对10年心血管疾病风险预测的生存机器学习模型进行基准测试,使用大规模的电子健康记录
Tianyi Liu1, Andrew Krentz1,2, Lei Lu1
1School of Life Course & Population Sciences, King's College London, London, UK.
Digital health
|January 28, 2026
概括
机器学习模型显著改善了对传统方法的10年心血管疾病 (CVD) 风险预测. 这些使用电子健康记录 (EHR) 的先进模型提供了更好的校准和歧视,以提高患者风险评估.
科学领域:
- 心血管疾病研究研究
- 医疗保健中的机器学习
- 医疗信息学 医疗信息学
背景情况:
- 心血管疾病 (CVD) 仍然是全球主要的死亡原因.
- 准确的10年风险预测对于初级预防策略至关重要.
- 目前的模型,如QRISK3和Cox比例危险 (CoxPH),在捕捉复杂的风险模式方面存在局限性.
研究的目的:
- 评估基于机器学习 (ML) 的存活模型,用于10年心血管疾病风险预测.
- 将ML模型与使用大型电子健康记录 (EHR) 的QRISK3和CoxPH模型进行比较.
- 评估ML在识别传统方法之外的复杂风险因素方面的潜力.
主要方法:
- 利用来自CPRD Aurum数据库 (2011-2021) 的469,496名患者 (40-85岁) 的个人数据.
- 开发了ML模型,包括深度神经网络 (DeepSurv,DeepHit) 和集合生存模型 (随机生存森林,梯度增强).
- 在伦敦的数据集上进行空间外部验证,评估校准和歧视指标.
主要成果:
- 合并方法和神经网络在预测心血管疾病风险方面表现优于CoxPH模型.
- 随机生存森林 (RSF) 显示出优越的歧视和校准 (AUROC:男性0.738,女性0.778;布赖尔分数:0.088,0.055).
- QRISK3表现出强的表现,特别是在女性中,这表明增强现有工具的价值.
结论:
- 与传统方法相比,机器学习模型为心血管疾病风险预测提供了增强的校准和歧视.
- 将预分层风险得分与ML模型相结合,进一步提高了预测性能.
- 机器学习模型显示了增强当前心血管疾病风险评估工具 (如QRISK) 的巨大潜力.
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