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通过在越南应用机器学习预测重症监护病房患者的抗生素耐药性

Predicting Antibiotic Resistance in ICUs Patients by Applying Machine Learning in Vietnam.

作者信息

Tran Quoc Viet, Nguyen Thi Ngoc Dung, Nguyen Hoang Trung, Vu Thi Hoa, Tong Duc Minh, Do Pham Nguyet Thanh, Nguyen Van Thanh, Ho Ngoc Diep, Vu Son Giang, Bui Duc Thanh

机构信息

Intensive Care Unit, Military Hospital 175, Ho Chi Minh City, Vietnam.

Department of Military Science and Training, Military Hospital 175, Ho Chi Minh City, Vietnam.

出版信息

Infect Drug Resist. 2023 Aug 22;16:5535-5546. doi: 10.2147/IDR.S415885. eCollection 2023.

Abstract

INTRODUCTION

Artificial Intelligence (AI) and machine learning (ML) are used extensively in HICs to detect and control antibiotic resistance (AMR) in laboratories and clinical institutions. ML is designed to predict outcome variables using an algorithm to enable "machines" to learn the "rules" from the data. ML is increasingly being applied in intensive care units to identify AMR and to assist empiric antibiotic therapy. This study aimed to evaluate the performance of ML models for predicting AMR bacteria and resistance to antibiotics in two Vietnamese hospitals.

PATIENTS AND METHODS

A cross-sectional study combined with retrospective was conducted from 1st January 2020 to 30th June 2022. Five models were developed to predict antibiotic resistance of bacterial infections of ICU patients. Two datasets were prepared to predict AMR bacteria and antibiotics with ML models. The performance of the prediction models was evaluated by various indicators (sensitivity, specificity, precision, accuracy, F1-score, PRC, AuROC, and NormMCC) to determine the optimal time point for data selection. Python version 3.8 was used for statistical analyses.

RESULTS

The accuracy, F1-score, AuROC, and normMMC of LightGBM, XGBoost, and Random Forest models were higher than those of other models in both datasets. In both datasets 1 and 2, accuracy, F1-score, AuROC and normMCC of the XGBoost model were the highest among five models (from 0.890 to 1.000). Only Random Forest models had specificity scores higher than 0.850. High scores of sensitivity, accuracy, precision, F1-score, and normMCC indicated that the models were making accurate predictions for datasets 1 and 2.

CONCLUSION

XGBoost, LightGBM, and Random Forest were the best-performed machine learning models to predict antibiotic resistance of bacterial infections of ICUs patients using the patients' EMRs.

摘要

引言

人工智能(AI)和机器学习(ML)在高收入国家(HICs)被广泛用于实验室和临床机构中检测和控制抗生素耐药性(AMR)。机器学习旨在使用算法预测结果变量,使“机器”能够从数据中学习“规则”。机器学习越来越多地应用于重症监护病房,以识别抗生素耐药性并协助经验性抗生素治疗。本研究旨在评估机器学习模型在两家越南医院预测AMR细菌和抗生素耐药性的性能。

患者与方法

于2020年1月1日至2022年6月30日进行了一项横断面研究并结合回顾性研究。开发了五个模型来预测ICU患者细菌感染的抗生素耐药性。准备了两个数据集,用于通过机器学习模型预测AMR细菌和抗生素。通过各种指标(敏感性、特异性、精确度、准确度、F1分数、PRC、AuROC和NormMCC)评估预测模型的性能,以确定数据选择的最佳时间点。使用Python 3.8版本进行统计分析。

结果

在两个数据集中,LightGBM、XGBoost和随机森林模型的准确度、F1分数、AuROC和NormMCC均高于其他模型。在数据集1和数据集中2,XGBoost模型的准确度、F1分数、AuROC和NormMCC在五个模型中都是最高的(从0.890到1.000)。只有随机森林模型的特异性得分高于0.850。敏感性、准确度、精确度、F1分数和NormMCC的高分表明这些模型对数据集1和数据集2做出了准确的预测。

结论

XGBoost、LightGBM和随机森林是使用患者电子病历预测ICU患者细菌感染抗生素耐药性的性能最佳的机器学习模型。

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