Zhou Senlin, Wei Jiajun, Tang Lairong, Gu Caimian, Liang Jiong
Department of Neurology, Beiliu People's Hospital Beiliu 537400, Guangxi, China.
Department of Neurology, Affiliated Hospital of Guilin Medical College Guilin 541001, Guangxi, China.
Am J Transl Res. 2023 May 15;15(5):3290-3299. eCollection 2023.
To investigate the predictive effect of a Back propagation (BP) neural network model, a random forest (RF) model and a decision tree model on the prognosis of interventional thrombolectomy for acute ischemic stroke (AIS) patients.
A total of 255 patients with AIS admitted to the Department of Neurology, Beiliu People's Hospital of Guangxi from March 2018 to February 2022 were retrospectively included, all of whom received interventional thromposectomy. Patients' prognosis was determined by the modified Rankin Scale (mRs) at 3 months after surgery, including the good prognosis group (mRs≤2 points) and the poor prognosis group (mRs 3-6 points). Clinical data of the two groups were collected to explore and screen the factors affecting poor clinical prognosis. Based on the selected influencing factors, the BP neural network, RF model, and decision tree models were established respectively, and their predictive performances were verified.
All the three models predicted the same verification set data. The prediction accuracy, sensitivity and specificity of the BP neural network model were 0.961, 0.983 and 0.875, respectively. The prediction accuracy, sensitivity and specificity of the RF model were 0.948, 0.952 and 0.933, respectively. The prediction accuracy, sensitivity and specificity of the decision tree model were 0.882, 0.953 and 0.667, respectively.
The three prediction models have shown good diagnostic efficacy and stability in the preliminary study of the prognosis of AIS mediated thrombectomy, which has important guiding significance for clinical prognosis assessment and selection of appropriate surgical population. The prediction model can be selected according to the actual situation of patients to provide more efficient guidance for clinicians.
探讨反向传播(BP)神经网络模型、随机森林(RF)模型和决策树模型对急性缺血性卒中(AIS)患者介入取栓预后的预测效果。
回顾性纳入2018年3月至2022年2月在广西北流市人民医院神经内科住院的255例AIS患者,所有患者均接受介入取栓治疗。术后3个月采用改良Rankin量表(mRs)评估患者预后,分为预后良好组(mRs≤2分)和预后不良组(mRs 3 - 6分)。收集两组患者的临床资料,探索并筛选影响临床预后不良的因素。基于筛选出的影响因素,分别建立BP神经网络、RF模型和决策树模型,并验证其预测性能。
三种模型均对同一验证集数据进行预测。BP神经网络模型的预测准确率、灵敏度和特异度分别为0.961、0.983和0.875。RF模型的预测准确率、灵敏度和特异度分别为0.948、0.952和0.933。决策树模型的预测准确率、灵敏度和特异度分别为0.882、0.953和0.667。
三种预测模型在AIS介入取栓预后的初步研究中均显示出良好的诊断效能和稳定性,对临床预后评估及选择合适的手术人群具有重要指导意义。可根据患者实际情况选择预测模型,为临床医生提供更高效的指导。