scholarly journals A Machine-Learning Model Based on Morphogeometric Parameters for RETICS Disease Classification and GUI Development

2020 ◽  
Vol 10 (5) ◽  
pp. 1874 ◽  
Author(s):  
José M. Bolarín ◽  
F. Cavas ◽  
J.S. Velázquez ◽  
J.L. Alió

This work pursues two objectives: defining a new concept of risk probability associated with suffering early-stage keratoconus, classifying disease severity according to the RETICS (Thematic Network for Co-Operative Research in Health) scale. It recruited 169 individuals, 62 healthy and 107 keratoconus diseased, grouped according to the RETICS classification: 44 grade I; 18 grade II; 15 grade III; 15 grade IV; 15 grade V. Different demographic, optical, pachymetric and eometrical parameters were measured. The collected data were used for training two machine-learning models: a multivariate logistic regression model for early keratoconus detection and an ordinal logistic regression model for RETICS grade assessments. The early keratoconus detection model showed very good sensitivity, specificity and area under ROC curve, with around 95% for training and 85% for validation. The variables that made the most significant contributions were gender, coma-like, central thickness, high-order aberrations and temporal thickness. The RETICS grade assessment also showed high-performance figures, albeit lower, with a global accuracy of 0.698 and a 95% confidence interval of 0.623–0.766. The most significant variables were CDVA, central thickness and temporal thickness. The developed web application allows the fast, objective and quantitative assessment of keratoconus in early diagnosis and RETICS grading terms.

2020 ◽  
Author(s):  
Qiqiang Liang ◽  
Qinyu Zhao ◽  
Xin Xu ◽  
Yu Zhou ◽  
Man Huang

Abstract Background The prevention and control of carbapenem-resistance gram-negative bacteria (CR-GNB) is the difficulty and focus for clinicians in the intensive care unit (ICU). This study construct a CR-GNB carriage prediction model in order to predict the CR-GNB incidence in one week. Methods The database is comprised of nearly 10,000 patients. the model is constructed by the multivariate logistic regression model and three machine learning algorithms. Then we choose the optimal model and verify the accuracy by daily predicted and recorded the occurrence of CR-GNB of all patients admitted for 4 months. Results There are 1385 patients with positive CR-GNB cultures and 1535 negative patients in this study. Forty-five variables have statistical significant differences. We include the 17 variables in the multivariate logistic regression model and build three machine learning models for all variables. In terms of accuracy and the area under the receiver operating characteristic (AUROC) curve, the random forest is better than XGBoost and multivariate logistic regression model, and better than decision tree model (accuracy: 84% >82%>81%>72%), (AUROC: 0.9089 > 0.8947 ≈ 0.8987 > 0.7845). In the 4-month prospective study, 81 cases were predicted to be positive in CR-GNB culture within 7 days, 146 cases were predicted to be negative, 86 cases were positive, and 120 cases were negative, with an overall accuracy of 84% and AUROC of 91.98%. Conclusions Prediction models by machine learning can predict the occurrence of CR-GNB colonization or infection within a week period, and can real-time predict and guide medical staff to identify high-risk groups more accurately.


2020 ◽  
Author(s):  
Atsushi Senda ◽  
Akira Endo ◽  
Takahiro Kinoshita ◽  
Yasuhiro Otomo

Abstract Background The clinical benefits of hybrid operating rooms are recognized globally. However, appropriate conditions for entry into such rooms must be urgently established, because they exclusively benefit few patients under severe trauma while requiring a significant amount of resources. This paper presents an algorithm to triage trauma patients into a hybrid operating room. Methods This retrospective observational study was conducted using the Japan Trauma Data Bank database comprising information collected between January 2004 and December 2018. A machine-learning-based triage algorithm is developed using the baseline demographics, injury mechanisms, and vital signs obtained from the database. The analysis dataset comprised information regarding 117,771 trauma patients with abbreviated injury scale (AIS) > 3. The performance of the proposed model was compared against those of other statistical models (logistic regression and classification and regression tree [CART] models) while considering the status quo entry condition (systolic blood pressure < 90 mmHg). Results The proposed trauma hybrid-suite entry algorithm (THETA) outperforms other algorithms (PR-AUC: THETA [0.59], logistic regression model [0.22], and CART [0.20]; AUROC: THETA [0.93], logistic regression model [0.88], and CART [0.86]), thereby facilitating appropriate triaging of patients who would potentially benefit from resuscitation performed using angiographic percutaneous techniques and operative resuscitation suites. Conclusions An accurate machine-learning-based algorithm is developed to triage patient entry into hybrid operating rooms via a web application, thereby enabling emergency doctors to utilize limited medical resources more efficiently.


