SepsisCalc:通过动态时间图构建将临床计算器集成到早期脓毒症预测中。

Changchang Yin, Shihan Fu, Bingsheng Yao, Thai-Hoang Pham, Weidan Cao, Dakuo Wang, Jeffrey Caterino, Ping Zhang
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引用次数: 0

摘要

败血症是一种器官功能障碍,由对感染的免疫反应失调引起。早期脓毒症的预测和识别可以及时干预,从而改善临床结果。临床计算器(如图1中SOFA的六器官功能障碍评估)在临床医生的工作流程中对脓毒症的识别起着至关重要的作用,为脓毒症诊断提供了必要的循证风险评估。然而,人工智能(AI)脓毒症预测模型通常只生成一个脓毒症风险评分,而不纳入用于评估器官功能障碍的临床计算器,这使得模型对临床医生来说缺乏说服力和透明度。为了弥补这一差距,我们建议用一个新颖的SepsisCalc框架来模拟临床医生的工作流程,将临床计算器集成到预测模型中,从而产生一个临床透明和精确的模型,供临床环境中使用。实际上,临床计算器通常结合来自电子健康记录(EHR)中多个组件变量的信息,当变量(部分)缺失时可能不适用。我们通过将电子病历表示为时间图并集成学习模块来动态地将准确估计的计算器添加到图中来缓解这个问题。在真实数据集上的实验结果表明,所提出的模型在脓毒症预测任务上优于最先进的方法。此外,我们开发了一个识别器官功能障碍和潜在败血症风险的系统,为部署提供了一个人机交互工具,可以帮助临床医生了解预测结果,并针对相应的功能障碍及时准备干预措施,为早期干预提供可操作的临床决策支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SepsisCalc: Integrating Clinical Calculators into Early Sepsis Prediction via Dynamic Temporal Graph Construction.

Sepsis is an organ dysfunction caused by a deregulated immune response to an infection. Early sepsis prediction and identification allow for timely intervention, leading to improved clinical outcomes. Clinical calculators (e.g., the six-organ dysfunction assessment of SOFA in Figure 1) play a vital role in sepsis identification within clinicians' workflow, providing evidence-based risk assessments essential for sepsis diagnosis. However, artificial intelligence (AI) sepsis prediction models typically generate a single sepsis risk score without incorporating clinical calculators for assessing organ dysfunctions, making the models less convincing and transparent to clinicians. To bridge the gap, we propose to mimic clinicians' workflow with a novel framework SepsisCalc to integrate clinical calculators into the predictive model, yielding a clinically transparent and precise model for utilization in clinical settings. Practically, clinical calculators usually combine information from multiple component variables in Electronic Health Records (EHR), and might not be applicable when the variables are (partially) missing. We mitigate this issue by representing EHRs as temporal graphs and integrating a learning module to dynamically add the accurately estimated calculator to the graphs. Experimental results on real-world datasets show that the proposed model outperforms state-of-the-art methods on sepsis prediction tasks. Moreover, we developed a system to identify organ dysfunctions and potential sepsis risks, providing a human-AI interaction tool for deployment, which can help clinicians understand the prediction outputs and prepare timely interventions for the corresponding dysfunctions, paving the way for actionable clinical decision-making support for early intervention.

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