scholarly journals Predicting Prolonged Length of ICU Stay through Machine Learning

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2242
Author(s):  
Jingyi Wu ◽  
Yu Lin ◽  
Pengfei Li ◽  
Yonghua Hu ◽  
Luxia Zhang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
External Validation ◽  
Prediction Performance ◽  
Brier Score ◽  
Support Vector ◽  
Internal Validation ◽  
Prolonged Length ◽  
Saps Ii ◽  
Overall Performance

This study aimed to construct machine learning (ML) models for predicting prolonged length of stay (pLOS) in intensive care units (ICU) among general ICU patients. A multicenter database called eICU (Collaborative Research Database) was used for model derivation and internal validation, and the Medical Information Mart for Intensive Care (MIMIC) III database was used for external validation. We used four different ML methods (random forest, support vector machine, deep learning, and gradient boosting decision tree (GBDT)) to develop prediction models. The prediction performance of the four models were compared with the customized simplified acute physiology score (SAPS) II. The area under the receiver operation characteristic curve (AUROC), area under the precision-recall curve (AUPRC), estimated calibration index (ECI), and Brier score were used to measure performance. In internal validation, the GBDT model achieved the best overall performance (Brier score, 0.164), discrimination (AUROC, 0.742; AUPRC, 0.537), and calibration (ECI, 8.224). In external validation, the GBDT model also achieved the best overall performance (Brier score, 0.166), discrimination (AUROC, 0.747; AUPRC, 0.536), and calibration (ECI, 8.294). External validation showed that the calibration curve of the GBDT model was an optimal fit, and four ML models outperformed the customized SAPS II model. The GBDT-based pLOS-ICU prediction model had the best prediction performance among the five models on both internal and external datasets. Furthermore, it has the potential to assist ICU physicians to identify patients with pLOS-ICU risk and provide appropriate clinical interventions to improve patient outcomes.

scholarly journals Using machine learning methods to predict in-hospital mortality of sepsis patients in the ICU

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Guilan Kong ◽  
Ke Lin ◽  
Yonghua Hu
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
High Risk ◽  
Prediction Performance ◽  
Brier Score ◽  
Gradient Boosting ◽  
Hospital Death ◽  
Good Prediction ◽  
Saps Ii ◽  
Mimic Iii

Abstract Background Early and accurate identification of sepsis patients with high risk of in-hospital death can help physicians in intensive care units (ICUs) make optimal clinical decisions. This study aimed to develop machine learning-based tools to predict the risk of hospital death of patients with sepsis in ICUs. Methods The source database used for model development and validation is the medical information mart for intensive care (MIMIC) III. We identified adult sepsis patients using the new sepsis definition Sepsis-3. A total of 86 predictor variables consisting of demographics, laboratory tests and comorbidities were used. We employed the least absolute shrinkage and selection operator (LASSO), random forest (RF), gradient boosting machine (GBM) and the traditional logistic regression (LR) method to develop prediction models. In addition, the prediction performance of the four developed models was evaluated and compared with that of an existent scoring tool – simplified acute physiology score (SAPS) II – using five different performance measures: the area under the receiver operating characteristic curve (AUROC), Brier score, sensitivity, specificity and calibration plot. Results The records of 16,688 sepsis patients in MIMIC III were used for model training and test. Amongst them, 2949 (17.7%) patients had in-hospital death. The average AUROCs of the LASSO, RF, GBM, LR and SAPS II models were 0.829, 0.829, 0.845, 0.833 and 0.77, respectively. The Brier scores of the LASSO, RF, GBM, LR and SAPS II models were 0.108, 0.109, 0.104, 0.107 and 0.146, respectively. The calibration plots showed that the GBM, LASSO and LR models had good calibration; the RF model underestimated high-risk patients; and SAPS II had the poorest calibration. Conclusion The machine learning-based models developed in this study had good prediction performance. Amongst them, the GBM model showed the best performance in predicting the risk of in-hospital death. It has the potential to assist physicians in the ICU to perform appropriate clinical interventions for critically ill sepsis patients and thus may help improve the prognoses of sepsis patients in the ICU.

scholarly journals Early Prediction of Seven-Day Mortality in Intensive Care Unit Using a Machine Learning Model: Results from the SPIN-UTI Project

