Kim Jeongmin, Chae Myunghun, Chang Hyuk-Jae, Kim Young-Ah, Park Eunjeong
Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul 03722, Korea.
Computer Engineering, AI R&D Lab. of Selvas AI Inc., Seoul 08594, Korea.
J Clin Med. 2019 Aug 29;8(9):1336. doi: 10.3390/jcm8091336.
We introduce a Feasible Artificial Intelligence with Simple Trajectories for Predicting Adverse Catastrophic Events (FAST-PACE) solution for preparing immediate intervention in emergency situations. FAST-PACE utilizes a concise set of collected features to construct an artificial intelligence model that predicts the onset of cardiac arrest or acute respiratory failure from 1 h to 6 h prior to its occurrence. Data from the trajectory of 29,181 patients in intensive care units of two hospitals includes periodic vital signs, a history of treatment, current health status, and recent surgery. It excludes the results of laboratory data to construct a feasible application in wards, out-hospital emergency care, emergency transport, or other clinical situations where instant medical decisions are required with restricted patient data. These results are superior to previous warning scores including the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS). The primary outcome was the feasibility of an artificial intelligence (AI) model predicting adverse events 1 h to 6 h prior to occurrence without lab data; the area under the receiver operating characteristic curve of this model was 0.886 for cardiac arrest and 0.869 for respiratory failure 6 h before occurrence. The secondary outcome was the superior prediction performance to MEWS (net reclassification improvement of 0.507 for predicting cardiac arrest and 0.341 for predicting respiratory failure) and NEWS (net reclassification improvement of 0.412 for predicting cardiac arrest and 0.215 for predicting respiratory failure) 6 h before occurrence. This study suggests that AI consisting of simple vital signs and a brief interview could predict a cardiac arrest or acute respiratory failure 6 h earlier.
我们推出了一种用于预测不良灾难性事件的具有简单轨迹的可行人工智能(FAST-PACE)解决方案,以便在紧急情况下进行即时干预。FAST-PACE利用一组简洁的收集特征构建人工智能模型,该模型可在心脏骤停或急性呼吸衰竭发生前1小时至6小时预测其发作。来自两家医院重症监护病房29181名患者的轨迹数据包括定期生命体征、治疗史、当前健康状况和近期手术情况。它排除了实验室数据结果,以便在病房、院外急救、紧急转运或其他需要在患者数据有限的情况下做出即时医疗决策的临床情况中构建可行的应用。这些结果优于包括改良早期预警评分(MEWS)和国家早期预警评分(NEWS)在内的先前预警评分。主要结果是人工智能(AI)模型在无实验室数据的情况下预测事件发生前1小时至6小时不良事件的可行性;该模型在心脏骤停发生前6小时的受试者操作特征曲线下面积为0.886,在呼吸衰竭发生前6小时为0.869。次要结果是在事件发生前6小时,其预测性能优于MEWS(预测心脏骤停的净重新分类改善为0.507,预测呼吸衰竭为0.341)和NEWS(预测心脏骤停的净重新分类改善为0.412,预测呼吸衰竭为0.215)。这项研究表明,由简单生命体征和简短问诊组成的人工智能可以提前6小时预测心脏骤停或急性呼吸衰竭。