Development and Validation of Multimodal Models to Predict the 30-Day Mortality of ICU Patients Based on Clinical Parameters and Chest X-Rays.

We aimed to develop and validate multimodal ICU patient prognosis models that combine clinical parameters data and chest X-ray (CXR) images. A total of 3798 subjects with clinical parameters and CXR images were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and...

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Publicado en:Journal of Digital Imaging Vol. 37; no. 4; pp. 1312 - 1323
Autores principales: Lin, Jiaxi, Yang, Jin, Yin, Minyue, Tang, Yuxiu, Chen, Liquan, Xu, Chang, Zhu, Shiqi, Gao, Jingwen, Liu, Lu, Liu, Xiaolin, Gu, Chenqi, Huang, Zhou, Wei, Yao, Zhu, Jinzhou
Formato: pictorial research tables/charts Journal Article
Publicado: Springer Nature Aug2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
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      pub: Springer Nature
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          Lin, Jiaxi
          Yang, Jin
          Yin, Minyue
          Tang, Yuxiu
          Chen, Liquan
          Xu, Chang
          Zhu, Shiqi
          Gao, Jingwen
          Liu, Lu
          Liu, Xiaolin
          Gu, Chenqi
          Huang, Zhou
          Wei, Yao
          Zhu, Jinzhou
        affil: https://ror.org/051jg5p78 Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, Jiangsu, China
      sug:
        subj:
          Instrument Validation
          Instrument Construction
          Intensive Care Units
          Critically Ill Patients
          Radiography, Thoracic
          Hospital Mortality
          APACHE (Acute Physiology and Chronic Health Evaluation)
          Critical Care
          Human
          Male
          Female
          Funding Source
          Automation
          Machine Learning
          Neural Networks (Computer)
          Deep Learning
          Chi Square Test
          Scales
          Fisher's Exact Test
          Data Analysis Software
          Descriptive Statistics
          Male
          Female
      ab: We aimed to develop and validate multimodal ICU patient prognosis models that combine clinical parameters data and chest X-ray (CXR) images. A total of 3798 subjects with clinical parameters and CXR images were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and an external hospital (the test set). The primary outcome was 30-day mortality after ICU admission. Automated machine learning (AutoML) and convolutional neural networks (CNNs) were used to construct single-modal models based on clinical parameters and CXR separately. An early fusion approach was used to integrate both modalities (clinical parameters and CXR) into a multimodal model named PrismICU. Compared to the single-modal models, i.e., the clinical parameter model (AUC = 0.80, F1-score = 0.43) and the CXR model (AUC = 0.76, F1-score = 0.45) and the scoring system APACHE II (AUC = 0.83, F1-score = 0.77), PrismICU (AUC = 0.95, F1 score = 0.95) showed improved performance in predicting the 30-day mortality in the validation set. In the test set, PrismICU (AUC = 0.82, F1-score = 0.61) was also better than the clinical parameters model (AUC = 0.72, F1-score = 0.50), CXR model (AUC = 0.71, F1-score = 0.36), and APACHE II (AUC = 0.62, F1-score = 0.50). PrismICU, which integrated clinical parameters data and CXR images, performed better than single-modal models and the existing scoring system. It supports the potential of multimodal models based on structured data and imaging in clinical management.
      pubtype: Academic Journal
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        research
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    language: English
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