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相关概念视频

Post-traumatic Stress Disorder01:27

Post-traumatic Stress Disorder

113
Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
113

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使用电子健康记录数据的创伤后应激障碍预测模型的误导性结果:算法验证研究

Thomas M Crow1, Eric Lin2,3, Kelly L Harper1,4

  • 1Behavioral Science Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, 150 S Huntington Ave, 13B, Boston, MA, 02130, United States, 1 6172329500.

Journal of medical Internet research
|August 27, 2025
PubMed
概括

预测创伤后应激障碍 (PTSD) 的电子健康记录 (EHR) 数据显示性能过高. 由于医疗保健使用模式,使用EHR数据进行PTSD诊断可能会高估准确性.

关键词:
后应激障碍医疗中心临床信息学临床预测模型医疗中心电子健康记录机器学习心理健康误导性的信息误导性的结果在创伤后创伤后应激障碍半结构面试敏感性分析压力障碍退伍军人

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科学领域:

  • 计算精神病学
  • 卫生信息学
  • 医疗保健中的机器学习

背景情况:

  • 电子健康记录 (EHR) 越来越多地用于创伤后应激障碍 (PTSD) 的预测建模.
  • 电子病历数据可能含有偏差,包括诊断错误分类和医疗保健使用差异.
  • 基于EHR的PTSD预测与严格的诊断标准的准确性尚不清楚.

研究的目的:

  • 基于EHR的预测模型性能与基于半结构面试的PTSD诊断进行比较.
  • 量化模型性能上的差异.
  • 调查导致性能差异的机制.

主要方法:

  • 机器学习模型 (弹性网,随机森林,XGBoost) 根据EHR数据预测PTSD与美国1343名退伍军人的DSM-5 (SCID-5) 结构化临床采访.
  • 使用嵌套交叉验证方案.
  • 模型使用29个EHR访问数量变量和8个人口变量.

主要成果:

  • 基于EHR的PTSD诊断显示73.3%与SCID-5一致,其中17.8%是虚假阴性,8.9%是虚假阳性.
  • 基于EHR的PTSD预测模型获得了高性能 (AUC .85.9;MCC .58.69).
  • 基于SCID-5的PTSD预测模型的表现中等 (AUC .71.76;MCC .24.28),受医疗保健访问频率的影响.

结论:

  • 仅使用EHR数据的PTSD预测模型与使用结构化临床访谈的模型相比,表现指标膨胀.
  • 绩效差异源于医疗保健使用与基于电子病历的诊断之间的循环关系.
  • 基于EHR的诊断可能不是真正的PTSD标准的充分代表;在解释仅基于EHR的预测模型时,建议谨慎.