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使用时间序列机器学习模型对个体进行非酒精性脂肪性肝病风险分层。

Stratifying individuals into non-alcoholic fatty liver disease risk levels using time series machine learning models.

机构信息

Faculty of Business Administration, Ono Academic College, 104 Zahal Street, Kiryat Ono 55000, Israel.

Faculty of Business Administration, Ono Academic College, 104 Zahal Street, Kiryat Ono 55000, Israel; Faculty of Business Administration, Peres Academic Center, 10 Shimon Peres Street, Rehovot, 7610202, Israel.

出版信息

J Biomed Inform. 2022 Feb;126:103986. doi: 10.1016/j.jbi.2022.103986. Epub 2022 Jan 7.

DOI:10.1016/j.jbi.2022.103986
PMID:35007752
Abstract

Non-alcoholic fatty liver disease (NAFLD) affects 25% of the population worldwide, and its prevalence is anticipated to increase globally. While most NAFLD patients are asymptomatic, NAFLD may progress to fibrosis, cirrhosis, cardiovascular disease, and diabetes. Research reports, with daunting results, show the challenge that NAFLD's burden causes to global population health. The current process for identifying fibrosis risk levels is inefficient, expensive, does not cover all potential populations, and does not identify the risk in time. Instead of invasive liver biopsies, we implemented a non-invasive fibrosis assessment process calculated from clinical data (accessed via EMRs/EHRs). We stratified patients' risks for fibrosis from 2007 to 2017 by modeling the risk in 5579 individuals. The process involved time-series machine learning models (Hidden Markov Models and Group-Based Trajectory Models) profiled fibrosis risk by modeling patients' latent medical status resulted in three groups. The high-risk group had abnormal lab test values and a higher prevalence of chronic conditions. This study can help overcome the inefficient, traditional process of detecting fibrosis via biopsies (that are also medically unfeasible due to their invasive nature, the medical resources involved, and costs) at early stages. Thus longitudinal risk assessment may be used to make population-specific medical recommendations targeting early detection of high risk patients, to avoid the development of fibrosis disease and its complications as well as decrease healthcare costs.

摘要

非酒精性脂肪性肝病 (NAFLD) 影响全球 25%的人口,预计其患病率将在全球范围内上升。虽然大多数 NAFLD 患者无症状,但 NAFLD 可能会进展为纤维化、肝硬化、心血管疾病和糖尿病。研究报告显示,NAFLD 的负担给全球人口健康带来了巨大挑战,结果令人担忧。目前识别纤维化风险水平的过程效率低下、成本高昂、不能涵盖所有潜在人群,并且不能及时识别风险。我们没有采用侵入性的肝活检,而是实施了一种从临床数据(通过 EMRs/EHRs 获得)计算的非侵入性纤维化评估过程。我们通过对 5579 名个体的风险建模,对 2007 年至 2017 年的患者纤维化风险进行分层。该过程涉及时间序列机器学习模型(隐马尔可夫模型和基于群组的轨迹模型),通过对患者潜在医疗状况进行建模来分析纤维化风险,结果分为三组。高风险组的实验室检测值异常,慢性病的患病率较高。这项研究可以帮助克服通过活检检测纤维化的低效、传统过程(由于其侵入性、涉及的医疗资源和成本,活检在医学上也不可行),在早期阶段。因此,纵向风险评估可用于针对高危患者进行早期检测,制定特定人群的医疗建议,以避免纤维化疾病及其并发症的发展,并降低医疗保健成本。

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