使用域调整和诱导转移学习来改善重症监护室患者结果预测:回顾性观察性研究
Maruthi Kumar Mutnuri1,2, Henry Thomas Stelfox3,4, Nils Daniel Forkert5,6
1Data Intelligence for Health Lab, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Journal of medical Internet research
|August 21, 2024
概括
转移学习 (TL) 显著改善了重症监护室 (ICU) 患者的预测结果,特别是在数据稀缺的情况下. 诱导转移学习 (ITL) 模型表现出优于域适应 (DA) 和基线模型的性能.
科学领域:
- 医疗保健中的人工智能
- 机器学习用于临床预测
- 电子健康记录 (EHR) 数据分析 数据分析
背景情况:
- 准确预测重症监护室 (ICU) 患者的结果对于有效的患者护理至关重要.
- 深度学习模型需要大量的数据和计算资源,在现实世界的临床环境中通常是不可用的.
- 转移学习 (TL) 通过利用预训练模型为数据稀缺提供解决方案,但其在EHR分析中的应用,特别是感应转移学习 (ITL),尚未得到充分探索.
研究的目的:
- 调查域调整 (DA) 和感应转移学习 (ITL) 对于基于EHR的ICU患者结果预测的有效性.
- 在不同程度的模拟数据稀缺的情况下评估这些TL方法的性能.
主要方法:
- 利用了两个大型的ICU患者队列:eCritical (多中心) 和重症监护III (单中心) 的医疗信息中心.
- 将DA和ITL模型与基线模型 (完全连接的神经网络,物流回归,拉索回归) 进行比较.
- 评估模型在预测30天死亡率,急性损伤和ICU/住院长度方面的表现,使用1%至75%的数据子集.
主要成果:
- 感应转移学习 (ITL) 模型在56个比较中55个比较中显著超过了基线模型 (P < .001).
- 域调整 (DA) 模型在56个比较中,在45个比较中 (P < .001) 也超过了基线模型.
- ITL模型表现出优于DA模型的性能,特别是当在非常小的数据子集 (例如1%的数据) 上进行训练时.
结论:
- 转移学习 (TL) 模型,特别是ITL,在数据稀缺的环境中对ICU患者的预测结果非常有效.
- 该研究提供了一个框架,用于估计在不同数据稀缺级别的TL和没有TL的预测性能.
- 公共可用的预训练模型可以加速未来的研究和模型开发,用于各种ICU队列和结果.
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