scholarly journals An Easy-to-Use Machine Learning Model to Predict the Prognosis of Patients With COVID-19: Retrospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Hyung-Jun Kim ◽  
Deokjae Han ◽  
Jeong-Han Kim ◽  
Daehyun Kim ◽  
Beomman Ha ◽  
...  

BACKGROUND Prioritizing patients in need of intensive care is necessary to reduce the mortality rate during the COVID-19 pandemic. Although several scoring methods have been introduced, many require laboratory or radiographic findings that are not always easily available. OBJECTIVE The purpose of this study was to develop a machine learning model that predicts the need for intensive care for patients with COVID-19 using easily obtainable characteristics—baseline demographics, comorbidities, and symptoms. METHODS A retrospective study was performed using a nationwide cohort in South Korea. Patients admitted to 100 hospitals from January 25, 2020, to June 3, 2020, were included. Patient information was collected retrospectively by the attending physicians in each hospital and uploaded to an online case report form. Variables that could be easily provided were extracted. The variables were age, sex, smoking history, body temperature, comorbidities, activities of daily living, and symptoms. The primary outcome was the need for intensive care, defined as admission to the intensive care unit, use of extracorporeal life support, mechanical ventilation, vasopressors, or death within 30 days of hospitalization. Patients admitted until March 20, 2020, were included in the derivation group to develop prediction models using an automated machine learning technique. The models were externally validated in patients admitted after March 21, 2020. The machine learning model with the best discrimination performance was selected and compared against the CURB-65 (confusion, urea, respiratory rate, blood pressure, and 65 years of age or older) score using the area under the receiver operating characteristic curve (AUC). RESULTS A total of 4787 patients were included in the analysis, of which 3294 were assigned to the derivation group and 1493 to the validation group. Among the 4787 patients, 460 (9.6%) patients needed intensive care. Of the 55 machine learning models developed, the XGBoost model revealed the highest discrimination performance. The AUC of the XGBoost model was 0.897 (95% CI 0.877-0.917) for the derivation group and 0.885 (95% CI 0.855-0.915) for the validation group. Both the AUCs were superior to those of CURB-65, which were 0.836 (95% CI 0.825-0.847) and 0.843 (95% CI 0.829-0.857), respectively. CONCLUSIONS We developed a machine learning model comprising simple patient-provided characteristics, which can efficiently predict the need for intensive care among patients with COVID-19.

10.2196/24225 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e24225
Author(s):  
Hyung-Jun Kim ◽  
Deokjae Han ◽  
Jeong-Han Kim ◽  
Daehyun Kim ◽  
Beomman Ha ◽  
...  

Background Prioritizing patients in need of intensive care is necessary to reduce the mortality rate during the COVID-19 pandemic. Although several scoring methods have been introduced, many require laboratory or radiographic findings that are not always easily available. Objective The purpose of this study was to develop a machine learning model that predicts the need for intensive care for patients with COVID-19 using easily obtainable characteristics—baseline demographics, comorbidities, and symptoms. Methods A retrospective study was performed using a nationwide cohort in South Korea. Patients admitted to 100 hospitals from January 25, 2020, to June 3, 2020, were included. Patient information was collected retrospectively by the attending physicians in each hospital and uploaded to an online case report form. Variables that could be easily provided were extracted. The variables were age, sex, smoking history, body temperature, comorbidities, activities of daily living, and symptoms. The primary outcome was the need for intensive care, defined as admission to the intensive care unit, use of extracorporeal life support, mechanical ventilation, vasopressors, or death within 30 days of hospitalization. Patients admitted until March 20, 2020, were included in the derivation group to develop prediction models using an automated machine learning technique. The models were externally validated in patients admitted after March 21, 2020. The machine learning model with the best discrimination performance was selected and compared against the CURB-65 (confusion, urea, respiratory rate, blood pressure, and 65 years of age or older) score using the area under the receiver operating characteristic curve (AUC). Results A total of 4787 patients were included in the analysis, of which 3294 were assigned to the derivation group and 1493 to the validation group. Among the 4787 patients, 460 (9.6%) patients needed intensive care. Of the 55 machine learning models developed, the XGBoost model revealed the highest discrimination performance. The AUC of the XGBoost model was 0.897 (95% CI 0.877-0.917) for the derivation group and 0.885 (95% CI 0.855-0.915) for the validation group. Both the AUCs were superior to those of CURB-65, which were 0.836 (95% CI 0.825-0.847) and 0.843 (95% CI 0.829-0.857), respectively. Conclusions We developed a machine learning model comprising simple patient-provided characteristics, which can efficiently predict the need for intensive care among patients with COVID-19.


