Center of Infectious Diseases, West China Hospital of Sichuan University, China.
West China Biomedical Big Data Center, West China Hospital, Sichuan University, China; Business School, Sichuan University, China.
Int J Med Inform. 2019 Sep;129:175-183. doi: 10.1016/j.ijmedinf.2019.06.001. Epub 2019 Jun 7.
The aim of this study was to conduct an effective assessment of peripherally inserted central venous catheter (PICC)-related thrombosis based on machine learning (ML) techniques considering genotype.
We conducted a prospective cohort study of 348 cancer patients with PICCs who were admitted to the Department of Oncology of West China Hospital, over a 1-year period, between February 1, 2016, and February 31, 2017. We obtained the clinical attributes, onset, duration, and outcome of thrombosis from electronic health records. We assigned all patients to either the training or testing set, and used four models for comparison with the currently used criteria.
ML methods showed good efficiency in PICC-related thrombosis risk assessment (with areas under the curve of 0.7733, 0.7869, 0.7833, and 0.7717 respectively) and outperform the currently used criteria (Seeley), which did not identify any positive case.
Our research confirmed that ML approaches are powerful tools to identify cancer patients with a high risk of PICC-related thrombosis, which outperform the currently used criteria (Seeley). Moreover, our research also offers some indications on the predictors and risk factors of PICC-related thrombosis. From our research, more-precise assessments can be performed in cancer patients with PICCs to help decide the prophylaxis and effectively lower the incidence of PICC-related thrombosis.
本研究旨在基于机器学习(ML)技术,针对基因型对经外周中心静脉置管(PICC)相关血栓形成进行有效评估。
我们进行了一项前瞻性队列研究,纳入了 2016 年 2 月 1 日至 2017 年 2 月 31 日期间在华西医院肿瘤科住院的 348 例 PICC 置管的癌症患者。我们从电子病历中获取了血栓形成的临床特征、发病时间、持续时间和结局。我们将所有患者分配到训练或测试集,并使用四种模型与目前使用的标准进行比较。
ML 方法在 PICC 相关血栓形成风险评估方面表现出良好的效率(曲线下面积分别为 0.7733、0.7869、0.7833 和 0.7717),优于目前使用的标准(Seeley),后者未识别出任何阳性病例。
我们的研究证实,ML 方法是识别 PICC 相关血栓形成高风险癌症患者的有力工具,优于目前使用的标准(Seeley)。此外,我们的研究还提供了一些关于 PICC 相关血栓形成的预测因子和危险因素的提示。通过我们的研究,可以对 PICC 置管的癌症患者进行更精确的评估,有助于决定预防措施,并有效降低 PICC 相关血栓形成的发生率。