Identification and Patient Benefit Evaluation of Machine Learning Models for Predicting 90-Day Mortality After Endovascular Thrombectomy Based on Routinely Ready Clinical Information.

IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL
Andrew Tik Ho Ng, Lawrence Wing Chi Chan
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引用次数: 0

Abstract

Endovascular thrombectomy (EVT) is regarded as the standard of care for acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). However, the mortality rates for these patients remain alarmingly high. Dependable mortality prediction based on timely clinical information is of great importance. This study retrospectively reviewed 151 patients who underwent EVT at Pamela Youde Nethersole Eastern Hospital between 1 April 2017, and 31 October 2023. The primary outcome of this study was 90-day mortality after AIS. The models were developed using two feature selection approaches (model I: sequential forward feature selection, model II: sequential forward feature selection after identifying variables through univariate logistic regression) and six algorithms. Model performance was evaluated by using external validation data of 312 cases and compared with three traditional prediction scores. This study identified support vector machine (SVM) using model II as the best algorithm among the various options. Meanwhile, the Houston Intra-Arterial recanalization 2 (HIAT2) score surpassed all algorithms with an AUC of 0.717. However, most algorithms provided a greater net benefit than the traditional prediction scores. Machine learning (ML) algorithms developed with routinely available variables could offer beneficial insights for predicting mortality in AIS patients undergoing EVT.

基于常规临床信息预测血管内血栓切除术后90天死亡率的机器学习模型的识别和患者受益评估。
血管内血栓切除术(EVT)被认为是急性缺血性卒中(AIS)合并大血管闭塞(LVO)患者的标准治疗方法。然而,这些病人的死亡率仍然高得惊人。基于及时的临床信息的可靠的死亡率预测是非常重要的。本研究回顾性回顾了2017年4月1日至2023年10月31日期间在东部尤德夫人那打素医院接受EVT治疗的151例患者。本研究的主要终点是AIS后90天死亡率。该模型使用两种特征选择方法(模型I:顺序前向特征选择,模型II:通过单变量逻辑回归识别变量后的顺序前向特征选择)和六种算法开发。采用312例外部验证数据对模型性能进行评价,并对三种传统预测评分进行比较。本研究使用模型II作为各种选择中的最佳算法来识别支持向量机(SVM)。同时,Houston动脉内再通2 (HIAT2)评分超过所有算法,AUC为0.717。然而,大多数算法提供了比传统预测分数更大的净收益。利用常规可用变量开发的机器学习(ML)算法可以为预测接受EVT的AIS患者的死亡率提供有益的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bioengineering
Bioengineering Chemical Engineering-Bioengineering
CiteScore
4.00
自引率
8.70%
发文量
661
期刊介绍: Aims Bioengineering (ISSN 2306-5354) provides an advanced forum for the science and technology of bioengineering. It publishes original research papers, comprehensive reviews, communications and case reports. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. All aspects of bioengineering are welcomed from theoretical concepts to education and applications. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. There are, in addition, four key features of this Journal: ● We are introducing a new concept in scientific and technical publications “The Translational Case Report in Bioengineering”. It is a descriptive explanatory analysis of a transformative or translational event. Understanding that the goal of bioengineering scholarship is to advance towards a transformative or clinical solution to an identified transformative/clinical need, the translational case report is used to explore causation in order to find underlying principles that may guide other similar transformative/translational undertakings. ● Manuscripts regarding research proposals and research ideas will be particularly welcomed. ● Electronic files and software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material. ● We also accept manuscripts communicating to a broader audience with regard to research projects financed with public funds. Scope ● Bionics and biological cybernetics: implantology; bio–abio interfaces ● Bioelectronics: wearable electronics; implantable electronics; “more than Moore” electronics; bioelectronics devices ● Bioprocess and biosystems engineering and applications: bioprocess design; biocatalysis; bioseparation and bioreactors; bioinformatics; bioenergy; etc. ● Biomolecular, cellular and tissue engineering and applications: tissue engineering; chromosome engineering; embryo engineering; cellular, molecular and synthetic biology; metabolic engineering; bio-nanotechnology; micro/nano technologies; genetic engineering; transgenic technology ● Biomedical engineering and applications: biomechatronics; biomedical electronics; biomechanics; biomaterials; biomimetics; biomedical diagnostics; biomedical therapy; biomedical devices; sensors and circuits; biomedical imaging and medical information systems; implants and regenerative medicine; neurotechnology; clinical engineering; rehabilitation engineering ● Biochemical engineering and applications: metabolic pathway engineering; modeling and simulation ● Translational bioengineering
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