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机器学习在提高中风患者溶栓安全性和效率方面的可行性与准确性:文献综述及改进建议

The feasibility and accuracy of machine learning in improving safety and efficiency of thrombolysis for patients with stroke: Literature review and proposed improvements.

作者信息

Shao Huiling, Chen Xiangyan, Ma Qilin, Shao Zhiyu, Du Heng, Chan Lawrence Wing Chi

机构信息

Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.

Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, China.

出版信息

Front Neurol. 2022 Oct 20;13:934929. doi: 10.3389/fneur.2022.934929. eCollection 2022.

Abstract

In the treatment of ischemic stroke, timely and efficient recanalization of occluded brain arteries can successfully salvage the ischemic brain. Thrombolysis is the first-line treatment for ischemic stroke. Machine learning models have the potential to select patients who could benefit the most from thrombolysis. In this study, we identified 29 related previous machine learning models, reviewed the models on the accuracy and feasibility, and proposed corresponding improvements. Regarding accuracy, lack of long-term outcome, treatment option consideration, and advanced radiological features were found in many previous studies in terms of model conceptualization. Regarding interpretability, most of the previous models chose restrictive models for high interpretability and did not mention processing time consideration. In the future, model conceptualization could be improved based on comprehensive neurological domain knowledge and feasibility needs to be achieved by elaborate computer science algorithms to increase the interpretability of flexible algorithms and shorten the processing time of the pipeline interpreting medical images.

摘要

在缺血性中风的治疗中,及时有效地再通闭塞的脑动脉能够成功挽救缺血的脑组织。溶栓是缺血性中风的一线治疗方法。机器学习模型有潜力筛选出最能从溶栓治疗中获益的患者。在本研究中,我们识别出29个相关的既往机器学习模型,从准确性和可行性方面对这些模型进行了回顾,并提出了相应的改进建议。在准确性方面,既往许多研究在模型概念化方面存在缺乏长期预后、未考虑治疗方案以及未纳入先进影像学特征等问题。在可解释性方面,既往大多数模型为了高可解释性选择了受限模型,且未提及对处理时间的考量。未来,可基于全面的神经学领域知识改进模型概念化,通过精心设计的计算机科学算法实现可行性,以提高灵活算法的可解释性并缩短医学图像解读流程的处理时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efac/9630915/15e03309780b/fneur-13-934929-g0001.jpg

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