Goodwin Travis R, Demner-Fushman Dina
Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
AMIA Annu Symp Proc. 2020 Mar 4;2019:467-476. eCollection 2019.
Hospital acquired pneumonia (HAP) is the second most common nosocomial infection in the ICU and costs an estimated $3.1 billion annually. The ability to predict HAP could improve patient outcomes and reduce costs. Traditional pneumonia risk prediction models rely on a small number of hand-chosen signs and symptoms and have been shown to poorly discriminate between low and high risk individuals. Consequently, we wanted to investigate whether modern data-driven techniques applied to respective pneumonia cohorts could provide more robust and discriminative prognostication of pneumonia risk. In this paper we present a deep learning system for predicting imminent pneumonia risk one or more days into the future using clinical observations documented in ICU notes for an at-risk population (n = 1, 467). We show how the system can be trained without direct supervision or feature engineering from sparse, noisy, and limited data to predict future pneumonia risk with 96% Sensitivity, 72% AUC, and 80% F1-measure, outperforming SVM approaches using the same features by 20% Accuracy (relative; 12% absolute).
医院获得性肺炎(HAP)是重症监护病房(ICU)中第二常见的医院感染,每年估计花费31亿美元。预测HAP的能力可以改善患者预后并降低成本。传统的肺炎风险预测模型依赖于少数精心挑选的体征和症状,并且已被证明在低风险和高风险个体之间的区分能力较差。因此,我们想研究应用于各个肺炎队列的现代数据驱动技术是否能提供更可靠、更具区分性的肺炎风险预后评估。在本文中,我们提出了一个深度学习系统,该系统利用ICU记录中为高危人群(n = 1467)记录的临床观察数据,预测未来一天或多天内即将发生肺炎的风险。我们展示了该系统如何在没有直接监督或特征工程的情况下,从稀疏、嘈杂和有限的数据中进行训练,以96%的灵敏度、72%的曲线下面积(AUC)和80%的F1值来预测未来的肺炎风险,在使用相同特征的情况下,其准确率比支持向量机(SVM)方法高出20%(相对;绝对为12%)。