Qin Yidi, Caldino Bohn Rebecca I, Sriram Aditya, Kernan Kate F, Carcillo Joseph A, Kim Soyeon, Park Hyun Jung
Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States.
Front Pediatr. 2023 Jan 30;11:1035576. doi: 10.3389/fped.2023.1035576. eCollection 2023.
Sepsis contributes to 1 of every 5 deaths globally with 3 million per year occurring in children. To improve clinical outcomes in pediatric sepsis, it is critical to avoid "one-size-fits-all" approaches and to employ a precision medicine approach. To advance a precision medicine approach to pediatric sepsis treatments, this review provides a summary of two phenotyping strategies, empiric and machine-learning-based phenotyping based on multifaceted data underlying the complex pediatric sepsis pathobiology. Although empiric and machine-learning-based phenotypes help clinicians accelerate the diagnosis and treatments, neither empiric nor machine-learning-based phenotypes fully encapsulate all aspects of pediatric sepsis heterogeneity. To facilitate accurate delineations of pediatric sepsis phenotypes for precision medicine approach, methodological steps and challenges are further highlighted.
脓毒症导致全球五分之一的死亡,每年有300万例发生在儿童身上。为改善儿童脓毒症的临床结局,避免“一刀切”的方法并采用精准医学方法至关重要。为推动儿童脓毒症治疗的精准医学方法,本综述总结了两种表型分析策略,即基于复杂儿童脓毒症病理生物学基础的多方面数据的经验性表型分析和基于机器学习的表型分析。尽管经验性和基于机器学习的表型有助于临床医生加快诊断和治疗,但经验性和基于机器学习的表型均未完全涵盖儿童脓毒症异质性的所有方面。为便于在精准医学方法中准确描绘儿童脓毒症表型,进一步强调了方法步骤和挑战。