scholarly journals Machine Learning Enables Prediction of Cardiac Amyloidosis by Routine Laboratory Parameters: A Proof-of-Concept Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1334 ◽  
Author(s):  
Asan Agibetov ◽  
Benjamin Seirer ◽  
Theresa-Marie Dachs ◽  
Matthias Koschutnik ◽  
Daniel Dalos ◽  
...  
Keyword(s):  
Machine Learning ◽  
Prediction Model ◽  
Sensitivity And Specificity ◽  
Cardiac Amyloidosis ◽  
Linear Prediction ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Proof Of Concept ◽  
Laboratory Parameters ◽  
Concept Study

(1) Background: Cardiac amyloidosis (CA) is a rare and complex condition with poor prognosis. While novel therapies improve outcomes, many affected individuals remain undiagnosed due to a lack of awareness among clinicians. This study was undertaken to develop an expert-independent machine learning (ML) prediction model for CA relying on routinely determined laboratory parameters. (2) Methods: In a first step, we developed baseline linear models based on logistic regression. In a second step, we used an ML algorithm based on gradient tree boosting to improve our linear prediction model, and to perform non-linear prediction. Then, we compared the performance of all diagnostic algorithms. All prediction models were developed on a training cohort, consisting of patients with proven CA (positive cases, n = 121) and amyloidosis-unrelated heart failure (HF) patients (negative cases, n = 415). Performances of all prediction models were evaluated on a separate prognostic validation cohort with 37 CA-positive and 124 CA-negative patients. (3) Results: Our best model, based on gradient-boosted ensembles of decision trees, achieved an area under the receiver operating characteristic curve (ROC AUC) score of 0.86, with sensitivity and specificity of 89.2% and 78.2%, respectively. The best linear model had an ROC AUC score of 0.75, with sensitivity and specificity of 84.6 and 71.7, respectively. (4) Conclusions: Our work demonstrates that ML makes it possible to utilize basic laboratory parameters to generate a distinct CA-related HF profile compared with CA-unrelated HF patients. This proof-of-concept study opens a potential new avenue in the diagnostic workup of CA and may assist physicians in clinical reasoning.

scholarly journals Prediction of Cardiac Arrest in the Emergency Department Based on Machine Learning and Sequential Characteristics: Model Development and Retrospective Clinical Validation Study (Preprint)

2019 ◽  
Author(s):  
Sungjun Hong ◽  
Sungjoo Lee ◽  
Jeonghoon Lee ◽  
Won Chul Cha ◽  
Kyunga Kim
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Prediction Model ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Machine Learning Algorithms ◽  
Clinical Usefulness ◽  
Class Imbalance Problem ◽  
Data Set

BACKGROUND The development and application of clinical prediction models using machine learning in clinical decision support systems is attracting increasing attention. OBJECTIVE The aims of this study were to develop a prediction model for cardiac arrest in the emergency department (ED) using machine learning and sequential characteristics and to validate its clinical usefulness. METHODS This retrospective study was conducted with ED patients at a tertiary academic hospital who suffered cardiac arrest. To resolve the class imbalance problem, sampling was performed using propensity score matching. The data set was chronologically allocated to a development cohort (years 2013 to 2016) and a validation cohort (year 2017). We trained three machine learning algorithms with repeated 10-fold cross-validation. RESULTS The main performance parameters were the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). The random forest algorithm (AUROC 0.97; AUPRC 0.86) outperformed the recurrent neural network (AUROC 0.95; AUPRC 0.82) and the logistic regression algorithm (AUROC 0.92; AUPRC=0.72). The performance of the model was maintained over time, with the AUROC remaining at least 80% across the monitored time points during the 24 hours before event occurrence. CONCLUSIONS We developed a prediction model of cardiac arrest in the ED using machine learning and sequential characteristics. The model was validated for clinical usefulness by chronological visualization focused on clinical usability.

scholarly journals Prediction of Cardiac Arrest in the Emergency Department Based on Machine Learning and Sequential Characteristics: Model Development and Retrospective Clinical Validation Study

10.2196/15932 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e15932
Author(s):  
Sungjun Hong ◽  
Sungjoo Lee ◽  
Jeonghoon Lee ◽  
Won Chul Cha ◽  
Kyunga Kim
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Prediction Model ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Machine Learning Algorithms ◽  
Clinical Usefulness ◽  
Class Imbalance Problem ◽  
Data Set

