可解释的预测自我评估模型,对老年人潜在不适当的处方风险进行预测
Fangyuan Tian1, Zhaoyan Chen2, Mengnan Zhao3
1Department of Pharmacy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
International journal of medical informatics
|October 11, 2025
概括
一个新的可解释的机器学习模型准确地预测了老年人可能不适当的处方 (PIP). 该工具帮助临床医生和患者提高药物安全性和自我管理,以获得更好的健康结果.
科学领域:
- 老年医学 老年医学
- 医疗保健中的人工智能
- 药物监督 药物监督 药物监督
背景情况:
- 患有多种慢性疾病的老年人经常经历潜在不适当的处方 (PIP).
- 在这种人口群体中,药物安全和自我管理方面的挑战仍然存在.
- 开发预测模型对于改善老年人药物治疗至关重要.
研究的目的:
- 开发和验证一种可解释的机器学习 (ML) 模型,用于预测老年人PIP风险.
- 为临床医生和患者提供一种工具,以提高药物安全性.
- 支持改善老年患者的自我管理策略.
主要方法:
- 使用中国标准对老年门诊处方的分析.
- 开发和验证后勤回归,随机森林和神经网络模型.
- 利用夏普利添加式扩展 (SHAP) 进行模型解释性和确定关键风险因素.
主要成果:
- 一个神经网络模型表现出卓越的性能,外部验证的AUC为0.842.
- 药物和睡眠障碍的数量被确定为PIP的显著预测因素.
- 为临床和患者使用而开发了一个Web应用程序和微信小程序.
结论:
- 开发的ML模型有效地预测了老年人PIP风险.
- 该模型是医疗保健专业人员和患者的宝贵工具.
- 有助于提高药物安全性和患者自我评估能力.
相关概念视频
Drug Dosing: Geriatric Patients
225
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
225
Pharmacodynamics in Geriatric Patients: Effects of Age
187
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
187
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
234
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
234
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
232
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
232
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
227
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
227
Self-Presentation: Self-Monitoring and Self-Handicapping
43.5K
People can go to great lengths to protect their self-image and present themselves in ways that they want others to see them. Sociologist Erving Goffman presented the idea that a person is like an actor on a stage. Calling his theory dramaturgy, Goffman believed that we use “impression management” to present ourselves to others as we hope to be perceived. Each situation is a new scene, and individuals perform different roles depending on who is present (Goffman, 1959). Think about...
43.5K