2021 ◽  
Vol 10 (5) ◽  
pp. 992
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Giuliana Favara ◽  
Paolo Marco Riela ◽  
Giovanni Gallo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Support Vector ◽  
Icu Admission ◽  
Risk Of Death ◽  
Saps Ii ◽  
Svm Algorithm

Patients in intensive care units (ICUs) were at higher risk of worsen prognosis and mortality. Here, we aimed to evaluate the ability of the Simplified Acute Physiology Score (SAPS II) to predict the risk of 7-day mortality, and to test a machine learning algorithm which combines the SAPS II with additional patients’ characteristics at ICU admission. We used data from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” network. Support Vector Machines (SVM) algorithm was used to classify 3782 patients according to sex, patient’s origin, type of ICU admission, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II, presence of invasive devices, trauma, impaired immunity, antibiotic therapy and onset of HAI. The accuracy of SAPS II for predicting patients who died from those who did not was 69.3%, with an Area Under the Curve (AUC) of 0.678. Using the SVM algorithm, instead, we achieved an accuracy of 83.5% and AUC of 0.896. Notably, SAPS II was the variable that weighted more on the model and its removal resulted in an AUC of 0.653 and an accuracy of 68.4%. Overall, these findings suggest the present SVM model as a useful tool to early predict patients at higher risk of death at ICU admission.

scholarly journals Development and validation of an online model to predict critical COVID-19 with immune-inflammatory parameters

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Yue Gao ◽  
Lingxi Chen ◽  
Jianhua Chi ◽  
Shaoqing Zeng ◽  
Xikang Feng ◽  
...  
Keyword(s):  
Machine Learning ◽  
Critical Illness ◽  
Prediction Model ◽  
Validation Cohort ◽  
External Validation ◽  
Validation Dataset ◽  
Support Vector ◽  
Internal Validation ◽  
Inflammatory Parameters ◽  
Severity Prediction

Abstract Background Immune and inflammatory dysfunction was reported to underpin critical COVID-19(coronavirus disease 2019). We aim to develop a machine learning model that enables accurate prediction of critical COVID-19 using immune-inflammatory features at admission. Methods We retrospectively collected 2076 consecutive COVID-19 patients with definite outcomes (discharge or death) between January 27, 2020 and March 30, 2020 from two hospitals in China. Critical illness was defined as admission to intensive care unit, receiving invasive ventilation, or death. Least Absolute Shrinkage and Selection Operator (LASSO) was applied for feature selection. Five machine learning algorithms, including Logistic Regression (LR), Support Vector Machine (SVM), Gradient Boosted Decision Tree (GBDT), K-Nearest Neighbor (KNN), and Neural Network (NN) were built in a training dataset, and assessed in an internal validation dataset and an external validation dataset. Results Six features (procalcitonin, [T + B + NK cell] count, interleukin 6, C reactive protein, interleukin 2 receptor, T-helper lymphocyte/T-suppressor lymphocyte) were finally used for model development. Five models displayed varying but all promising predictive performance. Notably, the ensemble model, SPMCIIP (severity prediction model for COVID-19 by immune-inflammatory parameters), derived from three contributive algorithms (SVM, GBDT, and NN) achieved the best performance with an area under the curve (AUC) of 0.991 (95% confidence interval [CI] 0.979–1.000) in internal validation cohort and 0.999 (95% CI 0.998–1.000) in external validation cohort to identify patients with critical COVID-19. SPMCIIP could accurately and expeditiously predict the occurrence of critical COVID-19 approximately 20 days in advance. Conclusions The developed online prediction model SPMCIIP is hopeful to facilitate intensive monitoring and early intervention of high risk of critical illness in COVID-19 patients. Trial registration This study was retrospectively registered in the Chinese Clinical Trial Registry (ChiCTR2000032161). Graphical abstracthelper lymphocytve vv

scholarly journals Machine learning based early warning system enables accurate mortality risk prediction for COVID-19

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Yue Gao ◽  
Guang-Yao Cai ◽  
Wei Fang ◽  
Hua-Yi Li ◽  
Si-Yuan Wang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Prediction ◽  
Mortality Risk ◽  
Validation Cohort ◽  
External Validation ◽  
Warning System ◽  
Support Vector ◽  
Internal Validation ◽  
Machine Learning Methods ◽  
Boosted Decision Tree

