使用可解释的机器学习来预测ICU患者的血液感染和抗菌素耐药性:基于EHR数据的早期预警预测器来指导抗菌素管理
Davide Ferrari1,2, Pietro Arina3, Jonathan Edgeworth2
1School of Life Course and Population Sciences, King's College London, London, United Kingdom.
PLOS digital health
|October 16, 2024
概括
使用多目标符号回归 (MOSR) 的新型机器学习方法有效预测重症监护室的血液感染 (BSI) 和抗菌素耐药性 (AMR),优于传统方法.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 机器学习在医学中的应用
- 传染病流行病学 传染病流行病学
背景情况:
- 鼻腔感染和抗菌素耐药性 (AMR) 构成了全球健康的重大威胁.
- 目前用于检测血液感染 (BSI) 和AMR的策略通常依赖于实验室测试和既定的协议.
- 对于复杂的临床数据,标准的单一目标机器学习 (ML) 方法存在局限性.
研究的目的:
- 引入和评估一个多目标符号回归 (MOSR) ML方法来预测BSI和AMR.
- 为了利用来自重症监护室 (ICU) 入院的现有临床数据.
- 在不平衡和平衡数据集上比较MOSR性能与传统的ML算法.
主要方法:
- 使用多目标符号回归 (MOSR) 开发一个ML模型.
- 利用在ICU入院时收集的临床数据进行预测.
- 与已建立的ML算法进行比较分析,使用不平衡和过量采样数据.
主要成果:
- 传统的ML模型在各种训练场景中表现不佳.
- 针对最小化虚假负数和最大化F1分数而优化的MOSR显著优于其他ML算法.
- 无论训练组的平衡,MOSR都取得了卓越和一致的结果,F1-分数比替代品高0.22和0.28.
结论:
- 对于抗微生物管理 (AMS) 策略来说,MOSR方法提供了一个有希望的进步.
- 这种可扩展的ML工具可以解决关键的医疗保健问题,即使数据可用性有限.
- MOSR提供了一种可靠的方法来预测BSI和AMR,增强患者护理和感染控制.
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