2020 ◽  
Vol 77 (1) ◽  
pp. 35-40
Author(s):  
Rade Milic ◽  
Boris Dzudovic ◽  
Bojana Subotic ◽  
Slobodan Obradovic ◽  
Ivan Soldatovic ◽  
...  

Background/Aim. Acute pulmonary embolism (APE) may have different clinical manifestations. Also, its outcome can range from complete recovery to early death. Major bleeding (MB) as a due of the therapy also contributes to the overall adverse outcome. So far, it is unknown what the best predictors are for short-term mortality and MB among the several commonly used biomarkers. The aim of this study was to evaluate the significance of Creactive protein (CRP) and other biomarkers for the prediction of adverse clinical outcomes. Methods. This clinical, observational, retrospective-prospective study included 219 consecutive adult patients treated for APE. Results. Among 219 patients, 22 (10%) died within the first month after diagnosis. Twenty seven patients (12.3%) had at least one episode of MB. Composite end-point [netadverse clinical outcome (NACO)] was estimated in 47 (21.5%) of patients. The average values of all biomarkers were higher in the group of patient who died, and differences were statistically significant. Similar results were obtained for composite end-point. In terms of MB, none of biomarkers did not have significance, but CRP had a slight tendency toward significance. Results from univariate logistic regression model showed that troponin was statistically significant predictor of 30-day mortality. However, after adjusting for other variables, in multivariate logistic regression model troponin failed to be significant independent predictor of 30-day mortality. Unlike troponin, CRP and brain natriuretic peptide (BNP) were significant in all models ? uni and multivariate (they were independent predictors of 30-day mortality). Conclusion. CRP has a good predictive value for 30-day mortality and NACO, and potential for MB in patients treated for APE.


2021 ◽  
Vol 8 ◽  
Author(s):  
Robert A. Reed ◽  
Andrei S. Morgan ◽  
Jennifer Zeitlin ◽  
Pierre-Henri Jarreau ◽  
Héloïse Torchin ◽  
...  

Introduction: Preterm babies are a vulnerable population that experience significant short and long-term morbidity. Rehospitalisations constitute an important, potentially modifiable adverse event in this population. Improving the ability of clinicians to identify those patients at the greatest risk of rehospitalisation has the potential to improve outcomes and reduce costs. Machine-learning algorithms can provide potentially advantageous methods of prediction compared to conventional approaches like logistic regression.Objective: To compare two machine-learning methods (least absolute shrinkage and selection operator (LASSO) and random forest) to expert-opinion driven logistic regression modelling for predicting unplanned rehospitalisation within 30 days in a large French cohort of preterm babies.Design, Setting and Participants: This study used data derived exclusively from the population-based prospective cohort study of French preterm babies, EPIPAGE 2. Only those babies discharged home alive and whose parents completed the 1-year survey were eligible for inclusion in our study. All predictive models used a binary outcome, denoting a baby's status for an unplanned rehospitalisation within 30 days of discharge. Predictors included those quantifying clinical, treatment, maternal and socio-demographic factors. The predictive abilities of models constructed using LASSO and random forest algorithms were compared with a traditional logistic regression model. The logistic regression model comprised 10 predictors, selected by expert clinicians, while the LASSO and random forest included 75 predictors. Performance measures were derived using 10-fold cross-validation. Performance was quantified using area under the receiver operator characteristic curve, sensitivity, specificity, Tjur's coefficient of determination and calibration measures.Results: The rate of 30-day unplanned rehospitalisation in the eligible population used to construct the models was 9.1% (95% CI 8.2–10.1) (350/3,841). The random forest model demonstrated both an improved AUROC (0.65; 95% CI 0.59–0.7; p = 0.03) and specificity vs. logistic regression (AUROC 0.57; 95% CI 0.51–0.62, p = 0.04). The LASSO performed similarly (AUROC 0.59; 95% CI 0.53–0.65; p = 0.68) to logistic regression.Conclusions: Compared to an expert-specified logistic regression model, random forest offered improved prediction of 30-day unplanned rehospitalisation in preterm babies. However, all models offered relatively low levels of predictive ability, regardless of modelling method.