Background The development and application of clinical prediction models using machine learning in clinical decision support systems is attracting increasing attention. Objective The aims of this study were to develop a prediction model for cardiac arrest in the emergency department (ED) using machine learning and sequential characteristics and to validate its clinical usefulness. Methods This retrospective study was conducted with ED patients at a tertiary academic hospital who suffered cardiac arrest. To resolve the class imbalance problem, sampling was performed using propensity score matching. The data set was chronologically allocated to a development cohort (years 2013 to 2016) and a validation cohort (year 2017). We trained three machine learning algorithms with repeated 10-fold cross-validation. Results The main performance parameters were the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). The random forest algorithm (AUROC 0.97; AUPRC 0.86) outperformed the recurrent neural network (AUROC 0.95; AUPRC 0.82) and the logistic regression algorithm (AUROC 0.92; AUPRC=0.72). The performance of the model was maintained over time, with the AUROC remaining at least 80% across the monitored time points during the 24 hours before event occurrence. Conclusions We developed a prediction model of cardiac arrest in the ED using machine learning and sequential characteristics. The model was validated for clinical usefulness by chronological visualization focused on clinical usability.

P2726Extremely boosted prediction of cardiac amyloidosis by routine laboratory paramaters

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Agibetov ◽  
B Seirer ◽  
S Aschauer ◽  
D Dalos ◽  
R Rettl ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cardiac Amyloidosis ◽  
Missing Values ◽  
Prediction Models ◽  
Regression Trees ◽  
Gradient Boosting ◽  
Routine Laboratory ◽  
Laboratory Parameters ◽  
Extreme Gradient Boosting ◽  
Laboratory Results

Abstract Background/Introduction Cardiac amyloidosis (CA) is a rare and complex condition with poor prognosis. Novel therapies have been shown to improve outcome, however, most of the affected individuals remain undiagnosed, mainly due to a lack in awareness among clinicians. One approach to overcome this issue is to use automated diagnostic algorithms that act based on routinely available laboratory results. Purpose We tested the performance of flexible machine learning and traditional statistical prediction models for non-invasive CA diagnosis based on routinely collected laboratory parameters. Since laboratory routines vary between hospitals or other health care providers, special attention has been taken to adaptive and dynamic parameter selection, and to dealing with the frequent occurrence of missing values. Methods Our cohort consisted of 376 clinically accepted patients with various types of heart failure. Of these, 69 were diagnosed with CA via endomyocardial biopsy (positives), and 307 had unrelated cardiac disorders (negatives). A total of 63 routine laboratory parameters were collected from these patients, with a high incidence of missing values (on average 60% of patients for each parameter). We tested the performance of two prediction models: logistic regression, and extreme gradient boosting with regression trees. To deal with missing values we adopted two strategies: a) finding an optimal overlap of parameters and deleting all patients with missing values (reduction of parameters and samples), and b) retaining all features and imputing missing values with parameter-wise means. To fairly assess the performance of prediction models we employed a 10-fold cross validation (stratified to preserve sample class ratio). Finally, area under curve for receiver-operator characteristic (ROC AUC) was used as our final performance measure. Results A complex machine learning model based on forests of regression trees proved to be the most performant (ROC AUC 0.94±4%) and robust to missing values. The best regression model was obtained with the 25 most frequent variables and patient deletion in case of missing values (ROC AUC 0.82±0.8%). While progressive inclusion of predictor variables worsened the performance of the logistic regression, it increased that of the machine learning approach. Conclusions Extreme gradient boosting of regression trees by routine laboratory parameters achieved staggering accuracy results for the automated diagnosis of CA. Our data suggest that implementations of such algorithms as independent interpreters of routine laboratory results may help to establish or suggest the diagnosis of CA in patients with heart failure symptoms, even in the absence of specialized experts.

scholarly journals Machine learning-based mortality prediction model for heat-related illness

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yohei Hirano ◽  
Yutaka Kondo ◽  
Toru Hifumi ◽  
Shoji Yokobori ◽  
Jun Kanda ◽  
...  
Keyword(s):  
Machine Learning ◽  
Prediction Model ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Vital Signs ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Support Vector ◽  
Mortality Prediction Model

AbstractIn this study, we aimed to develop and validate a machine learning-based mortality prediction model for hospitalized heat-related illness patients. After 2393 hospitalized patients were extracted from a multicentered heat-related illness registry in Japan, subjects were divided into the training set for development (n = 1516, data from 2014, 2017–2019) and the test set (n = 877, data from 2020) for validation. Twenty-four variables including characteristics of patients, vital signs, and laboratory test data at hospital arrival were trained as predictor features for machine learning. The outcome was death during hospital stay. In validation, the developed machine learning models (logistic regression, support vector machine, random forest, XGBoost) demonstrated favorable performance for outcome prediction with significantly increased values of the area under the precision-recall curve (AUPR) of 0.415 [95% confidence interval (CI) 0.336–0.494], 0.395 [CI 0.318–0.472], 0.426 [CI 0.346–0.506], and 0.528 [CI 0.442–0.614], respectively, compared to that of the conventional acute physiology and chronic health evaluation (APACHE)-II score of 0.287 [CI 0.222–0.351] as a reference standard. The area under the receiver operating characteristic curve (AUROC) values were also high over 0.92 in all models, although there were no statistical differences compared to APACHE-II. This is the first demonstration of the potential of machine learning-based mortality prediction models for heat-related illnesses.

