Department of Industrial Engineering, Tsinghua University, Beijing 100084, China.
Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15261, USA.
J Biomed Inform. 2021 Jan;113:103653. doi: 10.1016/j.jbi.2020.103653. Epub 2020 Dec 16.
Acute kidney injury (AKI) is a common clinical condition with high mortality and resource consumption. Early identification of high-risk patients to achieve an appropriate allocation of limited clinical resources and timely interventions is of significant importance, which has attracted substantial research to develop prediction models for AKI risk stratification. However, most available AKI prediction models have moderate performance and lack of interpretability, which limits their applicability in supporting care intervention. In this paper, a machine learning-based framework for AKI prediction and interpretation in critical care is presented. First, an ensemble model is developed to predict a patient's risk of AKI within 72 h of admission to the intensive care units. Next, the model is interpreted both globally and locally. For the global interpretation, the important predictors are pinpointed and the detailed relationships between AKI risk and these predictors are illustrated. For the local interpretation, patient-specific analysis is presented to provide a visualized explanation for each individual prediction. Experimental results show that such a prediction and interpretation framework can lead to good prediction and interpretation performance, which has the potential to provide effective clinical decision support.
急性肾损伤(AKI)是一种常见的临床病症,具有较高的死亡率和资源消耗。早期识别高危患者,实现有限临床资源的合理分配和及时干预非常重要,这吸引了大量研究来开发 AKI 风险分层预测模型。然而,大多数现有的 AKI 预测模型性能中等,缺乏可解释性,限制了其在支持护理干预方面的应用。本文提出了一种基于机器学习的重症监护 AKI 预测和解释框架。首先,开发了一个集成模型来预测患者在进入重症监护病房后 72 小时内发生 AKI 的风险。然后,对模型进行全局和局部解释。对于全局解释,确定了重要的预测因子,并说明了 AKI 风险与这些预测因子之间的详细关系。对于局部解释,提供了患者特定的分析,为每个个体预测提供可视化解释。实验结果表明,这种预测和解释框架可以实现良好的预测和解释性能,具有为临床决策提供有效支持的潜力。