通过生存分析预测30天的非计划性医院再入院情况
Pedro Pons-Suñer1, Laura Arnal1, François Signol1
1ITI, Universitat Politècnica de València, Camino de Vera, s/n, 46022 València, Spain.
Heliyon
|November 2, 2023
概括
生存分析模型有效地预测了计划外的医院再接收,优于传统的分类方法. 机器学习方法,特别是XGBoost,在医院出院后30天内估计再接收风险方面表现出色.
科学领域:
- 医疗信息学 医疗信息学
- 机器学习 机器学习
- 生物统计学 生物统计学
背景情况:
- 非计划性住院再接收对全球医疗保健系统构成重大挑战.
- 准确预测再接收风险是复杂的,因为有很多影响因素.
- 目前的解决方案主要利用分类机器学习模型,生存分析方法尚未得到充分探索.
研究的目的:
- 为了比较统计和机器学习的生存分析模型来预测医院再入院风险.
- 为了评估模型的性能,使用正确审查的全因住院数据与出院时间共变量.
- 根据比例危险假设,专注于树集回归方法.
主要方法:
- 各种统计和机器学习生存分析模型的比较.
- 培训模型与正确审查的数据和可在核准时使用的共变量.
- 模型的评估,特别是在放电后的30天期间,有可能进行长达90天的预测.
主要成果:
- 生存模型实现了竞争性表现,C指数从0.707到0.716不等,ROC-AUC从0.709到0.72在30天.
- 使用Cox目标函数的XGBoost回归产生了最高的性能.
- 与机器学习替代方案相比,考克斯比例危险模型的性能较低.
结论:
- 生存分析模型对于解决医院再入院预测是有效的.
- 机器学习生存模型的表现优于传统的统计方法.
- 这些模型在短期再接收预测方面比分类模型具有潜在的优势,特别是在优化预处理的情况下.
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