机器学习模型的开发和验证,用于在高风险成年人中使用临床数据现场预测冠心病
Liwen Mo1, Hua Lin1, Chengxuan Li2
1Health care center, the Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
PloS one
|November 13, 2025
概括
一个新的双层机器学习模型 (TLML) 准确地使用临床数据预测冠心病 (CHD) 风险. 该模型的性能优于传统的评分,为现场的CHD风险评估提供了有价值的工具.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 机器学习 机器学习
背景情况:
- 传统的冠心病 (CHD) 风险评估依赖于诸如聚合队列方程 (PCE) 等模型.
- 使用辅助诊断分数进行量化现场心血管疾病风险估计的研究不足.
- 机器学习 (ML) 模型对心脏病预测有希望,但需要临床验证.
研究的目的:
- 开发一种ML模型,仅使用临床数据来预测高风险人群中的CHD风险.
- 在侵入性诊断之前创建一个现场定量指标,用于CHD风险评估.
- 通过现实世界的临床数据验证ML模型,以便在实践中应用.
主要方法:
- 对20821名心血管疾病患者和9796名对照患者 (2017-2024) 的回顾性队列研究.
- 开发一个双层机器学习模型 (TLML),结合随机森林和渐变增强决策树.
- 模型培训和验证使用包括生命体,实验室,诊断和药物在内的综合临床数据.
主要成果:
- 在现场CHD预测中,TLML实现了高精度 (0.79),灵敏度 (0.79),和特异性 (0.79).
- 在预测性能方面,TLML显著优于PCE (精度为0.59).
- 确定的主要预测因素包括年龄,糖尿病,高血压和特定的实验室值;一个20个预测模型保留了0.73准确度.
结论:
- ML模型,特别是开发的TLML,显示出作为辅助的CHD现场诊断工具的潜力.
- 这些模型提供准确的CHD风险预测,随时可用的临床变量.
- 进一步验证和实施可以提高早期心脏病风险评估和患者管理.
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