Abstract Soaring cases of coronavirus disease (COVID-19) are pummeling the global health system. Overwhelmed health facilities have endeavored to mitigate the pandemic, but mortality of COVID-19 continues to increase. Here, we present a mortality risk prediction model for COVID-19 (MRPMC) that uses patients’ clinical data on admission to stratify patients by mortality risk, which enables prediction of physiological deterioration and death up to 20 days in advance. This ensemble model is built using four machine learning methods including Logistic Regression, Support Vector Machine, Gradient Boosted Decision Tree, and Neural Network. We validate MRPMC in an internal validation cohort and two external validation cohorts, where it achieves an AUC of 0.9621 (95% CI: 0.9464–0.9778), 0.9760 (0.9613–0.9906), and 0.9246 (0.8763–0.9729), respectively. This model enables expeditious and accurate mortality risk stratification of patients with COVID-19, and potentially facilitates more responsive health systems that are conducive to high risk COVID-19 patients.

scholarly journals Development of a machine learning model for predicting pediatric mortality in the early stages of intensive care unit admission

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bongjin Lee ◽  
Kyunghoon Kim ◽  
Hyejin Hwang ◽  
You Sun Kim ◽  
Eun Hee Chung ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Validation Cohort ◽  
External Validation ◽  
Learning Model ◽  
Derivation Cohort ◽  
Icu Admission ◽  
Early Stages ◽  
Machine Learning Model

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.

scholarly journals Prediction of Healing Performance of Autogenous Healing Concrete Using Machine Learning

Materials ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4068
Author(s):  
Xu Huang ◽  
Mirna Wasouf ◽  
Jessada Sresakoolchai ◽  
Sakdirat Kaewunruen
Keyword(s):  
Machine Learning ◽  
Search Algorithm ◽  
Weather Conditions ◽  
Prediction Performance ◽  
Machine Learning Algorithms ◽  
Coefficient Of Determination ◽  
Gradient Boosting ◽  
Support Vector ◽  
Self Healing ◽  
Artificial Neural Network Ann

Cracks typically develop in concrete due to shrinkage, loading actions, and weather conditions; and may occur anytime in its life span. Autogenous healing concrete is a type of self-healing concrete that can automatically heal cracks based on physical or chemical reactions in concrete matrix. It is imperative to investigate the healing performance that autogenous healing concrete possesses, to assess the extent of the cracking and to predict the extent of healing. In the research of self-healing concrete, testing the healing performance of concrete in a laboratory is costly, and a mass of instances may be needed to explore reliable concrete design. This study is thus the world’s first to establish six types of machine learning algorithms, which are capable of predicting the healing performance (HP) of self-healing concrete. These algorithms involve an artificial neural network (ANN), a k-nearest neighbours (kNN), a gradient boosting regression (GBR), a decision tree regression (DTR), a support vector regression (SVR) and a random forest (RF). Parameters of these algorithms are tuned utilising grid search algorithm (GSA) and genetic algorithm (GA). The prediction performance indicated by coefficient of determination (R2) and root mean square error (RMSE) measures of these algorithms are evaluated on the basis of 1417 data sets from the open literature. The results show that GSA-GBR performs higher prediction performance (R2GSA-GBR = 0.958) and stronger robustness (RMSEGSA-GBR = 0.202) than the other five types of algorithms employed to predict the healing performance of autogenous healing concrete. Therefore, reliable prediction accuracy of the healing performance and efficient assistance on the design of autogenous healing concrete can be achieved.

scholarly journals Proposing a machine-learning based method to predict stillbirth before and during delivery and ranking the features: nationwide retrospective cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Toktam Khatibi ◽  
Elham Hanifi ◽  
Mohammad Mehdi Sepehri ◽  
Leila Allahqoli
Keyword(s):  
Machine Learning ◽  
External Validation ◽  
Fetal Loss ◽  
Null Distribution ◽  
Training Dataset ◽  
Gradient Boosting ◽  
Support Vector ◽  
Cross Sectional ◽  
Boosting Method ◽  
Demographic Features

