使用机器学习预测胃肠道出血在血液透析中住院的风险
John W Larkin1, Suman Lama2, Sheetal Chaudhuri2
1Fresenius Medical Care, Global Medical Office, 920 Winter Street, Waltham, MA, 02451, USA. John.Larkin@freseniusmedicalcare.com.
BMC nephrology
|October 19, 2024
概括
机器学习模型可以预测血液透析 (HD) 患者的胃肠道出血 (GIB) 住院风险. 极端梯度增强 (XGBoost) 模型在此预测中表现出优于后勤回归的性能.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 数据科学数据科学数据科学
- 医疗信息学 医疗信息学
背景情况:
- 胃肠道出血 (GIB) 对患有功能衰竭的患者来说是一个重大的临床挑战.
- INSPIRE小组调查了机器学习 (ML) 的潜力,以预测血液透析 (HD) 患者GIB住院180天的风险.
研究的目的:
- 评估机器学习模型在识别经过血液透析的高风险胃肠道出血入院180天内患者的有效性.
- 为了比较 eXtreme Gradient Boosting (XGBoost) 模型与物流回归模型的预测性能.
主要方法:
- 开发和评估了 eXtreme Gradient Boosting (XGBoost) 和后勤回归模型,使用美国的血液透析数据集 (2017-2020).
- 数据被随机分为培训 (50%),验证 (30%) 和测试 (20%) 集.
- 模型分析了1,303个潜在的暴露/共变体,将GIB住院后180天内的HD治疗归类为积极的结果.
主要成果:
- 在HD患者中,180天GIB住院的总发病率为1.18%.
- 与物流回归的0.68 (95% CI 0.66-0.71) 相比,XGBoost实现了0.74 (95% CI 0.72-0.76) 的接收器操作特征曲线 (AUROC) 下的区域优越.
- 两种模型都确定了与GIB风险相关的年龄,贫血/铁障碍,最近住院和骨矿物代谢标记,XGBoost突出显示血清25-氧维生素D和后勤回归突出显示副甲状腺激素.
结论:
- 机器学习,特别是XGBoost,对在血液透析患者中早期发现GIB风险充满希望.
- 虽然XGBoost的性能优于逻辑回归,但这两种模型似乎都适合进行风险评估.
- 外部和前性验证是必要的,骨矿物代谢标志物与GIB之间的意想不到的关联需要进一步调查.
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