{"title":"AI-Enabled Clinical Decision Support System Modeling for the Prediction of Cirrhosis Complications","authors":"","doi":"10.1016/j.irbm.2024.100854","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Objective</h3><p>Utilizing artificial intelligence (AI), a clinical decision support system (CDSS), can help physicians anticipate possible complications of cirrhosis patients before prescribing more accurate treatments. This study aimed to establish a prototype of AI-CDSS modeling using electronic health records to predict five complications for cirrhosis patients who were controlled for oral antiviral drugs, lamivudine (LAM) or entecavir (ETV).</p></div><div><h3>Methods</h3><p>Our modeling attained a web-based AI-CDSS with four steps – data extraction, sample normalization, AI-enabled machine learning (ML), and system integration. We designed the extract-transform-load (ETL) procedure to filter the analytics features from a clinical database. The data training process applied 10-fold cross-validation to verify diverse ML models due to possible feature patterns with medications for predicting the complications. In addition, we applied both statistical means and standard deviations of the realistic datasets to create the simulative datasets, which contained sufficient and balanced data to train the most efficient models for evaluation. The modeling combined multiple ML methods, such as support vector machine (SVM), random forest (RF), extreme gradient boosting, naive Bayes, and logistic regression, for training fourteen features to generate the AI-CDSS's prediction functionality.</p></div><div><h3>Results</h3><p>The models achieving an accuracy of 0.8 after cross-validations would be qualified for the AI-CDSS. SVM and RF models using realistic data predicted jaundice with an accuracy of over 0.82. Furthermore, the SVM models using simulative data reached an accuracy of over 0.85 when predicting patients with jaundice. Our approaches implied that the simulative datasets based on the same distributions as that of the features in the realistic dataset were adequate for training the ML models. The RF model could reach an AUC of up to 0.82 for multiple complications by testing with the un-trained data. Finally, we successfully installed twenty models of the suitable ML methods in the AI-CDSS to predict five complications for cirrhosis patients prescribed with LAM or ETV.</p></div><div><h3>Conclusions</h3><p>Our modeling integrated a self-developed AI-CDSS with the approved ML models to predict cirrhosis complications for aiding clinical decision making.</p></div>","PeriodicalId":14605,"journal":{"name":"Irbm","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Irbm","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1959031824000356","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background and Objective
Utilizing artificial intelligence (AI), a clinical decision support system (CDSS), can help physicians anticipate possible complications of cirrhosis patients before prescribing more accurate treatments. This study aimed to establish a prototype of AI-CDSS modeling using electronic health records to predict five complications for cirrhosis patients who were controlled for oral antiviral drugs, lamivudine (LAM) or entecavir (ETV).
Methods
Our modeling attained a web-based AI-CDSS with four steps – data extraction, sample normalization, AI-enabled machine learning (ML), and system integration. We designed the extract-transform-load (ETL) procedure to filter the analytics features from a clinical database. The data training process applied 10-fold cross-validation to verify diverse ML models due to possible feature patterns with medications for predicting the complications. In addition, we applied both statistical means and standard deviations of the realistic datasets to create the simulative datasets, which contained sufficient and balanced data to train the most efficient models for evaluation. The modeling combined multiple ML methods, such as support vector machine (SVM), random forest (RF), extreme gradient boosting, naive Bayes, and logistic regression, for training fourteen features to generate the AI-CDSS's prediction functionality.
Results
The models achieving an accuracy of 0.8 after cross-validations would be qualified for the AI-CDSS. SVM and RF models using realistic data predicted jaundice with an accuracy of over 0.82. Furthermore, the SVM models using simulative data reached an accuracy of over 0.85 when predicting patients with jaundice. Our approaches implied that the simulative datasets based on the same distributions as that of the features in the realistic dataset were adequate for training the ML models. The RF model could reach an AUC of up to 0.82 for multiple complications by testing with the un-trained data. Finally, we successfully installed twenty models of the suitable ML methods in the AI-CDSS to predict five complications for cirrhosis patients prescribed with LAM or ETV.
Conclusions
Our modeling integrated a self-developed AI-CDSS with the approved ML models to predict cirrhosis complications for aiding clinical decision making.
期刊介绍:
IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux).
As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in:
-Physiological and Biological Signal processing (EEG, MEG, ECG…)-
Medical Image processing-
Biomechanics-
Biomaterials-
Medical Physics-
Biophysics-
Physiological and Biological Sensors-
Information technologies in healthcare-
Disability research-
Computational physiology-
…