Department of Nursing, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
J Affect Disord. 2022 Dec 1;318:364-379. doi: 10.1016/j.jad.2022.08.070. Epub 2022 Aug 31.
Postpartum depression (PPD) presents a serious health problem among women and their families. Machine learning (ML) is a rapidly advancing field with increasing utility in predicting PPD risk. We aimed to synthesize and evaluate the quality of studies on application of ML techniques in predicting PPD risk.
We conducted a systematic search of eight databases, identifying English and Chinese studies on ML techniques for predicting PPD risk and ML techniques with performance metrics. Quality of the studies involved was evaluated using the Prediction Model Risk of Bias Assessment Tool.
Seventeen studies involving 62 prediction models were included. Supervised learning was the main ML technique employed and the common ML models were support vector machine, random forest and logistic regression. Five studies (30 %) reported both internal and external validation. Two studies involved model translation, but none were tested clinically. All studies showed a high risk of bias, and more than half showed high application risk.
Including Chinese articles slightly reduced the reproducibility of the review. Model performance was not quantitatively analyzed owing to inconsistent metrics and the absence of methods for correlation meta-analysis.
Researchers have paid more attention to model development than to validation, and few have focused on improvement and innovation. Models for predicting PPD risk continue to emerge. However, few have achieved the acceptable quality standards. Therefore, ML techniques for successfully predicting PPD risk are yet to be deployed in clinical environments.
产后抑郁症(PPD)是女性及其家庭面临的严重健康问题。机器学习(ML)是一个快速发展的领域,在预测 PPD 风险方面的应用越来越多。我们旨在综合评估应用 ML 技术预测 PPD 风险的研究的质量。
我们对八个数据库进行了系统检索,确定了关于 ML 技术预测 PPD 风险和具有性能指标的 ML 技术的英文和中文研究。使用预测模型风险偏倚评估工具评估研究的质量。
共纳入了 17 项研究,涉及 62 个预测模型。监督学习是主要采用的 ML 技术,常见的 ML 模型包括支持向量机、随机森林和逻辑回归。五项研究(30%)报告了内部和外部验证。两项研究涉及模型翻译,但均未进行临床测试。所有研究均存在较高的偏倚风险,超过一半的研究存在较高的应用风险。
纳入中文文章略微降低了综述的可重复性。由于指标不一致且缺乏相关荟萃分析方法,因此未对模型性能进行定量分析。
研究人员更加关注模型的开发,而不是验证,很少有人关注改进和创新。预测 PPD 风险的模型不断涌现。然而,很少有模型达到了可接受的质量标准。因此,成功预测 PPD 风险的 ML 技术尚未在临床环境中得到应用。