Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
AIDS Care. 2024 Dec;36(12):1745-1753. doi: 10.1080/09540121.2024.2361245. Epub 2024 Jun 4.
Maintaining retention in care (RIC) for people living with HIV (PLWH) helps achieve viral suppression and reduce onward transmission. This study aims to identify the best machine learning model that predicts the RIC transition over time. Extracting from the enhanced HIV/AIDS reporting system, this study included 9765 PLWH from 2005 to 2020 in South Carolina. Transition of RIC was defined as the change of RIC status in each two-year time window. We applied seven classifiers, such as Random Forest, Support Vector Machine, eXtreme Gradient Boosting and Long-short-term memory, for each lagged response to predict the subsequent year's RIC transition. Classification performance was assessed using balanced prediction accuracy, the area under the curve (AUC), recall, precision and F1 scores. The proportion of the four categories of RIC transition was 13.59%, 29.78%, 9.06% and 47.57%, respectively. Support Vector Machine was the best approach for every lag model based on both the F1 score (0.713, 0.717 and 0.719) and AUC (0.920, 0.925 and 0.928). The findings could facilitate the risk augment of PLWH who are prone to follow-up so that clinicians and policymakers could come up with more specific strategies and relocate resources for intervention to keep them sustained in HIV care.
维持艾滋病毒感染者(PLWH)的治疗保留率(RIC)有助于实现病毒抑制并减少传播。本研究旨在确定预测 RIC 随时间转移的最佳机器学习模型。本研究从增强的艾滋病毒/艾滋病报告系统中提取了 2005 年至 2020 年南卡罗来纳州的 9765 名 PLWH。RIC 的转移定义为每个两年时间窗口 RIC 状态的变化。我们应用了七种分类器,如随机森林、支持向量机、极端梯度提升和长短期记忆,用于预测随后一年的 RIC 转移,每个滞后响应。使用平衡预测准确性、曲线下面积(AUC)、召回率、精度和 F1 分数评估分类性能。RIC 转移的四个类别的比例分别为 13.59%、29.78%、9.06%和 47.57%。基于 F1 分数(0.713、0.717 和 0.719)和 AUC(0.920、0.925 和 0.928),支持向量机是每种滞后模型的最佳方法。研究结果可以促进对易随访的 PLWH 的风险增强,以便临床医生和政策制定者能够制定更具体的策略,并重新分配资源进行干预,以维持他们的 HIV 护理。
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