2021 ◽  
Author(s):  
Jaeyoung Yang ◽  
Hong-Gook Lim ◽  
Wonhyeong Park ◽  
Dongseok Kim ◽  
Jin Sun Yoon ◽  
...  

Abstract BackgroundPrediction of mortality in intensive care units is very important. Thus, various mortality prediction models have been developed for this purpose. However, they do not accurately reflect the changing condition of the patient in real time. The aim of this study was to develop and evaluate a machine learning model that predicts short-term mortality in the intensive care unit using four easy-to-collect vital signs.MethodsTwo independent retrospective observational cohorts were included in this study. The primary training cohort included the data of 1968 patients admitted to the intensive care unit at the Veterans Health Service Medical Center, Seoul, South Korea, from January 2018 to March 2019. The external validation cohort comprised the records of 409 patients admitted to the medical intensive care unit at Seoul National University Hospital, Seoul, South Korea, from January 2019 to December 2019. Datasets of four vital signs (heart rate, systolic blood pressure, diastolic blood pressure, and peripheral capillary oxygen saturation [SpO2]) measured every hour for 10 h were used for the development of the machine learning model. The performances of mortality prediction models generated using five machine learning algorithms, Random Forest (RF), XGboost, perceptron, convolutional neural network, and Long Short-Term Memory, were calculated and compared using area under the receiver operating characteristic curve (AUROC) values and an external validation dataset.ResultsThe machine learning model generated using the RF algorithm showed the best performance. Its AUROC was 0.922, which is much better than the 0.8408 of the Acute Physiology and Chronic Health Evaluation II. Thus, to investigate the importance of variables that influence the performance of the machine learning model, machine learning models were generated for each observation time or vital sign using the RF algorithm. The machine learning model developed using SpO2 showed the best performance (AUROC, 0.89). ConclusionsThe mortality prediction model developed in this study using data from only four types of commonly recorded vital signs is simpler than any existing mortality prediction model. This simple yet powerful new mortality prediction model could be useful for early detection of probable mortality and appropriate medical intervention, especially in rapidly deteriorating patients.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bongjin Lee ◽  
Kyunghoon Kim ◽  
Hyejin Hwang ◽  
You Sun Kim ◽  
Eun Hee Chung ◽  
...  

AbstractThe aim of this study was to develop a predictive model of pediatric mortality in the early stages of intensive care unit (ICU) admission using machine learning. Patients less than 18 years old who were admitted to ICUs at four tertiary referral hospitals were enrolled. Three hospitals were designated as the derivation cohort for machine learning model development and internal validation, and the other hospital was designated as the validation cohort for external validation. We developed a random forest (RF) model that predicts pediatric mortality within 72 h of ICU admission, evaluated its performance, and compared it with the Pediatric Index of Mortality 3 (PIM 3). The area under the receiver operating characteristic curve (AUROC) of RF model was 0.942 (95% confidence interval [CI] = 0.912–0.972) in the derivation cohort and 0.906 (95% CI = 0.900–0.912) in the validation cohort. In contrast, the AUROC of PIM 3 was 0.892 (95% CI = 0.878–0.906) in the derivation cohort and 0.845 (95% CI = 0.817–0.873) in the validation cohort. The RF model in our study showed improved predictive performance in terms of both internal and external validation and was superior even when compared to PIM 3.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eyal Klang ◽  
Benjamin R. Kummer ◽  
Neha S. Dangayach ◽  
Amy Zhong ◽  
M. Arash Kia ◽  
...  

AbstractEarly admission to the neurosciences intensive care unit (NSICU) is associated with improved patient outcomes. Natural language processing offers new possibilities for mining free text in electronic health record data. We sought to develop a machine learning model using both tabular and free text data to identify patients requiring NSICU admission shortly after arrival to the emergency department (ED). We conducted a single-center, retrospective cohort study of adult patients at the Mount Sinai Hospital, an academic medical center in New York City. All patients presenting to our institutional ED between January 2014 and December 2018 were included. Structured (tabular) demographic, clinical, bed movement record data, and free text data from triage notes were extracted from our institutional data warehouse. A machine learning model was trained to predict likelihood of NSICU admission at 30 min from arrival to the ED. We identified 412,858 patients presenting to the ED over the study period, of whom 1900 (0.5%) were admitted to the NSICU. The daily median number of ED presentations was 231 (IQR 200–256) and the median time from ED presentation to the decision for NSICU admission was 169 min (IQR 80–324). A model trained only with text data had an area under the receiver-operating curve (AUC) of 0.90 (95% confidence interval (CI) 0.87–0.91). A structured data-only model had an AUC of 0.92 (95% CI 0.91–0.94). A combined model trained on structured and text data had an AUC of 0.93 (95% CI 0.92–0.95). At a false positive rate of 1:100 (99% specificity), the combined model was 58% sensitive for identifying NSICU admission. A machine learning model using structured and free text data can predict NSICU admission soon after ED arrival. This may potentially improve ED and NSICU resource allocation. Further studies should validate our findings.


