scholarly journals Machine Learning Algorithms to Predict Mortality of Neonates on Mechanical Intubation for Respiratory Failure

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1377
Author(s):  
Jen-Fu Hsu ◽  
Chi Yang ◽  
Chun-Yuan Lin ◽  
Shih-Ming Chu ◽  
Hsuan-Rong Huang ◽  
...  

Background: Early identification of critically ill neonates with poor outcomes can optimize therapeutic strategies. We aimed to examine whether machine learning (ML) methods can improve mortality prediction for neonatal intensive care unit (NICU) patients on intubation for respiratory failure. Methods: A total of 1734 neonates with respiratory failure were randomly divided into training (70%, n = 1214) and test (30%, n = 520) sets. The primary outcome was the probability of NICU mortality. The areas under the receiver operating characteristic curves (AUCs) of several ML algorithms were compared with those of the conventional neonatal illness severity scoring systems including the NTISS and SNAPPE-II. Results: For NICU mortality, the random forest (RF) model showed the highest AUC (0.939 (0.921–0.958)) for the prediction of neonates with respiratory failure, and the bagged classification and regression tree model demonstrated the next best results (0.915 (0.891–0.939)). The AUCs of both models were significantly better than the traditional NTISS (0.836 (0.800–0.871)) and SNAPPE-II scores (0.805 (0.766–0.843)). The superior performances were confirmed by higher accuracy and F1 score and better calibration, and the superior and net benefit was confirmed by decision curve analysis. In addition, Shapley additive explanation (SHAP) values were utilized to explain the RF prediction model. Conclusions: Machine learning algorithms increase the accuracy and predictive ability for mortality of neonates with respiratory failure compared with conventional neonatal illness severity scores. The RF model is suitable for clinical use in the NICU, and clinicians can gain insights and have better communication with families in advance.

2021 ◽  
Author(s):  
Fang He ◽  
John H Page ◽  
Kerry R Weinberg ◽  
Anirban Mishra

BACKGROUND The current COVID-19 pandemic is unprecedented; under resource-constrained setting, predictive algorithms can help to stratify disease severity, alerting physicians of high-risk patients, however there are few risk scores derived from a substantially large EHR dataset, using simplified predictors as input. OBJECTIVE To develop and validate simplified machine learning algorithms which predicts COVID-19 adverse outcomes, to evaluate the AUC (area under the receiver operating characteristic curve), sensitivity, specificity and calibration of the algorithms, to derive clinically meaningful thresholds. METHODS We conducted machine learning model development and validation via cohort study using multi-center, patient-level, longitudinal electronic health records (EHR) from Optum® COVID-19 database which provides anonymized, longitudinal EHR from across US. The models were developed based on clinical characteristics to predict 28-day in-hospital mortality, ICU admission, respiratory failure, mechanical ventilator usages at inpatient setting. Data from patients who were admitted prior to Sep 7, 2020, is randomly sampled into development, test and validation datasets; data collected from Sep 7, 2020 through Nov 15, 2020 was reserved as prospective validation dataset. RESULTS Of 3.7M patients in the analysis, a total of 585,867 patients were diagnosed or tested positive for SARS-CoV-2; and 50,703 adult patients were hospitalized with COVID-19 between Feb 1 and Nov 15, 2020. Among the study cohort (N=50,703), there were 6,204 deaths, 9,564 ICU admissions, 6,478 mechanically ventilated or EMCO patients and 25,169 patients developed ARDS or respiratory failure within 28 days since hospital admission. The algorithms demonstrated high accuracy (AUC = 0.89 (0.89 - 0.89) on validation dataset (N=10,752)), consistent prediction through the second wave of pandemic from September to November (AUC = 0.85 (0.85 - 0.86) on post-development validation (N= 14,863)), great clinical relevance and utility. Besides, a comprehensive 386 input covariates from baseline and at admission was included in the analysis; the end-to-end pipeline automates feature selection and model development process, producing 10 key predictors as input such as age, blood urea nitrogen, oxygen saturation, which are both commonly measured and concordant with recognized risk factors for COVID-19. CONCLUSIONS The systematic approach and rigorous validations demonstrate consistent model performance to predict even beyond the time period of data collection, with satisfactory discriminatory power and great clinical utility. Overall, the study offers an accurate, validated and reliable prediction model based on only ten clinical features as a prognostic tool to stratifying COVID-19 patients into intermediate, high and very high-risk groups. This simple predictive tool could be shared with a wider healthcare community, to enable service as an early warning system to alert physicians of possible high-risk patients, or as a resource triaging tool to optimize healthcare resources. CLINICALTRIAL N/A


2021 ◽  
Vol 11 ◽  
Author(s):  
Ximing Nie ◽  
Yuan Cai ◽  
Jingyi Liu ◽  
Xiran Liu ◽  
Jiahui Zhao ◽  
...  

Objectives: This study aims to investigate whether the machine learning algorithms could provide an optimal early mortality prediction method compared with other scoring systems for patients with cerebral hemorrhage in intensive care units in clinical practice.Methods: Between 2008 and 2012, from Intensive Care III (MIMIC-III) database, all cerebral hemorrhage patients monitored with the MetaVision system and admitted to intensive care units were enrolled in this study. The calibration, discrimination, and risk classification of predicted hospital mortality based on machine learning algorithms were assessed. The primary outcome was hospital mortality. Model performance was assessed with accuracy and receiver operating characteristic curve analysis.Results: Of 760 cerebral hemorrhage patients enrolled from MIMIC database [mean age, 68.2 years (SD, ±15.5)], 383 (50.4%) patients died in hospital, and 377 (49.6%) patients survived. The area under the receiver operating characteristic curve (AUC) of six machine learning algorithms was 0.600 (nearest neighbors), 0.617 (decision tree), 0.655 (neural net), 0.671(AdaBoost), 0.819 (random forest), and 0.725 (gcForest). The AUC was 0.423 for Acute Physiology and Chronic Health Evaluation II score. The random forest had the highest specificity and accuracy, as well as the greatest AUC, showing the best ability to predict in-hospital mortality.Conclusions: Compared with conventional scoring system and the other five machine learning algorithms in this study, random forest algorithm had better performance in predicting in-hospital mortality for cerebral hemorrhage patients in intensive care units, and thus further research should be conducted on random forest algorithm.


