在使用结构化和非结构化数据预测住院时间时,在性能和可解释性之间找到最佳的权衡
Franck Jaotombo1,2, Luca Adorni3, Badih Ghattas4
1EMLYON Business School, Ecully, France.
PloS one
|November 30, 2023
概括
结合结构化和非结构化临床数据,显著改善了用于预测住院时间 (LOS) 的机器学习模型. 这种数据融合提高了预测性能和模型可解释性,以获得更好的患者护理见解.
科学领域:
- 医疗信息学 医疗信息学
- 机器学习 机器学习
- 临床数据分析 临床数据分析
背景情况:
- 预测住院时间 (LOS) 对资源管理和患者护理至关重要.
- 现有的模型往往难以平衡预测性能和可解释性.
- 整合不同的数据源可以潜在地克服这些局限性.
研究的目的:
- 开发和比较机器学习 (ML) 和深度学习 (DL) 模型,用于预测医院LOS.
- 评估使用结构化数据,非结构化临床文本或两者的组合对模型性能和可解释性的影响.
- 提高LOS预测模型的可解释性.
主要方法:
- 在结构化数据上训练了十四个经典的ML模型,并在非结构化文本数据上微调了一个生物临床BERT变压器DL模型.
- 在使用隐性迪里克莱特分配进行文本向量化和维度减小后,合并结构化和非结构化数据.
- 使用了密集护理医疗信息中心 (MIMIC) III数据库和AutoGluon AutoML库.
主要成果:
- 使用结构化数据的最佳模型实现了高性能 (ROC AUC = 0.944),但其解释性有限.
- 在非结构化数据上的变压器模型显示出良好的性能 (ROC AUC = 0.842) 具有更丰富的可解释性.
- 在混合数据上训练的模型实现了卓越的性能 (ROC AUC = 0.963) 和增强的解释性,识别了各种临床因素.
结论:
- 结构化和非结构化临床数据的数据融合在LOS预测中显著提高了性能和可解释性.
- 开发的模型在LOS预测方面优于现有的最先进的方法.
- 这种方法可以更全面地了解影响患者住院的因素.
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