Zhang Jinbo, Yang Pingping, Zeng Lu, Li Shan, Zhou Jiamei
Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Nursing College, Zunyi Medical University, Zunyi, China.
JMIR Med Inform. 2024 May 14;12:e57026. doi: 10.2196/57026.
Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation therapy that affects patients' treatments and prognoses. Owing to its excellent data mining capabilities, artificial intelligence (AI) has been increasingly used to predict VAP.
This paper reviews VAP prediction models that are based on AI, providing a reference for the early identification of high-risk groups in future clinical practice.
A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The Wanfang database, the Chinese Biomedical Literature Database, Cochrane Library, Web of Science, PubMed, MEDLINE, and Embase were searched to identify relevant articles. Study selection and data extraction were independently conducted by 2 reviewers. The data extracted from the included studies were synthesized narratively.
Of the 137 publications retrieved, 11 were included in this scoping review. The included studies reported the use of AI for predicting VAP. All 11 studies predicted VAP occurrence, and studies on VAP prognosis were excluded. Further, these studies used text data, and none of them involved imaging data. Public databases were the primary sources of data for model building (studies: 6/11, 55%), and 5 studies had sample sizes of <1000. Machine learning was the primary algorithm for studying the VAP prediction models. However, deep learning and large language models were not used to construct VAP prediction models. The random forest model was the most commonly used model (studies: 5/11, 45%). All studies only performed internal validations, and none of them addressed how to implement and apply the final model in real-life clinical settings.
This review presents an overview of studies that used AI to predict and diagnose VAP. AI models have better predictive performance than traditional methods and are expected to provide indispensable tools for VAP risk prediction in the future. However, the current research is in the model construction and validation stage, and the implementation of and guidance for clinical VAP prediction require further research.
呼吸机相关性肺炎(VAP)是机械通气治疗的一种严重并发症,会影响患者的治疗和预后。由于具有出色的数据挖掘能力,人工智能(AI)已越来越多地用于预测VAP。
本文综述基于AI的VAP预测模型,为未来临床实践中早期识别高危人群提供参考。
按照PRISMA-ScR(系统评价和Meta分析扩展版的范围综述首选报告项目)指南进行范围综述。检索万方数据库、中国生物医学文献数据库、Cochrane图书馆、Web of Science、PubMed、MEDLINE和Embase以识别相关文章。由2名评审员独立进行研究选择和数据提取。对纳入研究中提取的数据进行叙述性综合。
在检索到的137篇出版物中,11篇被纳入本范围综述。纳入研究报告了使用AI预测VAP。所有11项研究均预测了VAP的发生,排除了关于VAP预后的研究。此外,这些研究使用的是文本数据,均未涉及影像数据。公共数据库是模型构建的主要数据来源(研究:6/11,55%),5项研究的样本量小于1000。机器学习是研究VAP预测模型的主要算法。然而,深度学习和大语言模型未用于构建VAP预测模型。随机森林模型是最常用的模型(研究:5/11,45%)。所有研究仅进行了内部验证,均未探讨如何在实际临床环境中实施和应用最终模型。
本综述概述了使用AI预测和诊断VAP的研究。AI模型比传统方法具有更好的预测性能,有望为未来VAP风险预测提供不可或缺的工具。然而,当前研究处于模型构建和验证阶段,临床VAP预测的实施和指导仍需进一步研究。