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使用结构化捐赠者特征和非结构化捐赠者叙述预测丢弃和无法恢复的高风险捐赠者
Junichiro Sageshima1, Peter Than1, Naeem Goussous1
1Department of Surgery, University of California, Davis Health, Sacramento.
JAMA surgery
|November 1, 2023
概括
机器学习模型可以识别高风险的已故捐赠者进行移植,但需要进一步开发. 使用非结构化捐赠者的数据显示了改善器官利用率和减少浪费的前景.
科学领域:
- 移植医学 移植医学
- 医疗保健中的人工智能
- 数据科学在器官捐献中的数据科学
背景情况:
- 由于分配效率低下和缺血时间长,大量的已故捐赠脏没有被回收或移植.
- 早期识别高风险捐赠者至关重要,以尽量减少器官损失和提高利用率.
研究的目的:
- 评估使用机器学习 (ML) 和自然语言处理 (NLP) 来分类已故捐赠者,其脏被用于移植与未被用于移植的可行性.
- 开发预测模型,以识别脏被移植的高风险的捐赠者.
主要方法:
- 使用来自联合国器官共享网络 (UNOS) 的捐赠者信息,包括结构化数据和非结构化捐赠者叙述的回顾性队列研究.
- 机器学习模型在2015年1月至2020年12月的捐赠者报价上进行了训练和验证,并在2021年的数据上进行了测试.
- 评估了各种ML模型,包括后勤回归,随机森林和来自变压器的双向编码器表示 (BERT),使用AUROC,F1得分,准确性,精度和回忆来评估性能.
主要成果:
- 该研究包括9,555名接受培训/验证的捐赠者和2,481名接受测试的捐赠者,只有20-30%的潜在捐赠者至少接受过一次移植.
- 使用结构化数据的ML模型实现了适度的预测性能 (例如,物流回归AUROC为0.70).
- 包括BERT在内的NLP模型在与基本捐助者信息集成时显示了可比或略有改进的指标,表明了非结构化数据利用的潜力.
结论:
- 机器学习模型显示出预测脏可能无法移植的高风险捐赠者的潜力,但需要进一步精细化以提高准确性.
- 整合非结构化捐赠者叙述数据有望提高预测模型的性能.
- 需要对先进的建模方法进行进一步的研究,以开发更强大的分类器,以优化器官分配和减少脏丢弃.
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