Predicting Future Occurrence of Acute Hypotensive Episodes Using Noninvasive and Invasive Features.

Introduction: Early prediction of the acute hypotensive episode (AHE) in critically ill patients has the potential to improve outcomes. In this study, we apply different machine learning algorithms to the MIMIC III Physionet dataset, containing more than 60,000 real-world intensive care unit records...

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Publicado en:Military Medicine Vol. 186; pp. 445 - 452
Autores principales: Yifei Sun, Rashedi, Navid, Vaze, Vikrant, Shah, Parikshit, Halter, Ryan, Elliott, Jonathan T., Paradis, Norman A., Sun, Yifei
Formato: research Journal Article
Publicado: Oxford University Press / USA 2021 Supplement
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Predicting Future Occurrence of Acute Hypotensive Episodes Using Noninvasive and Invasive Features.
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          Yifei Sun
          Rashedi, Navid
          Vaze, Vikrant
          Shah, Parikshit
          Halter, Ryan
          Elliott, Jonathan T.
          Paradis, Norman A.
          Sun, Yifei
        affil: Thayer School of Engineering, Dartmouth College, 14 Engineering Dr, Hanover, NH 03755, USA.
      sug:
        subj:
          Hypotension Diagnosis
          Algorithms
          Human
          Intensive Care Units
          Critical Illness
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
      ab: Introduction: Early prediction of the acute hypotensive episode (AHE) in critically ill patients has the potential to improve outcomes. In this study, we apply different machine learning algorithms to the MIMIC III Physionet dataset, containing more than 60,000 real-world intensive care unit records, to test commonly used machine learning technologies and compare their performances.Materials and Methods: Five classification methods including K-nearest neighbor, logistic regression, support vector machine, random forest, and a deep learning method called long short-term memory are applied to predict an AHE 30 minutes in advance. An analysis comparing model performance when including versus excluding invasive features was conducted. To further study the pattern of the underlying mean arterial pressure (MAP), we apply a regression method to predict the continuous MAP values using linear regression over the next 60 minutes.Results: Support vector machine yields the best performance in terms of recall (84%). Including the invasive features in the classification improves the performance significantly with both recall and precision increasing by more than 20 percentage points. We were able to predict the MAP with a root mean square error (a frequently used measure of the differences between the predicted values and the observed values) of 10 mmHg 60 minutes in the future. After converting continuous MAP predictions into AHE binary predictions, we achieve a 91% recall and 68% precision. In addition to predicting AHE, the MAP predictions provide clinically useful information regarding the timing and severity of the AHE occurrence.Conclusion: We were able to predict AHE with precision and recall above 80% 30 minutes in advance with the large real-world dataset. The prediction of regression model can provide a more fine-grained, interpretable signal to practitioners. Model performance is improved by the inclusion of invasive features in predicting AHE, when compared to predicting the AHE based on only the available, restricted set of noninvasive technologies. This demonstrates the importance of exploring more noninvasive technologies for AHE prediction.
      pubtype: Academic Journal
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        research
        Journal Article
      ougenre: Article
    language: English
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