在临床环境中部署机器学习模型:对一种模型的现实可行性分析,用于识别最初被归类为2型的成人发病1型糖尿病
Irene Brusini1, Suyin Lee2, Jacob Hollingsworth2
1AI for Healthcare & MedTech, IQVIA, London W2 1AF, United Kingdom.
JAMIA open
|October 29, 2025
概括
这项研究表明,机器学习 (ML) 模型可以识别成人发病型1型糖尿病 (T1D),在电子病历 (EMR) 中被错误分类为2型. 定位ML模型提高了患者查的准确性,证明了现实世界健康信息交换 (HIE) 数据的可行性.
科学领域:
- 医疗信息学 医疗信息学
- 机器学习应用 机器学习应用
- 糖尿病研究 糖尿病研究
背景情况:
- 成人发病的1型糖尿病 (T1D) 在电子病历 (EMR) 中经常被错误地归类为2型糖尿病.
- 卫生信息交换 (HIE) 汇总来自多个来源的数据,为大规模分析提供了机会.
- 准确识别T1D对于适当的患者管理和治疗至关重要.
研究的目的:
- 评估机器学习 (ML) 模型的性能和部署可行性,用于识别HIE数据中错误地归类为2型的成人T1D.
- 为了比较先前存在的国家ML模型与在区域HIE数据上重新训练的本地化模型.
- 调查有关ML模型性能的国家EMR数据和区域HIE数据之间的差异.
主要方法:
- 一个现有的ML模型,在国家EMR数据上训练,被调整并测试在区域HIE数据集上.
- 一个本地化的ML模型使用区域HIE数据集进行了重新训练,以进行直接比较.
- 分析了国家和区域数据集之间的特征和队列差异.
主要成果:
- 国家ML模型在HIE数据上取得了良好的表现 (AUROC = 0.751,PR5 = 25.5%).
- 对ML模型的定位显著改善了性能 (AUROC = 0.774,PR5 = 35.4%).
- 顶级预测因素的差异突出显示了HIE数据集差异和数据捕获差距.
结论:
- 机器学习模型在真实世界HIE数据中对识别错误分类的成人T1D显示出希望.
- 模型本地化提高了患者查的精度,但可能会带来复杂性和可扩展性挑战.
- 在HIEs中的数据不一致性需要仔细考虑,以保持ML模型的准确性和提供商的信任.
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