预测静脉血栓栓塞的机器学习在关节关节整形术后:临床适用性和模型性能系统审查
Junwei Ma1, Huifeng Tang2, Yunshan Zhang2
1School of Nursing, Jilin University, Changchun, China.
JMIR medical informatics
|February 12, 2026
概括
在关节置换后预测静脉血栓栓塞的机器学习模型显示出可变的性能和高偏差风险. 外部验证对于这些预测模型的临床适用性至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 人工智能在医学中的应用
- 临床预测模型临床预测模型
背景情况:
- 越来越多的人对应用机器学习 (ML) 来预测静脉血栓塞栓症 (VTE) 的兴趣.
- 然而,这些ML模型的临床实用性和方法严谨性需要彻底评估.
研究的目的:
- 系统地审查和评估ML模型在关节置换手术后对VTE风险的预测性能.
- 评估这些预测模型中的方法质量和偏差风险.
主要方法:
- 在多个数据库 (Web of Science,Embase,Scopus等) 进行了全面的文献搜索. 在2024年12月15日之前.
- 使用PROBAST检查清单来评估包含的模型的偏差风险和适用性.
- 关于模型特征和性能的数据被提取用于定性分析.
主要成果:
- 该审查包括来自9项研究的34个预测模型,其中极端梯度增强和物流回归是常见的ML技术.
- 在所有研究中都观察到显著的异质性和高偏差风险.
- 虽然一些模型报告了高分辨能力 (AUC>0.9),但它们往往缺乏外部验证,这表明潜在的过拟合;外部验证的模型显示了更保守的性能.
结论:
- 关节置换后VTE风险的ML模型的预测性能不一致且高度可变.
- 普遍存在的偏差高风险需要在临床应用中保持谨慎.
- 未来的研究应该优先考虑前性设计,强大的数据处理和外部验证,以提高模型的通用性和临床实用性.
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