{"title":"基于机器学习的冠心病监护病房再入院预测:多医院验证研究","authors":"Fei-Fei Flora Yau, I-Min Chiu, Kuan-Han Wu, Chi-Yung Cheng, Wei-Chieh Lee, Huang-Chung Chen, Cheng-I Cheng, Tien-Yu Chen","doi":"10.1177/20552076241277030","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Readmission to the coronary care unit (CCU) has significant implications for patient outcomes and healthcare expenditure, emphasizing the urgency to accurately identify patients at high readmission risk. This study aims to construct and externally validate a predictive model for CCU readmission using machine learning (ML) algorithms across multiple hospitals.</p><p><strong>Methods: </strong>Patient information, including demographics, medical history, and laboratory test results were collected from electronic health record system and contributed to a total of 40 features. Five ML models: logistic regression, random forest, support vector machine, gradient boosting, and multilayer perceptron were employed to estimate the readmission risk.</p><p><strong>Results: </strong>The gradient boosting model was selected demonstrated superior performance with an area under the receiver operating characteristic curve (AUC) of 0.887 in the internal validation set. Further external validation in hold-out test set and three other medical centers upheld the model's robustness with consistent high AUCs, ranging from 0.852 to 0.879.</p><p><strong>Conclusion: </strong>The results endorse the integration of ML algorithms in healthcare to enhance patient risk stratification, potentially optimizing clinical interventions, and diminishing the burden of CCU readmissions.</p>","PeriodicalId":51333,"journal":{"name":"DIGITAL HEALTH","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367690/pdf/","citationCount":"0","resultStr":"{\"title\":\"Machine learning-based prediction of coronary care unit readmission: A multihospital validation study.\",\"authors\":\"Fei-Fei Flora Yau, I-Min Chiu, Kuan-Han Wu, Chi-Yung Cheng, Wei-Chieh Lee, Huang-Chung Chen, Cheng-I Cheng, Tien-Yu Chen\",\"doi\":\"10.1177/20552076241277030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Readmission to the coronary care unit (CCU) has significant implications for patient outcomes and healthcare expenditure, emphasizing the urgency to accurately identify patients at high readmission risk. This study aims to construct and externally validate a predictive model for CCU readmission using machine learning (ML) algorithms across multiple hospitals.</p><p><strong>Methods: </strong>Patient information, including demographics, medical history, and laboratory test results were collected from electronic health record system and contributed to a total of 40 features. Five ML models: logistic regression, random forest, support vector machine, gradient boosting, and multilayer perceptron were employed to estimate the readmission risk.</p><p><strong>Results: </strong>The gradient boosting model was selected demonstrated superior performance with an area under the receiver operating characteristic curve (AUC) of 0.887 in the internal validation set. Further external validation in hold-out test set and three other medical centers upheld the model's robustness with consistent high AUCs, ranging from 0.852 to 0.879.</p><p><strong>Conclusion: </strong>The results endorse the integration of ML algorithms in healthcare to enhance patient risk stratification, potentially optimizing clinical interventions, and diminishing the burden of CCU readmissions.</p>\",\"PeriodicalId\":51333,\"journal\":{\"name\":\"DIGITAL HEALTH\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367690/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"DIGITAL HEALTH\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/20552076241277030\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"DIGITAL HEALTH","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20552076241277030","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的:冠心病监护病房(CCU)再入院对患者预后和医疗支出有重大影响,因此迫切需要准确识别再入院风险高的患者。本研究旨在利用机器学习(ML)算法在多家医院构建并从外部验证CCU再入院预测模型:方法:从电子病历系统中收集患者信息,包括人口统计学、病史和实验室检查结果,共收集了 40 个特征。采用了逻辑回归、随机森林、支持向量机、梯度提升和多层感知器等五种ML模型来估计再入院风险:结果:选定的梯度提升模型表现优异,内部验证集的接收器操作特征曲线下面积(AUC)为 0.887。在排除测试集和其他三个医疗中心进行的进一步外部验证证明了该模型的稳健性,其AUC值始终保持在0.852至0.879之间:研究结果支持在医疗保健中整合 ML 算法,以加强患者风险分层,从而优化临床干预措施,减轻 CCU 再入院的负担。
Machine learning-based prediction of coronary care unit readmission: A multihospital validation study.
Objective: Readmission to the coronary care unit (CCU) has significant implications for patient outcomes and healthcare expenditure, emphasizing the urgency to accurately identify patients at high readmission risk. This study aims to construct and externally validate a predictive model for CCU readmission using machine learning (ML) algorithms across multiple hospitals.
Methods: Patient information, including demographics, medical history, and laboratory test results were collected from electronic health record system and contributed to a total of 40 features. Five ML models: logistic regression, random forest, support vector machine, gradient boosting, and multilayer perceptron were employed to estimate the readmission risk.
Results: The gradient boosting model was selected demonstrated superior performance with an area under the receiver operating characteristic curve (AUC) of 0.887 in the internal validation set. Further external validation in hold-out test set and three other medical centers upheld the model's robustness with consistent high AUCs, ranging from 0.852 to 0.879.
Conclusion: The results endorse the integration of ML algorithms in healthcare to enhance patient risk stratification, potentially optimizing clinical interventions, and diminishing the burden of CCU readmissions.