scholarly journals Mechanical Learning for Prediction of Sepsis-Associated Encephalopathy

2021 ◽  
Vol 15 ◽  
Author(s):  
Lina Zhao ◽  
Yunying Wang ◽  
Zengzheng Ge ◽  
Huadong Zhu ◽  
Yi Li

Objective: The study aims to develop a mechanical learning model as a predictive model for predicting the appearance of sepsis-associated encephalopathy (SAE).Materials and Methods: The prediction model was developed in a primary cohort of 2,028 sepsis patients from June 2001 to October 2012, retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database. Least absolute shrinkage and selection operator (LASSO) regression model was used for data dimension reduction and feature selection. The model was developed using multivariable logistic regression analysis. The performance of the nomogram has been evaluated in terms of calibration, discrimination, and clinical utility.Results: There were nine particular features in septic patients that were significantly associated with SAE. Predictors of individualized prediction nomograms included age, rapid sequential evaluation of organ failure (qSOFA), and drugs including carbapenem antibiotics, quinolone antibiotics, steroids, midazolam, H2-antagonist, diphenhydramine hydrochloride, and heparin sodium injection. The area under the curve (AUC) was 0.743, indicating good discrimination. The prediction model showed calibration curves with minor deviations from the ideal predictions. Decision curve analysis (DCA) suggested that the nomogram was clinically useful.Conclusion: We propose a nomogram for the individualized prediction of SAE with satisfactory performance and clinical utility, which could aid the clinician in the early detection and management of SAE.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1004.1-1004
Author(s):  
D. Xu ◽  
R. Mu

Background:Scleroderma renal crisis (SRC) is a life-threatening syndrome. The early identification of patients at risk is essential for timely treatment to improve the outcome[1].Objectives:We aimed to provide a personalized tool to predict risk of SRC in systemic sclerosis (SSc).Methods:We tried to set up a SRC prediction model based on the PKUPH-SSc cohort of 302 SSc patients. The least absolute shrinkage and selection operator (Lasso) regression was used to optimize disease features. Multivariable logistic regression analysis was applied to build a SRC prediction model incorporating the features of SSc selected in the Lasso regression. Then, a multi-predictor nomogram combining clinical characteristics was constructed and evaluated by discrimination and calibration.Results:A multi-predictor nomogram for evaluating the risk of SRC was successfully developed. In the nomogram, four easily available predictors were contained including disease duration <2 years, cardiac involvement, anemia and corticosteroid >15mg/d exposure. The nomogram displayed good discrimination with an area under the curve (AUC) of 0.843 (95% CI: 0.797-0.882) and good calibration.Conclusion:The multi-predictor nomogram for SRC could be reliably and conveniently used to predict the individual risk of SRC in SSc patients, and be a step towards more personalized medicine.References:[1]Woodworth TG, Suliman YA, Li W, Furst DE, Clements P (2016) Scleroderma renal crisis and renal involvement in systemic sclerosis. Nat Rev Nephrol 12 (11):678-91.Disclosure of Interests:None declared


2021 ◽  
Vol 8 ◽  
pp. 204993612110340
Author(s):  
Saibin Wang

Background: Poor adherence to tuberculosis (TB) treatment is a substantial barrier to global TB control. The aim of this study was to construct a nomogram for predicting the probability of TB treatment default. Methods: A total of 1185 TB patients who had received treatment between 2010 and 2011 in Peru were analyzed in this study. Patient demographics, social, and medical information were recorded. Predictors were selected by least absolute shrinkage and selection operator (LASSO) regression analysis, and a nomogram for predicting TB treatment default was constructed by using multivariable logistic regression analysis. Bootstrapping method was applied for internal validation. Calibration and clinical utility of the nomogram was also evaluated. Results: The incidence of TB treatment default among the study patients was 11.6% (138/1185). Six predictors (secondary education status, alcohol use, illegal drug use, body mass index, multidrug-resistant tuberculosis, and human immunodeficiency virus serostatus) were selected through the LASSO regression analysis. A nomogram was developed based on the six predictors and it yielded an area under the curve (AUC) value of 0.797 [95% confidence interval (CI), 0.755–0.839]. In the internal validation, the AUC achieved 0.805 (95% CI, 0.759–0.844). Additionally, the nomogram was well-calibrated, and it showed clinical utility in decision curve analysis. Conclusion: A nomogram was constructed that incorporates six characteristics of the TB patients, which provides a good reference for predicting TB treatment default.


