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从预测到处方:应对 COVID-19 的数据驱动方法。

From predictions to prescriptions: A data-driven response to COVID-19.

机构信息

Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142, USA.

Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.

出版信息

Health Care Manag Sci. 2021 Jun;24(2):253-272. doi: 10.1007/s10729-020-09542-0. Epub 2021 Feb 15.

DOI:10.1007/s10729-020-09542-0
PMID:33590417
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7883965/
Abstract

The COVID-19 pandemic has created unprecedented challenges worldwide. Strained healthcare providers make difficult decisions on patient triage, treatment and care management on a daily basis. Policy makers have imposed social distancing measures to slow the disease, at a steep economic price. We design analytical tools to support these decisions and combat the pandemic. Specifically, we propose a comprehensive data-driven approach to understand the clinical characteristics of COVID-19, predict its mortality, forecast its evolution, and ultimately alleviate its impact. By leveraging cohort-level clinical data, patient-level hospital data, and census-level epidemiological data, we develop an integrated four-step approach, combining descriptive, predictive and prescriptive analytics. First, we aggregate hundreds of clinical studies into the most comprehensive database on COVID-19 to paint a new macroscopic picture of the disease. Second, we build personalized calculators to predict the risk of infection and mortality as a function of demographics, symptoms, comorbidities, and lab values. Third, we develop a novel epidemiological model to project the pandemic's spread and inform social distancing policies. Fourth, we propose an optimization model to re-allocate ventilators and alleviate shortages. Our results have been used at the clinical level by several hospitals to triage patients, guide care management, plan ICU capacity, and re-distribute ventilators. At the policy level, they are currently supporting safe back-to-work policies at a major institution and vaccine trial location planning at Janssen Pharmaceuticals, and have been integrated into the US Center for Disease Control's pandemic forecast.

摘要

COVID-19 大流行在全球范围内带来了前所未有的挑战。医疗保健提供者每天都在艰难地决定患者分诊、治疗和护理管理。政策制定者已经实施了社会隔离措施来减缓疾病的传播,这是以巨大的经济代价为代价的。我们设计分析工具来支持这些决策并对抗大流行。具体来说,我们提出了一种全面的数据驱动方法来了解 COVID-19 的临床特征,预测其死亡率,预测其演变,并最终减轻其影响。通过利用队列级别的临床数据、患者级别的医院数据和人口普查级别的流行病学数据,我们开发了一个综合的四步方法,结合描述性、预测性和规范性分析。首先,我们将数百项临床研究汇总到 COVID-19 的最全面数据库中,以描绘出疾病的新宏观图景。其次,我们构建个性化计算器来预测感染和死亡率的风险,其功能取决于人口统计学、症状、合并症和实验室值。第三,我们开发了一种新的流行病学模型来预测大流行的传播并为社会隔离政策提供信息。第四,我们提出了一个优化模型来重新分配呼吸机并缓解短缺。我们的研究结果已在临床层面上被几家医院用于对患者进行分诊、指导护理管理、规划 ICU 容量和重新分配呼吸机。在政策层面,它们目前正在支持一家主要机构的安全返工政策和杨森制药公司的疫苗试验地点规划,并已被纳入美国疾病控制与预防中心的大流行预测中。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/7883965/25e744fc633e/10729_2020_9542_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/7883965/ce38744c61c5/10729_2020_9542_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/7883965/ec8348d053ad/10729_2020_9542_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/7883965/f230c27025d5/10729_2020_9542_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/7883965/90c946261aff/10729_2020_9542_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d83/7883965/bfd45f39eeef/10729_2020_9542_Fig9_HTML.jpg

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