开发一种机器学习预测模型,用于在低资源环境中使用常规电子医疗记录在艾滋病毒护理中对随访损失的预测
Tamrat Endebu1, Girma Taye2, Wakgari Deressa2
1Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. seetame2008@gmail.com.
BMC medical informatics and decision making
|May 19, 2025
概括
机器学习可以准确地预测艾滋病毒护理中的随访损失 (LTFU),识别关键的风险因素,如遵守和服务交付模型. 这种工具有助于在资源较低的环境中进行主动干预.
科学领域:
- 医疗保健中的机器学习
- 艾滋病毒/艾滋病临床研究 临床研究
- 在公共卫生领域的预测分析.
背景情况:
- 失去跟进 (LTFU) 仍然是到2030年结束艾滋病的重要障碍.
- 数据驱动的工具对于识别LTFU高风险患者至关重要.
- 需要积极主动,个性化的干预措施来改善艾滋病毒护理保留率.
研究的目的:
- 开发一种机器学习 (ML) 预测模型,用于评估艾滋病毒治疗中LTFU的未来风险.
- 在低资源环境 (埃塞俄比亚) 中确定LTFU的关键预测因素.
- 评估开发的ML模型的临床实用性.
主要方法:
- 从3,720名艾滋病毒阳性成年患者的电子病历 (EMR) 进行了回顾性分析.
- 应用六个监督的ML分类器 (J48,随机森林,k-NN,SVM,后勤回归,naive Bayes).
- 十倍交叉验证用于性能评估和纠正重新采样的t测试进行比较;决策曲线分析 (DCA) 临床实用性.
主要成果:
- 确定了六个预测因素:差异化服务提供,坚持,结核病预防疗法,随访期,营养状况和地址.
- 随机森林算法实现了84.2%的准确性,89.5%的AUC,并展示了卓越的性能.
- ML模型显示出显著的临床实用性,优于"所有"或"没有"的干预策略.
结论:
- 一个强大的基于ML的LTFU在HIV护理中的预测模型被开发用于低资源环境.
- 随机森林模型为临床应用提供了高精度和分辨能力.
- 建议在不同人群中进行外部验证,以确保可通用性和可靠性.
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