Newborn Intensive Care Unit, Faculty of Pediatrics, the Seventh Medical Center of PLA General Hospital, Beiing, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Respir Res. 2024 May 8;25(1):199. doi: 10.1186/s12931-024-02797-z.
Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) remains a devastating clinical complication seriously affecting the therapeutic outcome of preterm infants. Hence, early prevention and timely diagnosis prior to pathological change is the key to reducing morbidity and improving prognosis. Our primary objective is to utilize machine learning techniques to build predictive models that could accurately identify BPD infants at risk of developing PH.
The data utilized in this study were collected from neonatology departments of four tertiary-level hospitals in China. To address the issue of imbalanced data, oversampling algorithms synthetic minority over-sampling technique (SMOTE) was applied to improve the model.
Seven hundred sixty one clinical records were collected in our study. Following data pre-processing and feature selection, 5 of the 46 features were used to build models, including duration of invasive respiratory support (day), the severity of BPD, ventilator-associated pneumonia, pulmonary hemorrhage, and early-onset PH. Four machine learning models were applied to predictive learning, and after comprehensive selection a model was ultimately selected. The model achieved 93.8% sensitivity, 85.0% accuracy, and 0.933 AUC. A score of the logistic regression formula greater than 0 was identified as a warning sign of BPD-PH.
We comprehensively compared different machine learning models and ultimately obtained a good prognosis model which was sufficient to support pediatric clinicians to make early diagnosis and formulate a better treatment plan for pediatric patients with BPD-PH.
支气管肺发育不良相关肺动脉高压(BPD-PH)仍然是一种严重影响早产儿治疗效果的破坏性临床并发症。因此,在发生病理变化之前,早期预防和及时诊断是降低发病率和改善预后的关键。我们的主要目标是利用机器学习技术构建预测模型,能够准确识别有发生 PH 风险的 BPD 婴儿。
本研究的数据来自中国四家三级医院的新生儿科。为了解决数据不平衡的问题,应用过采样算法合成少数过采样技术(SMOTE)来改进模型。
本研究共收集了 761 份临床记录。在数据预处理和特征选择后,使用了 5 个 46 个特征来构建模型,包括有创性呼吸支持的持续时间(天)、BPD 的严重程度、呼吸机相关性肺炎、肺出血和早发性 PH。应用了 4 种机器学习模型进行预测学习,经过综合选择最终选择了一个模型。该模型的敏感性为 93.8%,准确性为 85.0%,AUC 为 0.933。逻辑回归公式的分数大于 0 被确定为 BPD-PH 的警告标志。
我们综合比较了不同的机器学习模型,最终获得了一个良好的预后模型,足以支持儿科临床医生对 BPD-PH 患儿进行早期诊断并制定更好的治疗计划。