Souza Alexandra A de, Almeida Danilo Candido de, Barcelos Thiago S, Bortoletto Rodrigo Campos, Munoz Roberto, Waldman Helio, Goes Miguel Angelo, Silva Leandro A
Laboratory of Applied Computing - LABCOM3, Federal Institute of Education, Science and Technology of São Paulo, São Paulo, Brazil.
Nephrology Division - Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Soft comput. 2023;27(6):3295-3306. doi: 10.1007/s00500-021-05810-5. Epub 2021 May 17.
The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is related to new coronavirus disease (COVID-19) has mobilized several scientifics to explore clinical data using soft-computing approaches. In the context of machine learning, previous studies have explored supervised algorithms to predict and support diagnosis based on several clinical parameters from patients diagnosed with and without COVID-19. However, in most of them the decision is based on a "black-box" method, making it impossible to discover the variable relevance in decision making. Hence, in this study, we introduce a non-supervised clustering analysis with neural network self-organizing maps (SOM) as a strategy of decision-making. We propose to identify potential variables in routine blood tests that can support clinician decision-making during COVID-19 diagnosis at hospital admission, facilitating rapid medical intervention. Based on SOM features (visual relationships between clusters and identification of patterns and behaviors), and using linear discriminant analysis , it was possible to detect a group of units of the map with a discrimination power around 83% to SARS-CoV-2-positive patients. In addition, we identified some variables in admission blood tests (Leukocytes, Basophils, Eosinophils, and Red cell Distribution Width) that, in combination had strong influence in the clustering performance, which could assist a possible clinical decision. Thus, although with limitations, we believe that SOM can be used as a soft-computing approach to support clinician decision-making in the context of COVID-19.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的大流行与新型冠状病毒病(COVID-19)相关,这促使一些科学家使用软计算方法探索临床数据。在机器学习的背景下,先前的研究已经探索了监督算法,以根据确诊和未确诊COVID-19的患者的几个临床参数来预测和支持诊断。然而,在大多数研究中,决策是基于一种“黑箱”方法,这使得无法发现决策中的变量相关性。因此,在本研究中,我们引入了一种使用神经网络自组织映射(SOM)的无监督聚类分析作为决策策略。我们建议识别常规血液检查中的潜在变量,这些变量可以在医院入院时支持临床医生在COVID-19诊断过程中的决策,促进快速医疗干预。基于SOM特征(聚类之间的视觉关系以及模式和行为的识别),并使用线性判别分析,有可能检测到一组对SARS-CoV-2阳性患者具有约83%辨别力的映射单元。此外,我们在入院血液检查中确定了一些变量(白细胞、嗜碱性粒细胞、嗜酸性粒细胞和红细胞分布宽度),这些变量组合起来对聚类性能有很大影响,这可能有助于做出可能的临床决策。因此,尽管存在局限性,但我们认为SOM可以用作一种软计算方法,以在COVID-19背景下支持临床医生的决策。