数据的ML模型可以准确预测EST结果.
- 开发的系统可以识别患有不确或非诊断性EST高风险的患者.
- 这种预测能力可以作为临床医生个性化的决策支持工具,优化测试选择并降低医疗保健成本.
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