2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Jianqiu Kong ◽  
Junjiong Zheng ◽  
Jieying Wu ◽  
Shaoxu Wu ◽  
Jinhua Cai ◽  
...  

Abstract Background Preoperative diagnosis of pheochromocytoma (PHEO) accurately impacts preoperative preparation and surgical outcome in PHEO patients. Highly reliable model to diagnose PHEO is lacking. We aimed to develop a magnetic resonance imaging (MRI)-based radiomic-clinical model to distinguish PHEO from adrenal lesions. Methods In total, 305 patients with 309 adrenal lesions were included and divided into different sets. The least absolute shrinkage and selection operator (LASSO) regression model was used for data dimension reduction, feature selection, and radiomics signature building. In addition, a nomogram incorporating the obtained radiomics signature and selected clinical predictors was developed by using multivariable logistic regression analysis. The performance of the radiomic-clinical model was assessed with respect to its discrimination, calibration, and clinical usefulness. Results Seven radiomics features were selected among the 1301 features obtained as they could differentiate PHEOs from other adrenal lesions in the training (area under the curve [AUC], 0.887), internal validation (AUC, 0.880), and external validation cohorts (AUC, 0.807). Predictors contained in the individualized prediction nomogram included the radiomics signature and symptom number (symptoms include headache, palpitation, and diaphoresis). The training set yielded an AUC of 0.893 for the nomogram, which was confirmed in the internal and external validation sets with AUCs of 0.906 and 0.844, respectively. Decision curve analyses indicated the nomogram was clinically useful. In addition, 25 patients with 25 lesions were recruited for prospective validation, which yielded an AUC of 0.917 for the nomogram. Conclusion We propose a radiomic-based nomogram incorporating clinically useful signatures as an easy-to-use, predictive and individualized tool for PHEO diagnosis.


2021 ◽  
Author(s):  
Nianyue Wu ◽  
Siru Liu ◽  
Haotian Zhang ◽  
Xiaomin Hou ◽  
Ping Zhang ◽  
...  

BACKGROUND The intensive care unit (ICU) length of stay is significant to evaluate the effect of cardiac surgical treatment inpatient. OBJECTIVE This research aims to accurately predict the ICU length of stay in patients with cardiac surgery. Methods: We used machine learning methods to construct the model, and the medical information mart for intensive care (MIMIC IV) database was used as the data source. A total of 7,567 patients were enrolled and the mean length of stay in the ICU was 3.12 days. A total of 126 predictors were included, and 44 important predictors were screened by least absolute shrinkage and selection operator (Lasso) regression. METHODS We used machine learning methods to construct the model, and the medical information mart for intensive care (MIMIC IV) database was used as the data source. A total of 7,567 patients were enrolled and the mean length of stay in the ICU was 3.12 days. A total of 126 predictors were included, and 44 important predictors were screened by least absolute shrinkage and selection operator (Lasso) regression. RESULTS The mean accuracy are 0.603 (95% confidence interval (CI): [0.602-0.604]), 0.687 (95% confidence interval (CI): [0.687-0.688]) and 0.688 (95% confidence interval (CI): [0.687-0.689]) for the logistic regression (LR) with all variables, the gradient boosted decision tree (GBDT) with important variables and the GBDT with all variables respectively. CONCLUSIONS The GBDT model with important predictors partly overestimated patients whose length of stay was less than 3 days and underestimated patients whose length of stay was longer than 3 days. But the better prediction performance of GBDT facilitates early intervention of ICU patients with a long period of hospitalization.


2021 ◽  
Vol 9 ◽  
Author(s):  
Qiao-Ying Xie ◽  
Ming-Wei Wang ◽  
Zu-Ying Hu ◽  
Cheng-Jian Cao ◽  
Cong Wang ◽  
...  

