系统审查和对机器学习和传统统计模型进行比较,以预测透析患者的心血管事件
Yifei Lu1, Canyu Chen1, Junxiang Qiu2,3
1School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Renal failure
|November 19, 2025
概括
机器学习 (ML) 模型和传统统计模型 (CSM) 在预测透析患者心血管事件方面表现相似. 深度学习模型显示出前景,但整体上ML并没有显著超过CSM,CSM仍然是可行的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 人工智能的人工智能
- 生物统计学 生物统计学
背景情况:
- 心血管事件是透析患者的主要关注点.
- 预测模型可以帮助风险分层和风险管理.
- 评估机器学习 (ML) 和传统统计模型 (CSM) 的比较性能至关重要.
研究的目的:
- 系统地审查和比较ML模型与CSM的性能,以预测透析患者的心血管事件.
- 评估包含的研究中的偏差风险,并进行子组分析以探索性能变化.
主要方法:
- 按照PRISMA指南进行系统审查,搜索PubMed和Embase (2015年1月至2025年3月).
- 包括14项研究,涉及29310名患者和34个模型.
- 使用曼·惠特尼U测试比较模型性能 (AUC/C指数);通过PROBAST评估偏差风险.
主要成果:
- 在ML模型中,与CSM (0.772 ± 0.066) 的区别可比 (平均AUC:0.784 ± 0.112),但没有统计学上显著的差异 (p=0.24).
- 深度学习模型的表现明显优于传统的ML和CSM (p=0.005),而传统的ML对CSM没有任何优势 (p=0.727).
- 大多数研究 (71.43%) 的偏差风险较低,但主要来自中国 (71.40%) 并使用内部验证 (78.57%),限制了概括性.
结论:
- 总的来说,ML模型在预测透析患者心血管事件方面并不显著优于CSM.
- CSM仍然是一个可行的选择,特别是在资源有限的环境中.
- 未来的研究应该专注于强大的验证框架和临床实施,考虑准确性和可解释性之间的权衡.
更多相关视频
相关概念视频
01:27Dialysis
1.1K
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
1.1K
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
175
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
175
01:25Hemodialysis I: Introduction
1.2K
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
1.2K
01:28Chronic Kidney Disease III: Interprofessional Care
326
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
326
01:30Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
379
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
379
01:18Chronic Kidney Disease IV: Nursing Management
307
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
307