Abstract Background Stillbirth is defined as fetal loss in pregnancy beyond 28 weeks by WHO. In this study, a machine-learning based method is proposed to predict stillbirth from livebirth and discriminate stillbirth before and during delivery and rank the features. Method A two-step stack ensemble classifier is proposed for classifying the instances into stillbirth and livebirth at the first step and then, classifying stillbirth before delivery from stillbirth during the labor at the second step. The proposed SE has two consecutive layers including the same classifiers. The base classifiers in each layer are decision tree, Gradient boosting classifier, logistics regression, random forest and support vector machines which are trained independently and aggregated based on Vote boosting method. Moreover, a new feature ranking method is proposed in this study based on mean decrease accuracy, Gini Index and model coefficients to find high-ranked features. Results IMAN registry dataset is used in this study considering all births at or beyond 28th gestational week from 2016/04/01 to 2017/01/01 including 1,415,623 live birth and 5502 stillbirth cases. A combination of maternal demographic features, clinical history, fetal properties, delivery descriptors, environmental features, healthcare service provider descriptors and socio-demographic features are considered. The experimental results show that our proposed SE outperforms the compared classifiers with the average accuracy of 90%, sensitivity of 91%, specificity of 88%. The discrimination of the proposed SE is assessed and the average AUC of ±95%, CI of 90.51% ±1.08 and 90% ±1.12 is obtained on training dataset for model development and test dataset for external validation, respectively. The proposed SE is calibrated using isotopic nonparametric calibration method with the score of 0.07. The process is repeated 10,000 times and AUC of SE classifiers using random different training datasets as null distribution. The obtained p-value to assess the specificity of the proposed SE is 0.0126 which shows the significance of the proposed SE. Conclusions Gestational age and fetal height are two most important features for discriminating livebirth from stillbirth. Moreover, hospital, province, delivery main cause, perinatal abnormality, miscarriage number and maternal age are the most important features for classifying stillbirth before and during delivery.

scholarly journals Developing a Process for the Analysis of User Journeys and the Prediction of Dropout in Digital Health Interventions: Machine Learning Approach (Preprint)

2020 ◽  
Author(s):  
Vincent Bremer ◽  
Philip I Chow ◽  
Burkhardt Funk ◽  
Frances P Thorndike ◽  
Lee M Ritterband
Keyword(s):  
Machine Learning ◽  
Decision Trees ◽  
Behavioral Therapy ◽  
Digital Health ◽  
Area Under The Curve ◽  
Prediction Performance ◽  
Health Interventions ◽  
Drop Out ◽  
Support Vector ◽  
Boosted Decision Trees

BACKGROUND User dropout is a widespread concern in the delivery and evaluation of digital (ie, web and mobile apps) health interventions. Researchers have yet to fully realize the potential of the large amount of data generated by these technology-based programs. Of particular interest is the ability to predict who will drop out of an intervention. This may be possible through the analysis of user journey data—self-reported as well as system-generated data—produced by the path (or journey) an individual takes to navigate through a digital health intervention. OBJECTIVE The purpose of this study is to provide a step-by-step process for the analysis of user journey data and eventually to predict dropout in the context of digital health interventions. The process is applied to data from an internet-based intervention for insomnia as a way to illustrate its use. The completion of the program is contingent upon completing 7 sequential cores, which include an initial tutorial core. Dropout is defined as not completing the seventh core. METHODS Steps of user journey analysis, including data transformation, feature engineering, and statistical model analysis and evaluation, are presented. Dropouts were predicted based on data from 151 participants from a fully automated web-based program (Sleep Healthy Using the Internet) that delivers cognitive behavioral therapy for insomnia. Logistic regression with L1 and L2 regularization, support vector machines, and boosted decision trees were used and evaluated based on their predictive performance. Relevant features from the data are reported that predict user dropout. RESULTS Accuracy of predicting dropout (area under the curve [AUC] values) varied depending on the program core and the machine learning technique. After model evaluation, boosted decision trees achieved AUC values ranging between 0.6 and 0.9. Additional handcrafted features, including time to complete certain steps of the intervention, time to get out of bed, and days since the last interaction with the system, contributed to the prediction performance. CONCLUSIONS The results support the feasibility and potential of analyzing user journey data to predict dropout. Theory-driven handcrafted features increased the prediction performance. The ability to predict dropout at an individual level could be used to enhance decision making for researchers and clinicians as well as inform dynamic intervention regimens.

