在PICU患者中开发和验证内管道输入和机械通风预测模型
Daniela Chanci1, Jocelyn R Grunwell2,3, Alireza Rafiei1
1Department of Biomedical Informatics, Emory University, Atlanta, GA.
概括
一个新的机器学习模型准确地预测了使用电子健康记录数据在儿科重症监护室 (PICU) 患者中需要输管的需求. 这种工具可以帮助优化呼吸系统护理和为重症儿童分配人员.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 机器学习在医疗保健中的应用
- 临床决策支持系统临床决策支持系统
背景情况:
- 腹腔内输管是儿科重症监护室 (PICU) 中的一个关键程序.
- 预测输入管的需要对于及时干预和资源分配至关重要.
- 现有的方法通常依赖于主观的临床标准.
研究的目的:
- 开发和外部验证用于预测儿科患者输管治疗的机器学习模型.
- 为了利用客观,常规可用的电子病历 (EMR) 数据进行预测.
- 改进用于输管预测的传统临床标准.
主要方法:
- 在两个PICU进行的回顾性观察队列研究.
- 2010-2022年期间的13,208次PICU住院 (导出) 和17,841次PICU住院 (验证) 的数据.
- 通过使用生命体征,实验室测试,人口统计,药物和器官功能障碍得分,训练了一种分级提升 (CatBoost) 模型.
主要成果:
- CatBoost模型在导出队列中实现了0.88的接收器运行特征曲线 (AUC) 下的面积,在验证队列中达到0.92.
- 输管事件发生在8.90%的导出队列和6.53%的验证队列中.
- 该模型与极端梯度提升,随机森林和后勤回归模型相比,表现出了卓越的性能.
结论:
- 开发并验证了一种可解释的机器学习模型,用于预测PICU儿童的输管.
- 该模型有效地使用易于获得的EMR数据,优于传统的临床标准.
- 实施可以帮助临床医生优化机械通风儿童的输管时间和资源管理.
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