Aim: Metabolic syndrome (MS) screening is essential for the early detection of the occupational population. This study aimed to screen out biomarkers related to MS and establish a risk assessment and prediction model for the routine physical examination of an occupational population.Methods: The least absolute shrinkage and selection operator (Lasso) regression algorithm of machine learning was used to screen biomarkers related to MS. Then, the accuracy of the logistic regression model was further verified based on the Lasso regression algorithm. The areas under the receiving operating characteristic curves were used to evaluate the selection accuracy of biomarkers in identifying MS subjects with risk. The screened biomarkers were used to establish a logistic regression model and calculate the odds ratio (OR) of the corresponding biomarkers. A nomogram risk prediction model was established based on the selected biomarkers, and the consistency index (C-index) and calibration curve were derived.Results: A total of 2,844 occupational workers were included, and 10 biomarkers related to MS were screened. The number of non-MS cases was 2,189 and that of MS was 655. The area under the curve (AUC) value for non-Lasso and Lasso logistic regression was 0.652 and 0.907, respectively. The established risk assessment model revealed that the main risk biomarkers were absolute basophil count (OR: 3.38, CI:1.05–6.85), platelet packed volume (OR: 2.63, CI:2.31–3.79), leukocyte count (OR: 2.01, CI:1.79–2.19), red blood cell count (OR: 1.99, CI:1.80–2.71), and alanine aminotransferase level (OR: 1.53, CI:1.12–1.98). Furthermore, favorable results with C-indexes (0.840) and calibration curves closer to ideal curves indicated the accurate predictive ability of this nomogram.Conclusions: The risk assessment model based on the Lasso logistic regression algorithm helped identify MS with high accuracy in physically examining an occupational population.


2021 ◽  
Author(s):  
Jun Chen ◽  
Yimin Wang ◽  
Xinyang Shou ◽  
Qiang Liu ◽  
Ziwei Mei

Abstract BACKGROUND Despite the large number of studies focus on the prognosis and in-hospital outcomes risk factors of patients with takotsubo syndrome, there was still lack of utility and visual risk prediction model for predicting the in-hospital mortality of patients with takotsubo syndrome. OBJECTIVES Our study aimed to establish a utility risk prediction model for the prognosis of in-hospital patients with takotsubo syndrome (TTS). METHODS The study is a retrospective cohort study. Model of in-hospital mortality of TTS patients was developed by multivariable logistic regression analysis. Calibration and discrimination were used to assess the performance of the nomogram. The clinical utility of the model was evaluated by decision curve analysis (DCA). RESULTS Overall, 368 TTS patients (320 Survivals and 48 deaths) were included in our research from MIMIC-IV database. The incidence of in-hospital mortality with TTS is 13.04%. Lasso regression and multivariate logistic regression model verified that potassium, pt, age, myocardial infarction, WBC, hematocrit, anion gap and SOFA score were significantly associated with in-hospital mortality of TTS patients. The nomogram demonstrated a good discrimination with a AUC of ROC 0.811(95%Cl: 0.746-0.876) in training set and 0.793(95%Cl: 0.724-0.862) in test set. The calibration plot of risk prediction model showed predicted probabilities against observed death rates indicated excellent concordance. DCA showed that the nomogram has good clinical benefits. Conclusion We developed a nomogram that predict hospital mortality in patients with TTS according to clinical data. The nomogram exhibited excellent discrimination and calibration capacity, favoring its clinical utility.


2020 ◽  
Author(s):  
Qiao-Ying Xie ◽  
Ming-Wei Wang ◽  
Zu-Ying Hu ◽  
Yan-Ming Chu ◽  
Cheng-Jian Cao ◽  
...  

Abstract Background: Metabolic syndrome (MS) screening is important for the early detection of occupational population. This study aimed to screen out biomarkers related to MS and establish a risk assessment and prediction model for the routine physical examination of an occupational population.Methods: The least absolute shrinkage and selection operator (Lasso) regression algorithm of machine learning was used to screen biomarkers related to MS. Then, the accuracy of the logistic regression model was further verified based on the Lasso regression algorithm. Finally, the screened biomarkers were used to establish a logistic regression model and calculate the odds ratio (OR) of the corresponding biomarkers. Results: A total of 2844 occupational workers were included, and 10 biomarkers related to MS were screened. The area under the curve (AUC) value for non-Lasso and Lasso regression was 0.652 and 0.907, respectively. The established risk assessment model revealed that the main risk factors were basophil absolute count (OR: 3.38), platelet packed volume (OR: 2.63), leukocyte count (OR: 2.01), red blood cell count (OR: 1.99), and alanine aminotransferase level (OR: 1.53). Conclusion: The risk assessment model based on the Lasso regression algorithm helped identify Metabolic syndrome with high accuracy in physically examining an occupational population.


