可解释的机器学习用于早期预测结核病 - 糖尿病并发症患者中治疗失败风险
An-Zhou Peng1, Xiang-Hua Kong1, Song-Tao Liu1
1Department of the Fifth Tuberculosis, Chongqing Public Health Medical Center, Chongqing, People's Republic of China.
Scientific reports
|March 22, 2024
概括
使用电子医疗记录的机器学习模型可以早期预测糖尿病和结核病 (TB-DM) 患者的治疗失败. 这种方法有助于制定有效的TB-DM治疗策略,特别是在资源有限的环境中.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的机器学习
- 公共卫生 公共卫生
背景情况:
- 糖尿病和结核病 (TB-DM) 联合感染带来了复杂的治疗挑战.
- 早期识别患有治疗失败风险的患者对于改善治疗结果至关重要.
- 电子医疗记录 (EMR) 为预测建模提供了丰富的数据来源.
研究的目的:
- 用机器学习 (ML) 和EMR来评估TB-DM患者的早期治疗结果.
- 在这个患者群体中确定治疗失败的关键预测因素.
- 开发一个用于早期风险分层的预测模型.
主要方法:
- 利用了429名结核病-DM患者的EMR数据.
- 使用Boruta算法从69个候选变量中进行特征选择.
- 使用五倍交叉验证开发和评估了四个ML模型.
- 使用夏普利的添加式解释解释模型结果.
主要成果:
- 确定了9个基本预测因素,其中"抗性类型"是最重要的.
- 其他关键预测因素包括激活的局部血栓形成时间 (APTT),血时间 (TT),血小板分布宽度 (PDW) 和前血时间 (PT).
- 所有模型都实现了曲线下面积 (AUC) > 0.7;XGBoost以AUC为0.9281的最佳性能来预测治疗失败.
结论:
- 一种ML方法,特别是XGBoost,有效地使用EMR数据识别使用治疗失败高风险的TB-DM患者.
- 这种基于EMR的方便且经济的ML方法为TB-DM治疗策略提供了新的见解,特别是在低收入和中等收入国家.
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