通过可解释的机器学习算法预测急性缺血性中风的病因分类:一个多中心,前性队列研究.
Siding Chen1,2,3, Xiaomeng Yang1, Hongqiu Gu1,2
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
BMC medical research methodology
|September 10, 2024
概括
机器学习模型准确地预测急性缺血性中风 (AIS) 亚型,优于逻辑回归. 这些人工智能工具可以在未确定的情况下识别心血管栓塞 (CE),改进二次预防策略.
科学领域:
- 神经学 神经学
- 人工智能的人工智能
- 医疗信息学 医疗信息学
背景情况:
- 预后和二次预防在急性缺血性中风 (AIS) 亚型之间存在显著差异.
- 机器学习 (ML) 可以在医疗数据中发现复杂的模式,用于病因分类.
- 关于使用ML来预测AIS病因的研究有限.
研究的目的:
- 开发可解释的ML模型用于AIS病因预测.
- 确定影响中风病因学分类的关键因素.
- 完善目前的中风亚型的临床分类.
主要方法:
- 使用了第三个中国国家中风登记处 (CNSR-III) 数据集.
- 训练了九个ML模型 (NGBoost,CatBoost,XGBoost,RF,LGBM,GBDT,AdaBoost,SVM,LR) 来预测大动脉动脉硬化 (LAA),小血管封闭 (SVO) 和心血管栓塞 (CE).
- 使用SFS-XGB,对特征选择进行10倍交叉验证,并使用AUC和Brier分数评估模型.
主要成果:
- 包括5213名患者:47.4%的LAA,41.3%的SVO,11.3%的CE.
- 在LAA和SVO预测中,ML模型的性能明显优于逻辑回归 (LR) (P < 0.001).
- 最佳模型实现的AUC为0.932 (SVO/RF),0.917 (LAA/NGBoost) 和0.846 (CE/LGBM);模型显示了令人满意的校准.
- 最佳CE模型在45.7%的未确定病因 (SUE) 病例中确定了潜在的CE.
结论:
- ML算法有效地对AIS亚型 (LAA,SVO,CE) 进行分类,其性能优于LR.
- 最优的ML模型可以在SUE组内识别潜在的CE患者.
- 这些预测因素可以提高病因分类,并指导二次预防策略.
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