通过公平可解释的机器学习来个性化静脉注射到口服抗生素切换决策
William J Bolton1,2,3,4, Richard Wilson5,6,7, Mark Gilchrist5,6,8
1Centre for Antimicrobial Optimisation, Imperial College London, London, UK. william.bolton@imperial.ac.uk.
Nature communications
|January 13, 2024
概括
这项研究开发了一种机器学习模型,以预测患者何时可以从静脉注射转向口服抗生素. 该工具支持抗菌药物管理,并通过优化治疗途径来减少与医疗相关的感染.
科学领域:
- 临床医学 临床医学
- 传染性疾病 传染性疾病
- 医疗保健中的人工智能
背景情况:
- 抗菌素耐药性 (AMR) 和与医疗保健相关的感染 (HAI) 是全球卫生面临的关键挑战.
- 通过管理优化抗微生物药物的使用,包括及时过渡到口服治疗,对于打击AMR和HAI至关重要.
- 从静脉注射 (IV) 转向口服抗生素治疗的标准化基于患者特异性因素仍然是一个临床挑战.
研究的目的:
- 开发和验证一种机器学习模型,用于预测切换患者从静脉到口服抗生素治疗的最佳时间.
- 为抗微生物药物管理中的临床决策支持提供个性化,公平和可解释的预测工具.
主要方法:
- 利用了10,362次重症监护室 (ICU) 住院的数据集,提取了例行收集的临床参数.
- 开发和评估机器学习模型,识别用于预测的信息特征集.
- 采用可解释性方法来生成模型预测的临床有用的视觉解释.
主要成果:
- 性能最好的模型在持久测试套件上实现了0.80 (SD 0.01) 的接收器运行特征曲线 (AUROC) 下的平均面积.
- 该模型证明了公平性,没有显示与受保护的个体特征相关的偏见.
- 开发的可解释性方法为预测因素提供了临床相关的见解.
结论:
- 机器学习模型为个性化,公平和可解释的预测提供了一个有希望的方法,以指导IV-to-oral抗生素治疗过渡.
- 在临床实施之前,需要对模型的安全性和疗效进行前性评估.
- 这项技术有可能增强抗微生物药物管理实践并改善患者的治疗结果.
相关概念视频
One-Compartment Open Model for IV Bolus Administration: General Considerations
208
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
208
One-Compartment Model: IV Infusion
199
Intravenous (IV) infusion is often utilized when continuous and controlled drug delivery is necessary, such as during surgery or in the treatment of chronic diseases. This method offers numerous advantages, including immediate drug action, precise control over dosage, and bypassing the first-pass metabolism.
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
199
Pharmacokinetic Models: Comparison and Selection Criterion
74
Physiological and compartmental models are valuable tools used in studying biological systems. These models rely on differential equations to maintain mass balance within the system, ensuring an accurate representation of the dynamic processes at play.
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
74
Two-Compartment Open Model: IV Infusion
238
A two-compartment model is a vital tool in pharmacokinetics, providing an essential understanding of drug behavior, especially for those administered via zero-order intravenous infusion. This model outlines two compartments: the central compartment, where elimination occurs, and the peripheral compartment.
The model illustrates the decrease in plasma drug concentration from the central compartment with a specific equation. It shows that under steady-state conditions, the drug's input rate...
The model illustrates the decrease in plasma drug concentration from the central compartment with a specific equation. It shows that under steady-state conditions, the drug's input rate...
238
One-Compartment Open Model for IV Bolus Administration: Estimation of Elimination Rate Constant, Half-Life and Volume of Distribution
257
The one-compartment open model is a simplified approach used in pharmacokinetics to understand the distribution and elimination of a drug administered through an intravenous bolus. This model assumes rapid drug dispersal throughout the body and elimination using a first-order process. Key pharmacokinetic parameters, such as the elimination rate constant (k), half-life (t1/2), and the apparent volume of distribution (Vd), can be estimated from this model. The elimination rate is calculated...
257
Two-Compartment Open Model: IV Bolus Administration
516
The two-compartment model for intravenous (IV) bolus administration illustrates drug distribution in the body, subdividing it into central and peripheral compartments. This model operates on the concept of two-compartment kinetics. The drug's plasma concentration shows a bi-exponential decline following IV bolus administration, signaling the presence of two disposition processes: distribution and elimination.
The disparity between drug input and the sum of drug transfer rates between...
The disparity between drug input and the sum of drug transfer rates between...
516


