使用基于电子健康记录数据的机器学习因果概率网络算法预测败血症发病
John Karlsson Valik1,2, Logan Ward3,4, Hideyuki Tanushi5
1Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden. john.karlsson.valik@ki.se.
Scientific reports
|July 20, 2023
概括
一个新的机器学习模型SepsisFinder,准确地预测毒症发作,使用在ICU外的电子健康记录. 这种早期预警系统可以识别高风险的患者,潜在地提高生存率和指导干预措施.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的机器学习
- 关键护理医学 关键护理医学
背景情况:
- 败血症是医院死亡的主要原因,早期检测对生存至关重要.
- 目前的败血症预测模型通常集中在重症监护室 (ICU) 患者身上,错过了早期干预的机会.
- 医疗保健数据的数字化使得能够开发自动预测工具,以便快速识别败血症.
研究的目的:
- 开发和验证一种机器学习模型,用于在ICU外使用常规电子健康记录 (EHR) 数据进行早期败血症预测.
- 为了比较开发模型的性能与已建立的方法,如国家早期预警分数2 (NEWS2).
- 评估该模型在促进及时临床干预和改善患者治疗结果方面的潜力.
主要方法:
- 分析了82852例住院病例和8038例败血症病例 (败血症-3标准) 的队列.
- 开发了一种因果概率网络模型SepsisFinder,用于使用每小时更新的EHR数据在48小时内预测败血症的发作.
- 模型性能使用接收器操作特征曲线 (AUROC) 下面的区域和精度回调曲线 (APR) 下面的区域进行了评估,并与NEWS2和梯度增强模型进行了比较.
主要成果:
- 在ICU外使用稀疏的EHR数据时,SepsisFinder表现出高预测准确度 (AUROC 0.950).
- 该模型的触发时间早于NEWS2和一个渐变增强机器学习模型.
- 败血症寻找器在服用抗生素之前的中位数为5.5小时,在特定的患者亚组中准确性增加,表明败血症发作.
结论:
- 像SepsisFinder这样的机器学习模型可以使用常规的EHR数据在ICU外有效预测败血症的发病情况.
- 通过SepsisFinder早期检测败血症通过及时干预提供了显著的临床益处.
- 这种方法有望识别高风险人群并定制临床管理以改善败血症护理.
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