对仅使用电子日记预测发作的五种模型进行严格的评估:回顾性和前性数据集的表现并不优于纳普金方法
Chi-Yuan Chang1,2, Robert Moss3, M Brandon Westover1,2
1Harvard Medical School, Boston, Massachusetts, USA.
使用电子日记 (e-diaries) 预测发作,与简单的Napkin方法相比,没有显著的改善. 目前的技术可能不足以仅使用电子日记进行临床有效的24小时发作风险预测.
科学领域:
- 神经学 神经学
- 数据科学数据科学数据科学
- 医疗信息学 医疗信息学
背景情况:
- 电子日记 (e-日记) 提供了潜在的预测工具,以帮助患者日常生活管理.
- 以前的扣押预测模型缺乏对简单基准进行严格的测试.
- 纳普金法,一个基本的移动窗口平均值,作为预测简单性的基准.
研究的目的:
- 评估使用电子日记预测的机器学习模型是否优于纳普金方法.
- 评估基于电子日记数据的预测模型的临床有效性.
主要方法:
- 来自查追踪器的回顾性和前性队列的分析,包括电子日记和查类型数据.
- 实施和比较五个机器学习模型 (感知器,1D卷积,多层感知器,循环,点过程通用线性模型) 与Napkin预测.
- 使用90天历史窗口预测24小时发作概率,并通过标准指标 (AUC-PR,AUC-ROC,Brier分数) 进行评估.
主要成果:
- 总共分析了5501名回顾性和36名前性患者.
- 没有实施的机器学习模型在各种指标和发作频率上显示出与Napkin方法相比显著优异的性能.
- 如果模型不能超过Napkin方法的性能,则被认为是临床无效的.
结论:
- 目前仅使用电子日记数据的预测技术可能无法实现超出Napkin方法的简单性而实现临床有效的24小时风险预测.
- 仅使用电子日记进行有效的扣押预测的可行性在现有方法论下仍然值得怀疑.
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