基于电子健康记录的机器学习模型与胃肠道出血临床风险评分相比的验证
Dennis L Shung1, Colleen E Chan2, Kisung You3
1Section of Digestive Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Clinical and Translational Research Accelerator, Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Department of Biomedical Informatics and Data Science, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
Gastroenterology
|July 6, 2024
概括
一个新的基于电子健康记录 (EHR) 的胃肠道出血 (GIB) 机器学习模型识别了比现有的分数更多的非常低风险的急诊室出院患者. 这种先进的GIB风险分层提高了早期出院的患者选择.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
- 医疗保健中的机器学习
背景情况:
- 目前的指导方针推胃肠道出血 (GIB) 患者的风险分层分数,以促进急诊室 (ED) 的出院.
- 集成到电子健康记录 (EHR) 中的机器学习 (ML) 模型提供了实时,自动化风险评估的潜力.
研究的目的:
- 开发和验证第一个基于EHR的ML模型,用于GIB风险分层.
- 将这种ML模型的性能与格拉斯哥-布拉奇福德得分和奥克兰得分等既定得分进行比较.
主要方法:
- 训练并验证了一种ML模型,使用来自2500多名明显GIB患者的结构化EHR数据.
- 使用内部和外部验证队列,将ML模型性能 (AUC) 与格拉斯哥-布拉奇福德和奥克兰分数进行比较.
- 评估特异性在99%的灵敏度以识别非常低风险的患者.
主要成果:
- ML模型的表现明显超过了格拉斯哥-布拉奇福德得分 (AUC 0.92 与 0.89 相比) 和奥克兰得分 (AUC 0.92 与 0.89 相比).
- 在99%的灵敏度下,ML模型识别了与格拉斯哥-布拉奇福德 (18.5%) 和奥克兰 (11.7%) 评分相比,更高比例的非常低风险患者 (37.9%).
结论:
- 基于EHR的ML模型显示,与当前的临床分数相比,GIB患者的风险分层表现优越.
- 这种ML模型有助于识别适合早期ED出院的非常低风险患者.
相关概念视频
01:28Esophageal Varices-II: Clinical Features and Management
57
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
57
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
125
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
125