静脉血栓栓塞的机器学习 - 为什么以及接下来呢?
Gerard Gurumurthy1, Filip Kisiel2,3, Lianna Reynolds4
1The University of Manchester, Manchester, United Kingdom.
Seminars in thrombosis and hemostasis
|August 19, 2025
概括
机器学习 (ML) 在预测静脉血栓塞栓症 (VTE) 和相关风险方面表现有前途,在某些领域的表现优于传统得分. 然而,为了在VTE管理中广泛采用,必须解决诸如偏见,透明度和临床整合等挑战.
科学领域:
- 心血管医学 心血管医学
- 医疗信息学 医疗信息学
- 医疗保健中的人工智能
背景情况:
- 静脉血栓塞栓症 (VTE) 是致病率和死亡率的重要原因,由众多风险因素和平衡血栓预防与出血风险的挑战而复杂化.
- 目前对VTE的临床风险评分在不同患者群体的准确性有限.
- 机器学习 (ML) 为改善VTE风险预测和管理提供了潜在的解决方案.
研究的目的:
- 审查机器学习 (ML) 在预测静脉血栓塞栓症 (VTE) 和相关出血风险方面的应用和有效性.
- 在VTE预测中识别当前ML模型的优点和局限性.
- 概述在临床VTE护理中开发和实施ML的未来方向.
主要方法:
- 对ML在VTE预测中的应用现有文献的审查,包括成像分析,外科队列,癌症相关的血栓形成和出血风险评估.
- 对各种ML算法的性能指标 (例如AUC) 的分析与传统风险得分相比.
- 识别共同的挑战,如偏见,外部验证,透明度和临床工作流集成.
主要成果:
- 包括卷积神经网络和梯度增强模型在内的ML模型在成像上检测VTE (AUCs 0.85-0.96) 和预测术后VTE (AUCs 0.70-0.80) 中表现出很高的性能.
- ML模型显示出预测癌症相关血栓形成 (AUC 0.68-0.82) 和复发性静脉瘤 (AUC 0.93-0.99) 的潜力,尽管有警告.
- 使用ML进行出血风险预测仍然具有挑战性,通常与传统模型相比,对偏差和外部验证的担忧在应用程序中仍然存在.
结论:
- 机器学习显示出显著的潜力,可以提高静脉血栓栓塞 (VTE) 风险预测的准确性,超出传统方法.
- 解决诸如算法偏见,缺乏透明度和需要强有力的外部验证等局限性对于临床翻译至关重要.
- 未来的研究应该优先考虑标准化的报告,可解释的模型,前性验证和无集成到电子健康记录中,以便在VTE管理中有效地部署ML.
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