Author(s):  
Akshata Kulkarni

Abstract: Officials around the world are using several COVID-19 outbreak prediction models to make educated decisions and enact necessary control measures. In this study, we developed a Machine Learning model which predicts and forecasts the COVID-19 outbreak in India, with the goal of determining the best regression model for an in-depth examination of the novel coronavirus. Based on data available from January 31 to October 31, 2020, collected from Kaggle, this model predicts the number of confirmed cases in Maharashtra. We're using a Machine Learning model to foresee the future trend of these situations. The project has the potential to demonstrate the importance of information dissemination in improving response time and planning ahead of time to help reduce risk.


2019 ◽  
Author(s):  
Abdul Karim ◽  
Vahid Riahi ◽  
Avinash Mishra ◽  
Abdollah Dehzangi ◽  
M. A. Hakim Newton ◽  
...  

Abstract Representing molecules in the form of only one type of features and using those features to predict their activities is one of the most important approaches for machine-learning-based chemical-activity-prediction. For molecular activities like quantitative toxicity prediction, the performance depends on the type of features extracted and the machine learning approach used. For such cases, using one type of features and machine learning model restricts the prediction performance to specific representation and model used. In this paper, we study quantitative toxicity prediction and propose a machine learning model for the same. Our model uses an ensemble of heterogeneous predictors instead of typically using homogeneous predictors. The predictors that we use vary either on the type of features used or on the deep learning architecture employed. Each of these predictors presumably has its own strengths and weaknesses in terms of toxicity prediction. Our motivation is to make a combined model that utilizes different types of features and architectures to obtain better collective performance that could go beyond the performance of each individual predictor. We use six predictors in our model and test the model on four standard quantitative toxicity benchmark datasets. Experimental results show that our model outperforms the state-of-the-art toxicity prediction models in 8 out of 12 accuracy measures. Our experiments show that ensembling heterogeneous predictor improves the performance over single predictors and homogeneous ensembling of single predictors.The results show that each data representation or deep learning based predictor has its own strengths and weaknesses, thus employing a model ensembling multiple heterogeneous predictors could go beyond individual performance of each data representation or each predictor type.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gregor Lichtner ◽  
Felix Balzer ◽  
Stefan Haufe ◽  
Niklas Giesa ◽  
Fridtjof Schiefenhövel ◽  
...  

AbstractIn a pandemic with a novel disease, disease-specific prognosis models are available only with a delay. To bridge the critical early phase, models built for similar diseases might be applied. To test the accuracy of such a knowledge transfer, we investigated how precise lethal courses in critically ill COVID-19 patients can be predicted by a model trained on critically ill non-COVID-19 viral pneumonia patients. We trained gradient boosted decision tree models on 718 (245 deceased) non-COVID-19 viral pneumonia patients to predict individual ICU mortality and applied it to 1054 (369 deceased) COVID-19 patients. Our model showed a significantly better predictive performance (AUROC 0.86 [95% CI 0.86–0.87]) than the clinical scores APACHE2 (0.63 [95% CI 0.61–0.65]), SAPS2 (0.72 [95% CI 0.71–0.74]) and SOFA (0.76 [95% CI 0.75–0.77]), the COVID-19-specific mortality prediction models of Zhou (0.76 [95% CI 0.73–0.78]) and Wang (laboratory: 0.62 [95% CI 0.59–0.65]; clinical: 0.56 [95% CI 0.55–0.58]) and the 4C COVID-19 Mortality score (0.71 [95% CI 0.70–0.72]). We conclude that lethal courses in critically ill COVID-19 patients can be predicted by a machine learning model trained on non-COVID-19 patients. Our results suggest that in a pandemic with a novel disease, prognosis models built for similar diseases can be applied, even when the diseases differ in time courses and in rates of critical and lethal courses.


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