基于电子健康记录的机器学习模型的开发,以预测巴雷特食道和食道腺癌风险
Prasad G Iyer1, Karan Sachdeva1, Cadman L Leggett1
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Clinical and translational gastroenterology
|September 12, 2023
概括
机器学习模型使用电子健康记录准确预测巴雷特食道 (BE) 和食道腺癌 (EAC) 风险. 这种方法可以改善对这些疾病的查.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
背景情况:
- 对于具有危险因素的个体,建议对巴雷特食道 (BE) 进行查,但未得到充分利用.
- 现有的BE和食道腺癌 (EAC) 风险预测工具的准确性不高 (AUROC ≤0.7),并面临实施挑战.
研究的目的:
- 开发和评估机器学习 (ML) 模型,以使用大型电子健康记录 (EHR) 数据库预测BE和EAC风险.
主要方法:
- 使用了600万患者的非识别的EHR数据库.
- 使用ICD代码和临床笔记上的自然语言处理识别了BE和EAC病例和对照.
- 采用基于集成变压器的ML模型架构.
主要成果:
- 该BE ML模型实现了76%的灵敏度,76%的特异性和0.84 AUROC.
- EAC ML模型实现了84%的灵敏度,70%的特异性和0.84的AUROC.
- 确定了新的风险预测因素,包括冠状动脉疾病,血清甘油三和电解质.
结论:
- 与传统方法相比,在EHR数据上训练的ML模型在预测BE和EAC风险方面表现出更高的准确性.
- 这些模型有可能加强对BE和EAC的最小侵入性查技术的临床实施.
相关概念视频
Barrett Esophagus-I: Introduction
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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
122
Barrett Esophagus-II: Clinical Manifestations and Management
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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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