scholarly journals Machine Learning Models for Predicting Neonatal Mortality: A Systematic Review

Neonatology ◽  
2021 ◽  
pp. 1-12
Author(s):  
Cheyenne Mangold ◽  
Sarah Zoretic ◽  
Keerthi Thallapureddy ◽  
Axel Moreira ◽  
Kevin Chorath ◽  
...  
Keyword(s):  
Machine Learning ◽  
Neonatal Mortality ◽  
Sensitivity And Specificity ◽  
Health Care Providers ◽  
Prediction Models ◽  
Characteristic Curve ◽  
External Validation ◽  
Care Providers ◽  
Linear Discriminant ◽  
Increased Risk

<b><i>Introduction:</i></b> Approximately 7,000 newborns die every day, accounting for almost half of child deaths under 5 years of age. Deciphering which neonates are at increased risk for mortality can have an important global impact. As such, integrating high computational technology (e.g., artificial intelligence [AI]) may help identify the early and potentially modifiable predictors of neonatal mortality. Therefore, the objective of this study was to collate, critically appraise, and analyze neonatal prediction studies that included AI. <b><i>Methods:</i></b> A literature search was performed in PubMed, Cochrane, OVID, and Google Scholar. We included studies that used AI (e.g., machine learning (ML) and deep learning) to formulate prediction models for neonatal death. We excluded small studies (<i>n</i> &#x3c; 500 individuals) and studies using only antenatal factors to predict mortality. Two independent investigators screened all articles for inclusion. The data collection consisted of study design, number of models, features used per model, feature importance, internal and/or external validation, and calibration analysis. Our primary outcome was the average area under the receiving characteristic curve (AUC) or sensitivity and specificity for all models included in each study. <b><i>Results:</i></b> Of 434 articles, 11 studies were included. The total number of participants was 1.26 M with gestational ages ranging from 22 weeks to term. Number of features ranged from 3 to 66 with timing of prediction as early as 5 min of life to a maximum of 7 days of age. The average number of models per study was 4, with neural network, random forest, and logistic regression comprising the most used models (58.3%). Five studies (45.5%) reported calibration plots and 2 (18.2%) conducted external validation. Eight studies reported results by AUC and 5 studies reported the sensitivity and specificity. The AUC varied from 58.3% to 97.0%. The mean sensitivities ranged from 63% to 80% and specificities from 78% to 99%. The best overall model was linear discriminant analysis, but it also had a high number of features (<i>n</i> = 17). <b><i>Discussion/Conclusion:</i></b> ML models can accurately predict death in neonates. This analysis demonstrates the most commonly used predictors and metrics for AI prediction models for neonatal mortality. Future studies should focus on external validation, calibration, as well as deployment of applications that can be readily accessible to health-care providers.

scholarly journals Machine Learning-Based Cardiovascular Disease Prediction Model: A Cohort Study on the Korean National Health Insurance Service Health Screening Database

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 943
Author(s):  
Joung Ouk (Ryan) Kim ◽  
Yong-Suk Jeong ◽  
Jin Ho Kim ◽  
Jong-Weon Lee ◽  
Dougho Park ◽  
...  
Keyword(s):  
Machine Learning ◽  
Health Insurance ◽  
Prediction Model ◽  
National Health Insurance ◽  
National Health ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Health Screening ◽  
Gradient Boosting ◽  
Extreme Gradient Boosting

Background: This study proposes a cardiovascular diseases (CVD) prediction model using machine learning (ML) algorithms based on the National Health Insurance Service-Health Screening datasets. Methods: We extracted 4699 patients aged over 45 as the CVD group, diagnosed according to the international classification of diseases system (I20–I25). In addition, 4699 random subjects without CVD diagnosis were enrolled as a non-CVD group. Both groups were matched by age and gender. Various ML algorithms were applied to perform CVD prediction; then, the performances of all the prediction models were compared. Results: The extreme gradient boosting, gradient boosting, and random forest algorithms exhibited the best average prediction accuracy (area under receiver operating characteristic curve (AUROC): 0.812, 0.812, and 0.811, respectively) among all algorithms validated in this study. Based on AUROC, the ML algorithms improved the CVD prediction performance, compared to previously proposed prediction models. Preexisting CVD history was the most important factor contributing to the accuracy of the prediction model, followed by total cholesterol, low-density lipoprotein cholesterol, waist-height ratio, and body mass index. Conclusions: Our results indicate that the proposed health screening dataset-based CVD prediction model using ML algorithms is readily applicable, produces validated results and outperforms the previous CVD prediction models.