2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 441-441
Author(s):  
Marie Alt ◽  
Carlos Stecca ◽  
Shaum Kabadi ◽  
Benga Kazeem ◽  
Srikala S. Sridhar

441 Background: Immune checkpoint inhibitors (ICI) have changed the landscape of mUC, yet outcomes are variable as some patients (pts) do not respond to treatment while others have a durable response. To optimally select pts who may derive benefit from ICIs, predictive factors are required. This retrospective, post-hoc analysis evaluated pt characteristics to determine differences between short and long-term survivors among pts with mUC who received D (anti–PD-L1) with or without T (anti–CTLA-4) in two clinical studies. Methods: Pts with platinum-refractory mUC who received D monotherapy in the phase I/II study 1108 (10 mg/kg Q2W, up to 12 mo) or D+T in the phase I study 10 (D at 20 mg/kg + T at 1 mg/kg Q4W for 4 mo, then D at 10 mg/kg Q2W for 12 mo) were included. Pt characteristics, tumor characteristics, radiological assessments, and biological assessments were collected. The primary outcome measure was long-term overall survival (OS). Pts were categorized as OS ≥2 yrs (from 1st dose of study drug) or OS <2 yrs. A univariate analysis was conducted on each baseline characteristic to assess independent associations with long-term OS; a multivariate logistic regression model was employed including each variable with a p-value ≤0.1 as factors or covariates. Results: A total of 367 pts with mUC were included in the analysis: 88 (24.0%) had OS ≥2 yrs (range: 2.09–4.99) and 279 (76.0%) had OS <2 yrs (range: 0.03–1.98). Pts with OS ≥2 yrs had a significantly higher objective response rates than those with OS <2 yrs (71.6% vs 5.7%; p<0.0001) and a significantly longer duration of response (median 2.3 yrs vs 0.39 yrs; p<0.0001). The characteristics included in the multivariate logistic regression model are listed in the Table. Long-term OS was significantly associated with ECOG PS, PD-L1 status, baseline hemoglobin level, and baseline absolute neutrophils count. Conclusions: Our analyses show that several characteristics, including tumor response to treatment, are associated with long-term OS for pts with mUC treated with D or D+T. Further investigation into these and other characteristics may provide additional insights into long-term survival outcomes with ICIs. [Table: see text]


Author(s):  
Pouya Gholizadeh ◽  
Behzad Esmaeili

The ability to identify factors that influence serious injuries and fatalities would help construction firms triage hazardous situations and direct their resources towards more effective interventions. Therefore, this study used odds ratio analysis and logistic regression modeling on historical accident data to investigate the contributing factors impacting occupational accidents among small electrical contracting enterprises. After conducting a thorough content analysis to ensure the reliability of reports, the authors adopted a purposeful variable selection approach to determine the most significant factors that can explain the fatality rates in different scenarios. Thereafter, this study performed an odds ratio analysis among significant factors to determine which factors increase the likelihood of fatality. For example, it was found that having a fatal accident is 4.4 times more likely when the source is a “vehicle” than when it is a “tool, instrument, or equipment”. After validating the consistency of the model, 105 accident scenarios were developed and assessed using the model. The findings revealed which severe accident scenarios happen commonly to people in this trade, with nine scenarios having fatality rates of 50% or more. The highest fatality rates occurred in “fencing, installing lights, signs, etc.” tasks in “alteration and rehabilitation” projects where the source of injury was “parts and materials”. The proposed analysis/modeling approach can be applied among all specialty contracting companies to identify and prioritize more hazardous situations within specific trades. The proposed model-development process also contributes to the body of knowledge around accident analysis by providing a framework for analyzing accident reports through a multivariate logistic regression model.


2020 ◽  
Vol 8 (2) ◽  
pp. e001314
Author(s):  
Chao Liu ◽  
Li Li ◽  
Kehan Song ◽  
Zhi-Ying Zhan ◽  
Yi Yao ◽  
...  

