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使用人工智能方法预测结核病的不良反应和预后。

Using an Artificial Intelligence Approach to Predict the Adverse Effects and Prognosis of Tuberculosis.

作者信息

Liao Kuang-Ming, Liu Chung-Feng, Chen Chia-Jung, Feng Jia-Yih, Shu Chin-Chung, Ma Yu-Shan

机构信息

Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan 722013, Taiwan.

Department of Medical Research, Chi Mei Medical Center, Tainan 710402, Taiwan.

出版信息

Diagnostics (Basel). 2023 Mar 13;13(6):1075. doi: 10.3390/diagnostics13061075.

Abstract

BACKGROUND

Tuberculosis (TB) is one of the leading causes of death worldwide and a major cause of ill health. Without treatment, the mortality rate of TB is approximately 50%; with treatment, most patients with TB can be cured. However, anti-TB drug treatments may result in many adverse effects. Therefore, it is important to detect and predict these adverse effects early. Our study aimed to build models using an artificial intelligence/machine learning approach to predict acute hepatitis, acute respiratory failure, and mortality after TB treatment.

MATERIALS AND METHODS

Adult patients (age ≥ 20 years) who had a TB diagnosis and received treatment from January 2004 to December 2021 were enrolled in the present study. Thirty-six feature variables were used to develop the predictive models with AI. The data were randomly stratified into a training dataset for model building (70%) and a testing dataset for model validation (30%). These algorithms included XGBoost, random forest, MLP, light GBM, logistic regression, and SVM.

RESULTS

A total of 2248 TB patients in Chi Mei Medical Center were included in the study; 71.7% were males, and the other 28.3% were females. The mean age was 67.7 ± 16.4 years. The results showed that our models using the six AI algorithms all had a high area under the receiver operating characteristic curve (AUC) in predicting acute hepatitis, respiratory failure, and mortality, and the AUCs ranged from 0.920 to 0.766, 0.884 to 0.797, and 0.834 to 0.737, respectively.

CONCLUSIONS

Our AI models were good predictors and can provide clinicians with a valuable tool to detect the adverse prognosis in TB patients early.

摘要

背景

结核病是全球主要死因之一,也是健康不佳的主要原因。未经治疗,结核病的死亡率约为50%;经过治疗,大多数结核病患者可以治愈。然而,抗结核药物治疗可能会导致许多不良反应。因此,早期检测和预测这些不良反应很重要。我们的研究旨在使用人工智能/机器学习方法构建模型,以预测结核病治疗后的急性肝炎、急性呼吸衰竭和死亡率。

材料与方法

纳入2004年1月至2021年12月期间诊断为结核病并接受治疗的成年患者(年龄≥20岁)。使用36个特征变量通过人工智能开发预测模型。数据被随机分层为用于模型构建的训练数据集(70%)和用于模型验证的测试数据集(30%)。这些算法包括XGBoost、随机森林、多层感知器、轻量级梯度提升机、逻辑回归和支持向量机。

结果

奇美医学中心共有2248例结核病患者纳入研究;71.7%为男性,其余28.3%为女性。平均年龄为67.7±16.4岁。结果表明,我们使用六种人工智能算法的模型在预测急性肝炎、呼吸衰竭和死亡率方面均具有较高的受试者操作特征曲线下面积(AUC),AUC分别在0.920至0.766、0.884至0.797和0.834至0.737之间。

结论

我们的人工智能模型是良好的预测工具,可以为临床医生提供一个早期检测结核病患者不良预后的有价值工具。

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