将因果随机森林和线性回归进行比较,以估计组织因素与ICU效率的独立关联
Leonardo S L Bastos1, Safira A Wortel2, Ferishta Bakhshi-Raiez2
1Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil.
International journal of medical informatics
|August 7, 2024
概括
因果随机森林 (CRF) 和线性回归建模 (LRM) 都确定了影响ICU效率的因素. CRF强调了具有重大影响的具体单位,帮助改善医疗管理的有针对性的干预措施.
科学领域:
- 关键护理医学 关键护理医学
- 医疗服务研究 医疗服务研究
- 统计建模 统计建模
背景情况:
- 参数回归模型是平均治疗效果的标准.
- 因果机器学习模型对异质治疗效果有希望.
- 进行因果随机森林 (CRF) 和线性回归建模 (LRM) 的比较对于ICU效率分析至关重要.
研究的目的:
- 为了比较CRF和LRM在估计组织因素对ICU效率的影响中的应用.
- 评估两种模型识别影响ICU效率的重要因素的能力.
- 评估CRF在检测特定ICU内的局部影响方面的实用性.
主要方法:
- 在巴西和乌拉圭的128个ICU对277,459名患者进行了三年的回顾性分析.
- 用标准化平均效率比率 (ASER) 衡量ICU效率,包括标准化死亡率 (SMR) 和标准化资源使用率 (SRU).
- 用于估计组织因素的条件平均治疗效应 (CATE) 的因果推断框架,使用LRM与相互作用和CRF.
主要成果:
- 无论是CRF还是LRM,都确定每10张床位的护士平均数量与ICU效率独立相关.
- CRF在特定ICU中发现了显著的CATE,对于LRM没有显著的平均效应的风险.
- 住院死亡率为14%,平均ICU和住院长度分别为2天和7天.
结论:
- CRF和LRM在识别与ICU效率相关的组织因素方面表现出相似的能力.
- CRF的优势在于识别具有重大影响的特定ICU,即使平均影响不显著.
- 结果可以指导医疗保健管理人员进行有针对性的干预,以提高ICU的效率.
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