2020 ◽  
Author(s):  
Yu Tian ◽  
Wei Zhao ◽  
Yuefu Wang ◽  
Chunrong Wang ◽  
Xiaolin Diao ◽  
...  

Abstract Background In the development of scoring systems for acute kidney injury (AKI) following cardiac surgery, previous investigations have primarily and solely attached importance to preoperative associated risk factors without any consideration for surgery-derived physiopathology. We sought to internally derive and then validate risk score systems using pre- and intraoperative variables to predict the occurrence of any-stage (stage 1-3) and stage-3 AKI within 7 days.Methods Patients undergoing cardiac surgery from Jan 1, 2012, to Jan 1, 2019, were enrolled in our retrospective study. The clinical data were divided into a derivation cohort (n= 43799) and a validation cohort (n= 14600). Multivariable logistic regression analysis was used to develop the prediction models.Results The overall prevalence of any-stage and stage-3 AKI after cardiac surgery was 34.3% and 1.7%, respectively. Any-stage AKI prediction-model discrimination measured by the area under the curve (AUC) was acceptable (AUC = 0.69, 95% CI: 0.68, 0.69), and the prediction model calibration measured by the Hosmer-Lemshow test was good (P = 0.95). The stage-3 AKI prediction model had an AUC of 0.84 (95% CI 0.83, 0.85) and good calibration according to the Hosmer-Lemshow test (P = 0.73).Conclusions Using pre- and intraoperative data, we developed two scoring systems for any-stage AKI and stage-3 AKI in a cardiac surgery population. These scoring systems can potentially be adopted clinically in the field of AKI recognition and therapeutic intervention.


Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1221
Author(s):  
Fan Hu ◽  
Ruijie Gong ◽  
Yexin Chen ◽  
Jinxin Zhang ◽  
Tian Hu ◽  
...  

Since China’s launch of the COVID-19 vaccination, the situation of the public, especially the mobile population, has not been optimistic. We investigated 782 factory workers for whether they would get a COVID-19 vaccine within the next 6 months. The participants were divided into a training set and a testing set for external validation conformed to a ratio of 3:1 with R software. The variables were screened by the Lead Absolute Shrinkage and Selection Operator (LASSO) regression analysis. Then, the prediction model, including important variables, used a multivariate logistic regression analysis and presented as a nomogram. The Receiver Operating Characteristic (ROC) curve, Kolmogorov–Smirnov (K-S) test, Lift test and Population Stability Index (PSI) were performed to test the validity and stability of the model and summarize the validation results. Only 45.54% of the participants had vaccination intentions, while 339 (43.35%) were unsure. Four of the 16 screened variables—self-efficacy, risk perception, perceived support and capability—were included in the prediction model. The results indicated that the model has a high predictive power and is highly stable. The government should be in the leading position, and the whole society should be mobilized and also make full use of peer education during vaccination initiatives.


2021 ◽  
Vol 13 ◽  
Author(s):  
Zirui Meng ◽  
Minjin Wang ◽  
Shuo Guo ◽  
Yanbing Zhou ◽  
Mingxue Zheng ◽  
...  

BackgroundTimely diagnosis of ischemic stroke (IS) in the acute phase is extremely vital to achieve proper treatment and good prognosis. In this study, we developed a novel prediction model based on the easily obtained information at initial inspection to assist in the early identification of IS.MethodsA total of 627 patients with IS and other intracranial hemorrhagic diseases from March 2017 to June 2018 were retrospectively enrolled in the derivation cohort. Based on their demographic information and initial laboratory examination results, the prediction model was constructed. The least absolute shrinkage and selection operator algorithm was used to select the important variables to form a laboratory panel. Combined with the demographic variables, multivariate logistic regression was performed for modeling, and the model was encapsulated within a visual and operable smartphone application. The performance of the model was evaluated on an independent validation cohort, formed by 304 prospectively enrolled patients from June 2018 to May 2019, by means of the area under the curve (AUC) and calibration.ResultsThe prediction model showed good discrimination (AUC = 0.916, cut-off = 0.577), calibration, and clinical availability. The performance was reconfirmed in the more complex emergency department. It was encapsulated as the Stroke Diagnosis Aid app for smartphones. The user can obtain the identification result by entering the values of the variables in the graphical user interface of the application.ConclusionThe prediction model based on laboratory and demographic variables could serve as a favorable supplementary tool to facilitate complex, time-critical acute stroke identification.


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