2021 ◽  
Author(s):  
Yasser EL-Manzalawy ◽  
Mostafa Abbas ◽  
Ian Hoaglund ◽  
Alvaro Ulloa Cerna ◽  
Thomas B. Morland ◽  
...  

ABSTRACTSeverity scores assess the acuity of critical illness by penalizing for the deviation of physiologic measurements from normal and aggregating these penalties (also called “weights” or “subscores”) into a final score (or probability) for quantifying the severity of critical illness (or the likelihood of in-hospital mortality). Although these simple additive models are human readable and interpretable, their predictive performance needs to be further improved. To address this need, we argue for replacing these simple additive models with models based on state-of-the-art non-linear supervised learning algorithms (e.g., Random Forest (RF) and eXtreme Gradient Boosting (XGB)). Specifically, we present OASIS+, a variant of the Oxford Acute Severity of Illness Score (OASIS) in which an ensemble of 200 decision trees is used to predict in-hospital mortality based on the 10 same clinical variables in OASIS. Using a test set of 9566 admissions extracted from MIMIC-III database, we show that the performance of OASIS can be substantially improved from AUC score of 0.77 to 0.83 using OASIS+. Moreover, we show that OASIS+ has superior performance compared to eight other commonly used severity scoring methods. Our results underscore the potential of improving existing severity scores by using more sophisticated machine learning algorithms (e.g., ensemble of non-linear decision tress) not just via including additional physiologic measurements.


2017 ◽  
Vol 7 (1.1) ◽  
pp. 449
Author(s):  
N Ravikumar ◽  
Dr P. Tamil Selvan

Text categorization with machine learning algorithms generally reckons to possess horizontal set of classes. Several advanced machine learning algorithms have been designed in the past few decades. With the growing research work for text categorization, it has become important to categorize the research outcome and provide the learners with an effective machine learning method, a framework called, Hierarchical Decision Tree and Deep Neural Network (HDT-DNN).It investigates machine learning algorithms to create horizontal set of classes and it is used for classification of text. With this objective, a novel and efficient text categorization framework based on decision tree model is used in order to categorize text according to superior and subordinate level. The text to be categorized is presented in the form of a tree with parent text category being superior to all. The intermediate level represents the text that is both superior and subordinate. Then Deep Neural Network model is presented initiating compositional model, where the text has to be categorized, as a layered integration of primitives from the constructed decision tree model. The extra layers enable composition of features from lower layers, potentially modeling complex text with fewer units than a similarly carried out shallow network producing hierarchical classification. The significance of the impact of HDT-DNN framework is evaluated through empirical study. Extensive experiments are carried out and the performance of HDT-DNN framework is evaluated and compared with existing state-of-art methods using parameters such as precision, classification accuracy, classification time, with respect to varied number of features and document size.


2020 ◽  
Vol 39 (5) ◽  
pp. 6579-6590
Author(s):  
Sandy Çağlıyor ◽  
Başar Öztayşi ◽  
Selime Sezgin

The motion picture industry is one of the largest industries worldwide and has significant importance in the global economy. Considering the high stakes and high risks in the industry, forecast models and decision support systems are gaining importance. Several attempts have been made to estimate the theatrical performance of a movie before or at the early stages of its release. Nevertheless, these models are mostly used for predicting domestic performances and the industry still struggles to predict box office performances in overseas markets. In this study, the aim is to design a forecast model using different machine learning algorithms to estimate the theatrical success of US movies in Turkey. From various sources, a dataset of 1559 movies is constructed. Firstly, independent variables are grouped as pre-release, distributor type, and international distribution based on their characteristic. The number of attendances is discretized into three classes. Four popular machine learning algorithms, artificial neural networks, decision tree regression and gradient boosting tree and random forest are employed, and the impact of each group is observed by compared by the performance models. Then the number of target classes is increased into five and eight and results are compared with the previously developed models in the literature.


2020 ◽  
pp. 1-11
Author(s):  
Jie Liu ◽  
Lin Lin ◽  
Xiufang Liang

The online English teaching system has certain requirements for the intelligent scoring system, and the most difficult stage of intelligent scoring in the English test is to score the English composition through the intelligent model. In order to improve the intelligence of English composition scoring, based on machine learning algorithms, this study combines intelligent image recognition technology to improve machine learning algorithms, and proposes an improved MSER-based character candidate region extraction algorithm and a convolutional neural network-based pseudo-character region filtering algorithm. In addition, in order to verify whether the algorithm model proposed in this paper meets the requirements of the group text, that is, to verify the feasibility of the algorithm, the performance of the model proposed in this study is analyzed through design experiments. Moreover, the basic conditions for composition scoring are input into the model as a constraint model. The research results show that the algorithm proposed in this paper has a certain practical effect, and it can be applied to the English assessment system and the online assessment system of the homework evaluation system algorithm system.


2019 ◽  
Vol 1 (2) ◽  
pp. 78-80
Author(s):  
Eric Holloway

Detecting some patterns is a simple task for humans, but nearly impossible for current machine learning algorithms.  Here, the "checkerboard" pattern is examined, where human prediction nears 100% and machine prediction drops significantly below 50%.


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