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机器学习和人工智能在儿科重症监护中的应用。

The use of machine learning and artificial intelligence within pediatric critical care.

机构信息

Department of Pediatrics, Washington University, St. Louis, MO, USA.

Department of Pediatrics, University of Oklahoma, Oklahoma, OK, USA.

出版信息

Pediatr Res. 2023 Jan;93(2):405-412. doi: 10.1038/s41390-022-02380-6. Epub 2022 Nov 14.


DOI:10.1038/s41390-022-02380-6
PMID:36376506
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9660024/
Abstract

The field of pediatric critical care has been hampered in the era of precision medicine by our inability to accurately define and subclassify disease phenotypes. This has been caused by heterogeneity across age groups that further challenges the ability to perform randomized controlled trials in pediatrics. One approach to overcome these inherent challenges include the use of machine learning algorithms that can assist in generating more meaningful interpretations from clinical data. This review summarizes machine learning and artificial intelligence techniques that are currently in use for clinical data modeling with relevance to pediatric critical care. Focus has been placed on the differences between techniques and the role of each in the clinical arena. The various forms of clinical decision support that utilize machine learning are also described. We review the applications and limitations of machine learning techniques to empower clinicians to make informed decisions at the bedside. IMPACT: Critical care units generate large amounts of under-utilized data that can be processed through artificial intelligence. This review summarizes the machine learning and artificial intelligence techniques currently being used to process clinical data. The review highlights the applications and limitations of these techniques within a clinical context to aid providers in making more informed decisions at the bedside.

摘要

在精准医学时代,儿科危重病医学领域受到阻碍,因为我们无法准确定义和细分疾病表型。这是由于各年龄段之间存在异质性,进一步挑战了在儿科进行随机对照试验的能力。一种克服这些固有挑战的方法包括使用机器学习算法,该算法可以帮助从临床数据中生成更有意义的解释。本综述总结了目前用于儿科危重病临床数据建模的机器学习和人工智能技术。重点介绍了技术之间的差异以及每种技术在临床领域中的作用。还描述了利用机器学习的各种形式的临床决策支持。我们回顾了机器学习技术的应用和局限性,以使临床医生能够在床边做出明智的决策。 影响:重症监护病房产生大量未充分利用的数据,可以通过人工智能进行处理。本综述总结了目前用于处理临床数据的机器学习和人工智能技术。该综述突出了这些技术在临床环境中的应用和局限性,以帮助提供者在床边做出更明智的决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/4f88915db741/41390_2022_2380_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/36f8381d45ee/41390_2022_2380_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/2619fef6917f/41390_2022_2380_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/4f88915db741/41390_2022_2380_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/36f8381d45ee/41390_2022_2380_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/2619fef6917f/41390_2022_2380_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886d/9660024/4f88915db741/41390_2022_2380_Fig3_HTML.jpg

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本文引用的文献

[1]
AI recognition of patient race in medical imaging: a modelling study.

Lancet Digit Health. 2022-6

[2]
Pediatric severe traumatic brain injury mortality prediction determined with machine learning-based modeling.

Injury. 2022-3

[3]
Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Contemporary Organ Dysfunction Criteria: Executive Summary.

Pediatrics. 2022-1-1

[4]
Using explainable machine learning to characterise data drift and detect emergent health risks for emergency department admissions during COVID-19.

Sci Rep. 2021-11-26

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External validation of EPIC's Risk of Unplanned Readmission model, the LACE+ index and SQLape as predictors of unplanned hospital readmissions: A monocentric, retrospective, diagnostic cohort study in Switzerland.

PLoS One. 2021

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Use of a Risk Analytic Algorithm to Inform Weaning From Vasoactive Medication in Patients Following Pediatric Cardiac Surgery.

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Designing a Clinical Decision Support Tool That Leverages Machine Learning for Suicide Risk Prediction: Development Study in Partnership With Native American Care Providers.

JMIR Public Health Surveill. 2021-9-2

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Machine learning model for early prediction of acute kidney injury (AKI) in pediatric critical care.

Crit Care. 2021-8-10

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External Validation of a Widely Implemented Proprietary Sepsis Prediction Model in Hospitalized Patients.

JAMA Intern Med. 2021-8-1

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