Department of Radiology, NanFang Hospital of Southern Medical University, Guangzhou, China.
Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital of Southern Medical University, Guangzhou, China.
Respir Res. 2024 Jan 3;25(1):2. doi: 10.1186/s12931-023-02624-x.
Accurately distinguishing between pulmonary infection and colonization in patients with Acinetobacter baumannii is of utmost importance to optimize treatment and prevent antibiotic abuse or inadequate therapy. An efficient automated sorting tool could prompt individualized interventions and enhance overall patient outcomes. This study aims to develop a robust machine learning classification model using a combination of time-series chest radiographs and laboratory data to accurately classify pulmonary status caused by Acinetobacter baumannii.
We proposed nested logistic regression models based on different time-series data to automatically classify the pulmonary status of patients with Acinetobacter baumannii. Advanced features were extracted from the time-series data of hospitalized patients, encompassing dynamic pneumonia indicators observed on chest radiographs and laboratory indicator values recorded at three specific time points.
Data of 152 patients with Acinetobacter baumannii cultured from sputum or alveolar lavage fluid were retrospectively analyzed. Our model with multiple time-series data demonstrated a higher performance of AUC (0.850, with a 95% confidence interval of [0.638-0.873]), an accuracy of 0.761, a sensitivity of 0.833. The model, which only incorporated a single time point feature, achieved an AUC of 0.741. The influential model variables included difference in the chest radiograph pneumonia score.
Dynamic assessment of time-series chest radiographs and laboratory data using machine learning allowed for accurate classification of colonization and infection with Acinetobacter baumannii. This demonstrates the potential to help clinicians provide individualized treatment through early detection.
准确区分鲍曼不动杆菌感染和定植对于优化治疗方案、预防抗生素滥用或治疗不足至关重要。高效的自动化分类工具可以促使采取个体化干预措施,从而提高整体患者预后。本研究旨在开发一种使用时间序列胸部 X 线片和实验室数据相结合的强大机器学习分类模型,以准确分类鲍曼不动杆菌引起的肺部状况。
我们提出了基于不同时间序列数据的嵌套逻辑回归模型,以自动分类鲍曼不动杆菌患者的肺部状况。从住院患者的时间序列数据中提取高级特征,包括胸部 X 光片上观察到的动态肺炎指标和三个特定时间点记录的实验室指标值。
回顾性分析了 152 例从痰或肺泡灌洗液中培养出鲍曼不动杆菌的患者数据。我们的多时间序列数据模型表现出更高的 AUC(0.850,95%置信区间为 [0.638-0.873])、准确性为 0.761、敏感性为 0.833。仅纳入单个时间点特征的模型的 AUC 为 0.741。有影响力的模型变量包括胸部 X 光片肺炎评分的差异。
使用机器学习对时间序列胸部 X 线片和实验室数据进行动态评估,可以准确分类鲍曼不动杆菌的定植和感染。这表明有可能通过早期检测帮助临床医生提供个体化治疗。