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利用机器学习预测丹麦 COVID-19 大流行期间重症监护病房资源使用情况。

Using machine learning for predicting intensive care unit resource use during the COVID-19 pandemic in Denmark.

机构信息

Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.

Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.

出版信息

Sci Rep. 2021 Sep 23;11(1):18959. doi: 10.1038/s41598-021-98617-1.

DOI:10.1038/s41598-021-98617-1
PMID:34556789
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8460747/
Abstract

The COVID-19 pandemic has put massive strains on hospitals, and tools to guide hospital planners in resource allocation during the ebbs and flows of the pandemic are urgently needed. We investigate whether machine learning (ML) can be used for predictions of intensive care requirements a fixed number of days into the future. Retrospective design where health Records from 42,526 SARS-CoV-2 positive patients in Denmark was extracted. Random Forest (RF) models were trained to predict risk of ICU admission and use of mechanical ventilation after n days (n = 1, 2, …, 15). An extended analysis was provided for n = 5 and n = 10. Models predicted n-day risk of ICU admission with an area under the receiver operator characteristic curve (ROC-AUC) between 0.981 and 0.995, and n-day risk of use of ventilation with an ROC-AUC between 0.982 and 0.997. The corresponding n-day forecasting models predicted the needed ICU capacity with a coefficient of determination (R) between 0.334 and 0.989 and use of ventilation with an R between 0.446 and 0.973. The forecasting models performed worst, when forecasting many days into the future (for large n). For n = 5, ICU capacity was predicted with ROC-AUC 0.990 and R 0.928, and use of ventilator was predicted with ROC-AUC 0.994 and R 0.854. Random Forest-based modelling can be used for accurate n-day forecasting predictions of ICU resource requirements, when n is not too large.

摘要

COVID-19 大流行给医院带来了巨大压力,迫切需要工具来指导医院规划者在疫情的潮起潮落中分配资源。我们研究了机器学习 (ML) 是否可用于预测未来固定天数内的重症监护需求。回顾性设计,从丹麦 42526 例 SARS-CoV-2 阳性患者的健康记录中提取数据。随机森林 (RF) 模型用于预测 n 天后 ICU 入院和机械通气的风险 (n=1,2,···,15)。对于 n=5 和 n=10,提供了扩展分析。模型预测 n 天内 ICU 入院风险的接收者操作特征曲线下面积 (ROC-AUC) 在 0.981 到 0.995 之间,n 天内通气风险的 ROC-AUC 在 0.982 到 0.997 之间。相应的 n 天预测模型预测 ICU 容量的决定系数 (R) 在 0.334 到 0.989 之间,预测通气的 R 在 0.446 到 0.973 之间。当预测未来很多天时,预测模型的表现最差(对于较大的 n)。对于 n=5,预测 ICU 容量的 ROC-AUC 为 0.990,R 为 0.928,预测使用呼吸机的 ROC-AUC 为 0.994,R 为 0.854。随机森林建模可用于准确预测未来 n 天的 ICU 资源需求,当 n 不太大时。

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