Swaminathan Sumanth, Qirko Klajdi, Smith Ted, Corcoran Ethan, Wysham Nicholas G, Bazaz Gaurav, Kappel George, Gerber Anthony N
Revon Systems Inc, Louisville, KY, United States of America, 40014.
Department of Mathematics, University of Delaware, Newark, DE, United States of America, 19716.
PLoS One. 2017 Nov 22;12(11):e0188532. doi: 10.1371/journal.pone.0188532. eCollection 2017.
COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set. Our results show that algorithm accuracy and safety indicators surpass all individual pulmonologists in both identifying exacerbations and predicting the consensus triage in a 101 case validation set. The algorithm is also the top performer in sensitivity, specificity, and ppv when predicting a patient's need for emergency care.
慢性阻塞性肺疾病(COPD)患者每天都面临急性加重和病情失控的风险,而有效的按需决策支持工具可以减轻这种风险。在本研究中,我们提出了一种基于机器学习的策略,用于早期检测病情加重并进行后续分类。我们的应用程序利用一组在统计学和临床上具有全面性的患者病例中的医生意见,来训练一种监督预测算法。该模型的准确性是通过一组医生在代表性患者验证集中对相同病例进行分类来评估的。我们的结果表明,在一个包含101个病例的验证集中,该算法在识别病情加重和预测共识分类方面的准确性和安全指标超过了所有个体肺科医生。在预测患者对紧急护理的需求时,该算法在敏感性、特异性和阳性预测值方面也是表现最佳的。