从入院数据的前2天预测长期住院时间:基于SHAP值的变量选择方法用于简化模型
Rui Fa1, Daniel Stoessel2, Svetlana Artemova3
1Elsevier Health Analytics, London, EC2Y 5AS, United Kingdom.
概括
预测长期住院时间 (LOS) 对资源管理和患者护理至关重要. 使用早期住院数据的机器学习模型可以准确识别有风险的患者,从而实现及时干预.
科学领域:
- 医疗信息学 医疗信息学
- 临床预测模型临床预测模型
- 医疗保健服务研究 医疗服务研究
背景情况:
- 长期住院时间 (LOS) 耗费医院资源,并对患者产生负面影响.
- 早期识别患有长期LOS风险的患者对于主动管理和资源分配至关重要.
- 预测长期LOS需要分析广泛的临床,人口和医疗保健参数.
研究的目的:
- 用入院前两天内可用的变量开发长期住院LOS的预测模型.
- 从早期临床数据中确定长期LOS的关键预测因素.
- 创建一个简化,临床适用的模型来预测长时间住院的情况.
主要方法:
- 在大量成人住院病例 (2016-2018) 的数据集上使用了两阶段的预测建模方法.
- 采用机器学习算法,包括XGBoost,并使用AUC-ROC和F2分数评估性能.
- 在变量选择和模型简化方面应用了SHAP (SHapley增材扩张) 方法.
主要成果:
- 使用低样本的XGBoost实现了AUC-ROC为0.802和F2得分为0.533.
- 使用SHAP值的变量减小保持了高预测性能 (AUC-ROC 0.804,F2得分0.536).
- 从523到150的变量显著减少,对预测准确度的影响最小.
结论:
- 复杂的模型可以预测长期的LOS,但通常不适合临床使用.
- 基于SHAP值的变量选择简化了模型,同时保持了预测能力.
- 简化模型有助于在常规临床实践中更容易实施及时干预.
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