scholarly journals Development and Validation of Unplanned Extubation Prediction Models Using Intensive Care Unit Data: Comparative Machine Learning Study (Preprint)

2020 ◽  
Author(s):  
Sujeong Hur ◽  
Ji Young Min ◽  
Junsang Yoo ◽  
Kyunga Kim ◽  
Chi Ryang Chung ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Predictive Value ◽  
Prediction Models ◽  
Support Vector ◽  
Unplanned Extubation ◽  
Electronic Health Record Data ◽  
Icu Patients

BACKGROUND Patient safety in the intensive care unit (ICU) is one of the most critical issues, and unplanned extubation (UE) is considered as the most adverse event for patient safety. Prevention and early detection of such an event is an essential but difficult component of quality care. OBJECTIVE This study aimed to develop and validate prediction models for UE in ICU patients using machine learning. METHODS This study was conducted an academic tertiary hospital in Seoul. The hospital had approximately 2,000 inpatient beds and 120 intensive care unit (ICU) beds. The number of patients, on daily basis, was approximately 9,000 for the out-patient. The number of annual ICU admission was approximately 10,000. We conducted a retrospective study between January 1, 2010 and December 31, 2018. A total of 6,914 extubation cases were included. We developed an unplanned extubation prediction model using machine learning algorithms, which included random forest (RF), logistic regression (LR), artificial neural network (ANN), and support vector machine (SVM). For evaluating the model’s performance, we used area under the receiver operator characteristic curve (AUROC). Sensitivity, specificity, positive predictive value negative predictive value, and F1-score were also determined for each model. For performance evaluation, we also used calibration curve, the Brier score, and the Hosmer-Lemeshow goodness-of-fit statistic. RESULTS Among the 6,914 extubation cases, 248 underwent UE. In the UE group, there were more males than females, higher use of physical restraints, and fewer surgeries. The incidence of UE was more likely to occur during the night shift compared to the planned extubation group. The rate of reintubation within 24 hours and hospital mortality was higher in the UE group. The UE prediction algorithm was developed, and the AUROC for RF was 0.787, for LR was 0.762, for ANN was 0.762, and for SVM was 0.740. CONCLUSIONS We successfully developed and validated machine learning-based prediction models to predict UE in ICU patients using electronic health record data. The best AUROC was 0.787, which was obtained using RF. CLINICALTRIAL N/A

scholarly journals Artificial Intelligence in the Intensive Care Unit

2020 ◽  
Author(s):  
Massimiliano Greco ◽  
Pier F. Caruso ◽  
Maurizio Cecconi
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Intensive Care ◽  
Language Processing ◽  
Laboratory Data ◽  
Kidney Injury ◽  
Support Vector ◽  
Learning Models ◽  
Electronic Health ◽  
Natural Terrain

AbstractThe diffusion of electronic health records collecting large amount of clinical, monitoring, and laboratory data produced by intensive care units (ICUs) is the natural terrain for the application of artificial intelligence (AI). AI has a broad definition, encompassing computer vision, natural language processing, and machine learning, with the latter being more commonly employed in the ICUs. Machine learning may be divided in supervised learning models (i.e., support vector machine [SVM] and random forest), unsupervised models (i.e., neural networks [NN]), and reinforcement learning. Supervised models require labeled data that is data mapped by human judgment against predefined categories. Unsupervised models, on the contrary, can be used to obtain reliable predictions even without labeled data. Machine learning models have been used in ICU to predict pathologies such as acute kidney injury, detect symptoms, including delirium, and propose therapeutic actions (vasopressors and fluids in sepsis). In the future, AI will be increasingly used in ICU, due to the increasing quality and quantity of available data. Accordingly, the ICU team will benefit from models with high accuracy that will be used for both research purposes and clinical practice. These models will be also the foundation of future decision support system (DSS), which will help the ICU team to visualize and analyze huge amounts of information. We plea for the creation of a standardization of a core group of data between different electronic health record systems, using a common dictionary for data labeling, which could greatly simplify sharing and merging of data from different centers.

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