重症监护下获得性急性肾损伤患者神经紊乱的Granger因果发现。

AMIA ... Annual Symposium proceedings. AMIA Symposium Pub Date : 2025-05-22 eCollection Date: 2024-01-01
Haowei Xu, Wentie Liu, Tongyue Shi, Guilan Kong
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引用次数: 0

摘要

如今,医疗保健系统越来越多地利用电子病历(EMR)数据的自动监控来检测具有特定模式的不良事件。尽管有这些技术进步,但由于缺乏明确定义的前驱序列,可能标志着这些事件的发生,因此早期识别不良事件仍然具有挑战性。实现临床意义和可解释的预测结果需要一个能够(i)推断EMR数据中各种时间序列特征之间的时间关系(例如,实验室测试结果,生命体征)的框架,以及(ii)识别预示不良事件发生的特定模式(例如,急性肾损伤(AKI))。本研究采用时间序列预测方法进行神经格兰杰因果分析,并结合个性化PageRank算法进一步加强神经格兰杰因果分析,分析icu获得性aki患者的关键因果错乱。利用MIMIC-IV的数据集进行了基于该方法的实验分析。最后,生成了一个格兰杰因果关系(GC)图,其中显示了几个可解释的GC链,可用于预测ICU设置中aki的发生。本研究中发现的GC图和GC链有可能帮助ICU医生提供及时的干预措施,并有助于改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neural Granger Causal Discovery for Derangements in ICU-Acquired Acute Kidney Injury Patients.

Nowadays, healthcare systems increasingly utilize automated surveillance of electronic medical record (EMR) data to detect adverse events with specific patterns. Despite these technological advances, the early identification of adverse events remains challenging due to the absence of clearly defined prodromal sequences that could signal the onset of such events. Achieving clinically meaningful and interpretable prediction outcomes necessitates a framework that is capable of (i) deducing temporal relationships among various time series features within EMR data (e.g., laboratory test results, vital signs), and (ii) identifying specific patterns that herald the occurrence of an adverse event (e.g., acute kidney injury (AKI)). This study employs a time series forecasting approach to undertake neural Granger causal analysis, and further enhance it by integrating a personalized PageRank algorithm to analyze the critical causal derangements among ICU-acquired AKIpatients. An experimental analysis based on the proposed methodology was conducted using a dataset from MIMIC-IV.Finally, a Granger causality (GC) graph, which revealed several interpretable GC chains that could be used to predict the occurrence ofAKI in ICU settings, was generated. The GC graph and GC chains identified in this study have the potential to aid ICU physicians in providing timely interventions and may help improve patient outcomes.

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