冠状动脉干预后并发症的机器学习模型的预测性能:系统审查和元分析
Soroush Najdaghi1, Delaram Narimani Davani2, Davood Shafie2
1Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Science, Isfahan, Iran. Soroush.najdaghi@yahoo.com.
International urology and nephrology
|October 31, 2024
概括
机器学习模型在心脏手术后有效预测急性损伤 (AKI) 和对比诱导的病 (CIN). 梯度增强机和支向量机模型显示了最有前途的早期检测和干预.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 医疗信息学 医疗信息学
背景情况:
- 急性损伤 (AKI) 和对比诱导的病 (CIN) 是皮肤冠状动脉干预 (PCI) 和冠状动脉动脉扫描 (CAG) 后的重大并发症.
- 早期发现和干预对于改善患者的治疗结果至关重要.
- 机器学习 (ML) 提供了增强预测能力的潜力.
研究的目的:
- 系统地审查和评估ML模型在PCI/CAG后预测AKI和CIN方面的表现.
- 为此临床应用确定最有效的ML算法.
- 评估影响模型性能的关键患者因素.
主要方法:
- 在PubMed,Scopus和Embase上进行了系统的文献搜索,遵循PRISMA指南.
- 数据提取包括研究特征,ML模型,性能指标 (AUC,精度,灵敏度,特异性,精度) 和偏差风险 (PROBAST工具).
- 使用随机效应模型将AUC值组合起来,使用I2统计学来评估异质性.
主要成果:
- 14项研究符合纳入标准,评估了各种ML模型.
- 梯度增强机 (GBM) 和支向量机 (SVM) 模型显示了较高的聚合AUC (分别为0.87和0.85),异质性较低.
- 随机森林 (RF),多层感知器 (MLP) 和XGBoost模型显示具有竞争力的AUC,但表现出显著的异质性. 关键预测因素包括年龄,血清肌素,LVEF和血红蛋白.
结论:
- 由于其强大的性能和低异质性,GBM和SVM模型对于预测PCI/CAG后的AKI和CIN是有效和可靠的.
- 虽然RF,MLP和XGBoost等其他模型显示出潜力,但它们的相当多样性需要进一步验证.
- 这些发现强调了特定的ML模型在接受PCI/CAG患者的风险分层和管理方面的临床实用性.
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