Casal-Guisande Manuel, Comesaña-Campos Alberto, Núñez-Fernández Marta, Torres-Durán María, Fernández-Villar Alberto
Fundación Pública Galega de Investigación Biomédica Galicia Sur, Hospital Álvaro Cunqueiro, 36312 Vigo, Spain.
NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain.
Biomedicines. 2024 Apr 12;12(4):854. doi: 10.3390/biomedicines12040854.
Long COVID is a condition that affects a significant proportion of patients who have had COVID-19. It is characterised by the persistence of associated symptoms after the acute phase of the illness has subsided. Although several studies have investigated the risk factors associated with long COVID, identifying which patients will experience long-term symptoms remains a complex task. Among the various symptoms, dyspnea is one of the most prominent due to its close association with the respiratory nature of COVID-19 and its disabling consequences. This work proposes a new intelligent clinical decision support system to predict dyspnea 12 months after a severe episode of COVID-19 based on the SeguiCovid database from the Álvaro Cunqueiro Hospital in Vigo (Galicia, Spain). The database is initially processed using a CART-type decision tree to identify the variables with the highest predictive power. Based on these variables, a cascade of expert systems has been defined with Mamdani-type fuzzy-inference engines. The rules for each system were generated using the Wang-Mendel automatic rule generation algorithm. At the output of the cascade, a risk indicator is obtained, which allows for the categorisation of patients into two groups: those with dyspnea and those without dyspnea at 12 months. This simplifies follow-up and the performance of studies aimed at those patients at risk. The system has produced satisfactory results in initial tests, supported by an AUC of 0.75, demonstrating the potential and usefulness of this tool in clinical practice.
长期新冠是一种影响相当一部分感染过新冠病毒患者的病症。其特征是在疾病急性期消退后相关症状仍持续存在。尽管有多项研究调查了与长期新冠相关的风险因素,但确定哪些患者会出现长期症状仍然是一项复杂的任务。在各种症状中,呼吸困难是最突出的症状之一,因为它与新冠病毒的呼吸道性质密切相关且会导致功能障碍。这项研究基于西班牙加利西亚维戈市阿尔瓦罗·孔克耶罗医院的SeguiCovid数据库,提出了一种新的智能临床决策支持系统,用于预测新冠严重发作12个月后的呼吸困难情况。该数据库最初使用CART型决策树进行处理,以识别预测能力最强的变量。基于这些变量,定义了一系列使用Mamdani型模糊推理引擎的专家系统。每个系统的规则使用王-门德尔自动规则生成算法生成。在该系列系统的输出端,得到一个风险指标,可将患者分为两组:12个月时有呼吸困难的患者和无呼吸困难的患者。这简化了随访工作以及针对那些有风险患者的研究工作。该系统在初步测试中取得了令人满意的结果,曲线下面积(AUC)为0.75,证明了该工具在临床实践中的潜力和实用性。