Saxe Glenn N, Ma Sisi, Ren Jiwen, Aliferis Constantin
Department of Child and Adolescent Psychiatry, New York University School of Medicine, One Park Avenue, New York, NY, 10016, USA.
Institute for Health Informatics and Department of Medicine, University of Minnesota, 330 Diehl Hall, MMC912, 420 Delaware Street S.E, Minneapolis, Minnesota, Mpls, MN, 55455, USA.
BMC Psychiatry. 2017 Jul 10;17(1):223. doi: 10.1186/s12888-017-1384-1.
The care of traumatized children would benefit significantly from accurate predictive models for Posttraumatic Stress Disorder (PTSD), using information available around the time of trauma. Machine Learning (ML) computational methods have yielded strong results in recent applications across many diseases and data types, yet they have not been previously applied to childhood PTSD. Since these methods have not been applied to this complex and debilitating disorder, there is a great deal that remains to be learned about their application. The first step is to prove the concept: Can ML methods - as applied in other fields - produce predictive classification models for childhood PTSD? Additionally, we seek to determine if specific variables can be identified - from the aforementioned predictive classification models - with putative causal relations to PTSD.
ML predictive classification methods - with causal discovery feature selection - were applied to a data set of 163 children hospitalized with an injury and PTSD was determined three months after hospital discharge. At the time of hospitalization, 105 risk factor variables were collected spanning a range of biopsychosocial domains.
Seven percent of subjects had a high level of PTSD symptoms. A predictive classification model was discovered with significant predictive accuracy. A predictive model constructed based on subsets of potentially causally relevant features achieves similar predictivity compared to the best predictive model constructed with all variables. Causal Discovery feature selection methods identified 58 variables of which 10 were identified as most stable.
In this first proof-of-concept application of ML methods to predict childhood Posttraumatic Stress we were able to determine both predictive classification models for childhood PTSD and identify several causal variables. This set of techniques has great potential for enhancing the methodological toolkit in the field and future studies should seek to replicate, refine, and extend the results produced in this study.
利用创伤发生时可得的信息,准确的创伤后应激障碍(PTSD)预测模型将极大地有助于对受创伤儿童的护理。机器学习(ML)计算方法在最近针对多种疾病和数据类型的应用中取得了显著成果,但此前尚未应用于儿童PTSD。由于这些方法尚未应用于这种复杂且使人衰弱的疾病,关于它们的应用仍有许多有待了解之处。第一步是证明概念:ML方法——如同在其他领域的应用——能否生成儿童PTSD的预测分类模型?此外,我们试图确定是否能从上述预测分类模型中识别出与PTSD存在假定因果关系的特定变量。
将具有因果发现特征选择的ML预测分类方法应用于163名因伤住院儿童的数据集,并在出院三个月后确定是否患有PTSD。在住院时,收集了涵盖一系列生物心理社会领域的105个风险因素变量。
7%的受试者有高水平的PTSD症状。发现了一个具有显著预测准确性的预测分类模型。基于潜在因果相关特征子集构建的预测模型与使用所有变量构建的最佳预测模型相比,具有相似的预测能力。因果发现特征选择方法识别出58个变量,其中10个被确定为最稳定的变量。
在ML方法预测儿童创伤后应激的首次概念验证应用中,我们能够确定儿童PTSD的预测分类模型,并识别出几个因果变量。这套技术在增强该领域的方法工具包方面具有巨大潜力,未来的研究应设法复制、完善和扩展本研究产生的结果。