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人工神经网络算法模型作为预测重症急性胰腺炎后急性肺损伤的有力工具。

Artificial neural network algorithm model as powerful tool to predict acute lung injury following to severe acute pancreatitis.

机构信息

Medical School of Nanjing University, Jinling Hospital/Nanjing General Hospital of Nanjing Military Region of P.L.A., P.L.A. Research Institute of General Surgery, Nanjing, 210002, China.

Medical School of Nanjing University, Jinling Hospital/Nanjing General Hospital of Nanjing Military Region of P.L.A., P.L.A. Research Institute of General Surgery, Nanjing, 210002, China.

出版信息

Pancreatology. 2018 Dec;18(8):892-899. doi: 10.1016/j.pan.2018.09.007. Epub 2018 Sep 26.

Abstract

OBJECTIVE

The aim of this study is to predict the risk of severe acute pancreatitis (SAP) associated with acute lung injury (ALI) by artificial neural networks (ANNs) model.

METHODS

The ANNs and logistic regression model were constructed using clinical and laboratory data of 217 SAP patients. The models were first trained on 152 randomly chosen patients, validated and tested on the 33 patients and 32 patients respectively. Statistical indices were used to evaluate the value of the forecast in two models.

RESULTS

The training set, validation set and test set were not significantly different for any of the 13 variables. After training, the back propagation network retained excellent pattern recognition ability. When the ANNs model was applied to the test set, it revealed a sensitivity of 87.5%, specificity of 83.3%. The accuracy was 84.43%. Significant differences could be found between ANNs model and logistic regression model in these parameter. When ANNs model was used to identify ALI, the area under receiver operating characteristic curve was 0.859 ± 0.048, which demonstrated the better overall properties than logistic regression modeling (AUC = 0.701 + 0.041) (95% CI: 0.664-0.857). Meanwhile, pancreatic necrosis rate, lactic dehydrogenase and oxyhemoglobin saturation were the important factors among all thirteen independent variable for ALI.

CONCLUSION

The ANNs model was a valuable tool in dealing with the clinical risk prediction problem of ALI following to SAP. In addition, our approach can extract informative risk factors of ALI via the ANNs model.

摘要

目的

本研究旨在通过人工神经网络(ANNs)模型预测与急性肺损伤(ALI)相关的重症急性胰腺炎(SAP)的风险。

方法

使用 217 例 SAP 患者的临床和实验室数据构建 ANN 和逻辑回归模型。首先在 152 名随机选择的患者中对模型进行训练,然后分别在 33 名患者和 32 名患者中对模型进行验证和测试。使用统计指标评估两个模型的预测值。

结果

训练集、验证集和测试集在 13 个变量中的任何一个变量上均无显著差异。经过训练,反向传播网络保留了出色的模式识别能力。当将 ANNs 模型应用于测试集时,其灵敏度为 87.5%,特异性为 83.3%。准确率为 84.43%。在这些参数中,ANNs 模型与逻辑回归模型之间存在显著差异。当使用 ANNs 模型识别 ALI 时,接收者操作特征曲线下的面积为 0.859±0.048,表明其整体性能优于逻辑回归建模(AUC=0.701±0.041)(95%CI:0.664-0.857)。同时,胰腺坏死率、乳酸脱氢酶和氧合血红蛋白饱和度是 13 个独立变量中与 ALI 相关的重要因素。

结论

ANNs 模型是处理 SAP 后 ALI 临床风险预测问题的有价值的工具。此外,我们的方法可以通过 ANNs 模型提取 ALI 的信息性风险因素。

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