沟通儿童疾病年龄分类中的探索性无监督机器学习分析.
Joshua William Spear1,2, Eleni Pissaridou1,2, Stuart Bowyer1,2
1DRIVE, Great Ormond Street Hospital for Children, London, UK.
BMJ health & care informatics
|July 29, 2024
概括
应用到电子医疗记录的机器学习在儿科患者中确定了四个基于年龄的疾病集群. 在数据预处理中传达不确定性对于可靠的临床决策至关重要.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 机器学习应用 机器学习应用
- 儿科医学 儿科医学
背景情况:
- 尽管有电子医疗记录 (EHR) 数据和机器学习 (ML) 工具,但医院对数据驱动决策的采用有限.
- 需要探索对EHR数据的ML分析和对非专家利益相关者有效传达结果.
研究的目的:
- 调查ML分析EHR数据以获得基于年龄的诊断集群.
- 评估ML驱动的洞察力的临床有效性和沟通策略.
主要方法:
- 利用来自第三级儿科医院的观测EHR数据 (61,522名患者,3315个诊断码).
- 应用K-means聚类来确定诊断的年龄分布.
- 使用定量指标和专家临床验证选择最终模型,分析预处理不确定性.
主要成果:
- 确定了四个不同的疾病年龄群 (0-1,1-5,5-5-13,13-18岁).
- 集群与已知的疾病表现和进展保持一致,验证现有方法.
- 预处理不确定性显著影响了个体诊断,但没有影响到人口一级的结果;证明了缓解策略.
结论:
- 在EHR数据上的无监督ML可以识别临床相关的年龄疾病分布,以加强决策.
- 医疗保健数据偏差显著影响ML结果,需要缓解或明确沟通不确定性.
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