StrokeClassifier:通过使用电子健康记录的整体共识建模对缺血性中风病因的分类
Ho-Joon Lee1, Lee H Schwamm2,3, Lauren H Sansing3
1Department of Genetics and Yale Center for Genome Analysis, Yale School of Medicine, New Haven, CT, USA. ho-joon.lee@yale.edu.
NPJ digital medicine
|May 17, 2024
概括
一个人工智能工具StrokeClassifier准确地使用电子健康记录预测急性缺血性中风的原因. 这种人工智能系统与神经科医生的表现相美,有助于识别中风病因,以更好地预防.
科学领域:
- 神经学 神经学
- 人工智能的人工智能
- 医疗信息学 医疗信息学
背景情况:
- 确定急性缺血性中风 (AIS) 病因对于二次预防至关重要,但在诊断上仍然具有挑战性.
- 准确的病因分类指导了针对性的治疗策略,并改善了患者的治疗结果.
- 现有的方法依赖于专家审查,这可能是耗时和资源密集的.
研究的目的:
- 开发和验证一个自动分类工具StrokeClassifier,用于预测AIS病因.
- 用电子健康记录 (EHR) 数据对 StrokeClassifier 与专家诊断的性能进行评估.
- 评估StrokeClassifier在减少密码性中风诊断方面的潜力.
主要方法:
- 经过训练和验证的StrokeClassifier,一个整体共识元模型,基于来自2039名非密码性AIS患者的EHR文本.
- 使用自然语言处理 (NLP) 来从排放摘要中提取特征.
- 在MIMIC-III数据集中的406份排放摘要上对该工具进行了外部验证.
主要成果:
- 对于多类分类,StrokeClassifier实现了0.74的平均交叉验证精度和0.74的加权F1.
- 在MIMIC-III的外部验证中,准确度为0.70,加权F1为0.71.
- 该工具在对密码性中风患者应用时,将密码性诊断从25.2%降至7.2%.
结论:
- 在分类缺血性中风病因方面,StrokeClassifier的表现与血管神经病学家的表现相当.
- 人工智能工具显示出作为中风诊断临床决策支持系统的前景.
- 进一步开发可以提高其在现实世界临床环境中的实用性.
相关概念视频
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...