BackgroundIndividualized prediction of mortality risk can inform the treatment strategy for patients with COVID-19 and solid tumors and potentially improve patient outcomes. We aimed to develop a nomogram for predicting in-hospital mortality of patients with COVID-19 with solid tumors.MethodsWe enrolled patients with COVID-19 with solid tumors admitted to 32 hospitals in China between December 17, 2020, and March 18, 2020. A multivariate logistic regression model was constructed via stepwise regression analysis, and a nomogram was subsequently developed based on the fitted multivariate logistic regression model. Discrimination and calibration of the nomogram were evaluated by estimating the area under the receiver operator characteristic curve (AUC) for the model and by bootstrap resampling, a Hosmer-Lemeshow test, and visual inspection of the calibration curve.ResultsThere were 216 patients with COVID-19 with solid tumors included in the present study, of whom 37 (17%) died and the other 179 all recovered from COVID-19 and were discharged. The median age of the enrolled patients was 63.0 years and 113 (52.3%) were men. Multivariate logistic regression revealed that increasing age (OR=1.08, 95% CI 1.00 to 1.16), receipt of antitumor treatment within 3 months before COVID-19 (OR=28.65, 95% CI 3.54 to 231.97), peripheral white blood cell (WBC) count ≥6.93 ×109/L (OR=14.52, 95% CI 2.45 to 86.14), derived neutrophil-to-lymphocyte ratio (dNLR; neutrophil count/(WBC count minus neutrophil count)) ≥4.19 (OR=18.99, 95% CI 3.58 to 100.65), and dyspnea on admission (OR=20.38, 95% CI 3.55 to 117.02) were associated with elevated mortality risk. The performance of the established nomogram was satisfactory, with an AUC of 0.953 (95% CI 0.908 to 0.997) for the model, non-significant findings on the Hosmer-Lemeshow test, and rough agreement between predicted and observed probabilities as suggested in calibration curves. The sensitivity and specificity of the model were 86.4% and 92.5%.ConclusionIncreasing age, receipt of antitumor treatment within 3 months before COVID-19 diagnosis, elevated WBC count and dNLR, and having dyspnea on admission were independent risk factors for mortality among patients with COVID-19 and solid tumors. The nomogram based on these factors accurately predicted mortality risk for individual patients.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040132
Author(s):  
Innocent B Mboya ◽  
Michael J Mahande ◽  
Mohanad Mohammed ◽  
Joseph Obure ◽  
Henry G Mwambi

ObjectiveWe aimed to determine the key predictors of perinatal deaths using machine learning models compared with the logistic regression model.DesignA secondary data analysis using the Kilimanjaro Christian Medical Centre (KCMC) Medical Birth Registry cohort from 2000 to 2015. We assessed the discriminative ability of models using the area under the receiver operating characteristics curve (AUC) and the net benefit using decision curve analysis.SettingThe KCMC is a zonal referral hospital located in Moshi Municipality, Kilimanjaro region, Northern Tanzania. The Medical Birth Registry is within the hospital grounds at the Reproductive and Child Health Centre.ParticipantsSingleton deliveries (n=42 319) with complete records from 2000 to 2015.Primary outcome measuresPerinatal death (composite of stillbirths and early neonatal deaths). These outcomes were only captured before mothers were discharged from the hospital.ResultsThe proportion of perinatal deaths was 3.7%. There were no statistically significant differences in the predictive performance of four machine learning models except for bagging, which had a significantly lower performance (AUC 0.76, 95% CI 0.74 to 0.79, p=0.006) compared with the logistic regression model (AUC 0.78, 95% CI 0.76 to 0.81). However, in the decision curve analysis, the machine learning models had a higher net benefit (ie, the correct classification of perinatal deaths considering a trade-off between false-negatives and false-positives)—over the logistic regression model across a range of threshold probability values.ConclusionsIn this cohort, there was no significant difference in the prediction of perinatal deaths between machine learning and logistic regression models, except for bagging. The machine learning models had a higher net benefit, as its predictive ability of perinatal death was considerably superior over the logistic regression model. The machine learning models, as demonstrated by our study, can be used to improve the prediction of perinatal deaths and triage for women at risk.


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