一个护理笔记意识到深度神经网络,用于预测医院出院后的死亡风险
Yong-Zhen Huang1, Yan-Ming Chen2, Chih-Cheng Lin2
1Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan.
International journal of nursing studies
|May 24, 2024
概括
本研究介绍了关键护理描述提取器 (CNDE) 和NurnaNet深度学习模型,用于使用非结构化护理记录预测患者死亡风险. 该系统有效地识别高风险患者,以改善ICU后护理和再接收预防.
科学领域:
- 使用自然语言处理 (NLP) 和深度学习进行临床数据分析.
- 专注于从非结构化的电子护理记录中提取有价值的见解.
背景情况:
- 在重症监护室 (ICU) 后的再入院和死亡率对医疗保健构成重大挑战.
- 现有的研究往往忽略了非结构化的护理数据,限制了预测准确性.
- 自然语言处理 (NLP) 提供了一种从临床文本中提取结构化信息的方法.
研究的目的:
- 开发关键护理描述提取器 (CNDE) 用于分析电子护理记录.
- 预测ICU出院后的死亡率,并识别高风险再入院的患者.
- 实施一个深度神经网络 (NurnaNet) 与BioClinicalBERT相结合,用于风险预测.
主要方法:
- 采用使用MIMIC-III数据库 (2001-2012) 的队列和系统开发设计.
- 排除了18岁以下或89岁以上的患者,以及在医院死亡的患者;分析了16973份护理记录.
- 开发了用于关键字提取的对数概率比的CNDE,与用于生存预测 (6个月,2年) 的BioClinicalBERT集成.
主要成果:
- 努尔纳网取得了值得注意的F1分数,分别为0.67030 (6个月) 和0.70874 (2年).
- 与单独的BioClinicalBERT相比,已经证明了2.05% (6个月) 和1.08% (2年) 的性能改善.
- 模型性能使用精度,回忆,F1得分,ROC曲线,AUC和PR曲线进行评估.
结论:
- 关键护理描述提取器 (Crucial Nursing Description Extractor,简称CNDE) 有效地处理长时间的护理记录,提取关键信息.
- 在分析护理记录以预测出院后患者死亡风险方面,NurnaNet表现出强的表现.
- 这些发现支持对高风险患者的随访和治疗计划进行及时调整.
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