Departments of Neonatology.
Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development.
Pediatrics. 2022 Jul 1;150(1). doi: 10.1542/peds.2021-056052.
Outcome prediction of preterm birth is important for neonatal care, yet prediction performance using conventional statistical models remains insufficient. Machine learning has a high potential for complex outcome prediction. In this scoping review, we provide an overview of the current applications of machine learning models in the prediction of neurodevelopmental outcomes in preterm infants, assess the quality of the developed models, and provide guidance for future application of machine learning models to predict neurodevelopmental outcomes of preterm infants.
A systematic search was performed using PubMed. Studies were included if they reported on neurodevelopmental outcome prediction in preterm infants using predictors from the neonatal period and applying machine learning techniques. Data extraction and quality assessment were independently performed by 2 reviewers.
Fourteen studies were included, focusing mainly on very or extreme preterm infants, predicting neurodevelopmental outcome before age 3 years, and mostly assessing outcomes using the Bayley Scales of Infant Development. Predictors were most often based on MRI. The most prevalent machine learning techniques included linear regression and neural networks. None of the studies met all newly developed quality assessment criteria. Studies least prone to inflated performance showed promising results, with areas under the curve up to 0.86 for classification and R2 values up to 91% in continuous prediction. A limitation was that only 1 data source was used for the literature search.
Studies least prone to inflated prediction results are the most promising. The provided evaluation framework may contribute to improved quality of future machine learning models.
早产儿的结局预测对于新生儿护理至关重要,但常规统计模型的预测性能仍不够充分。机器学习在复杂结局预测方面具有很高的潜力。在本次范围综述中,我们概述了机器学习模型在预测早产儿神经发育结局方面的当前应用,评估了所开发模型的质量,并为未来应用机器学习模型预测早产儿神经发育结局提供了指导。
使用 PubMed 进行系统检索。如果研究报告了使用新生儿期预测因子并应用机器学习技术预测早产儿的神经发育结局,则将其纳入。由 2 名评审员独立进行数据提取和质量评估。
共纳入 14 项研究,主要关注极早早产儿或超早产儿,预测 3 岁前的神经发育结局,且大多使用贝利婴幼儿发展量表评估结局。预测因子主要基于 MRI。最常见的机器学习技术包括线性回归和神经网络。没有一项研究符合所有新制定的质量评估标准。不易产生过度拟合的研究结果显示出有前景的结果,分类的曲线下面积高达 0.86,连续预测的 R2 值高达 91%。一个局限性是仅使用了 1 个数据源进行文献检索。
不易产生过度拟合预测结果的研究最有前景。所提供的评估框架可能有助于提高未来机器学习模型的质量。