scholarly journals Development of Machine Learning Models to Predict Probabilities and Types of Stroke at Prehospital Stage: the Japan Urgent Stroke Triage Score Using Machine Learning (JUST-ML)

2021 ◽  
Author(s):  
Kazutaka Uchida ◽  
Junichi Kouno ◽  
Shinichi Yoshimura ◽  
Norito Kinjo ◽  
Fumihiro Sakakibara ◽  
...  
Keyword(s):  
Machine Learning ◽  
Logistic Regression ◽  
Random Forests ◽  
Prediction Models ◽  
Characteristic Curve ◽  
Predictive Performance ◽  
Vessel Occlusion ◽  
Predictive Values ◽  
Training Cohort ◽  
Sensitivity Specificity

AbstractIn conjunction with recent advancements in machine learning (ML), such technologies have been applied in various fields owing to their high predictive performance. We tried to develop prehospital stroke scale with ML. We conducted multi-center retrospective and prospective cohort study. The training cohort had eight centers in Japan from June 2015 to March 2018, and the test cohort had 13 centers from April 2019 to March 2020. We use the three different ML algorithms (logistic regression, random forests, XGBoost) to develop models. Main outcomes were large vessel occlusion (LVO), intracranial hemorrhage (ICH), subarachnoid hemorrhage (SAH), and cerebral infarction (CI) other than LVO. The predictive abilities were validated in the test cohort with accuracy, positive predictive value, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and F score. The training cohort included 3178 patients with 337 LVO, 487 ICH, 131 SAH, and 676 CI cases, and the test cohort included 3127 patients with 183 LVO, 372 ICH, 90 SAH, and 577 CI cases. The overall accuracies were 0.65, and the positive predictive values, sensitivities, specificities, AUCs, and F scores were stable in the test cohort. The classification abilities were also fair for all ML models. The AUCs for LVO of logistic regression, random forests, and XGBoost were 0.89, 0.89, and 0.88, respectively, in the test cohort, and these values were higher than the previously reported prediction models for LVO. The ML models developed to predict the probability and types of stroke at the prehospital stage had superior predictive abilities.

scholarly journals Proof-of-Concept Study on an Automatic Computational System in Detecting and Classifying Occlusal Caries Lesions from Smartphone Color Images of Unrestored Extracted Teeth

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1136
Author(s):  
Duc Long Duong ◽  
Quoc Duy Nam Nguyen ◽  
Minh Son Tong ◽  
Manh Tuan Vu ◽  
Joseph Dy Lim ◽  
...  
Keyword(s):  
Support Vector Machine ◽  
Dental Caries ◽  
Sensitivity And Specificity ◽  
Color Images ◽  
Caries Detection ◽  
Support Vector ◽  
Proof Of Concept ◽  
Computational System ◽  
Occlusal Caries ◽  
Concept Study

Dental caries has been considered the heaviest worldwide oral health burden affecting a significant proportion of the population. To prevent dental caries, an appropriate and accurate early detection method is demanded. This proof-of-concept study aims to develop a two-stage computational system that can detect early occlusal caries from smartphone color images of unrestored extracted teeth according to modified International Caries Detection and Assessment System (ICDAS) criteria (3 classes: Code 0; Code 1-2; Code 3-6): in the first stage, carious lesion areas were identified and extracted from sound tooth regions. Then, five characteristic features of these areas were intendedly selected and calculated to be inputted into the classification stage, where five classifiers (Support Vector Machine, Random Forests, K-Nearest Neighbors, Gradient Boosted Tree, Logistic Regression) were evaluated to determine the best one among them. On a set of 587 smartphone images of extracted teeth, our system achieved accuracy, sensitivity, and specificity that were 87.39%, 89.88%, and 68.86% in the detection stage when compared to modified visual and image-based ICDAS criteria. For the classification stage, the Support Vector Machine model was recorded as the best model with accuracy, sensitivity, and specificity at 88.76%, 92.31%, and 85.21%. As the first step in developing the technology, our present findings confirm the feasibility of using smartphone color images to employ Artificial Intelligence algorithms in caries detection. To improve the performance of the proposed system, there is a need for further development in both in vitro and in vivo modeling. Besides that, an applicable system for accurately taking intra-oral images that can capture entire dental arches including the occlusal surfaces of premolars and molars also needs to be developed.

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