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机器学习模型在急性冠状动脉综合征和下尿路症状患者中风风险评估中的应用。

Implementation of a machine learning model in acute coronary syndrome and stroke risk assessment for patients with lower urinary tract symptoms.

机构信息

Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan.

Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2024 Jul;63(4):518-526. doi: 10.1016/j.tjog.2024.01.037.

Abstract

OBJECTIVE

The global population is aging and the burden of lower urinary tract symptoms (LUTS) is expected to increase. According to the National Health Insurance Research Database, our previous studies have showed LUTS may predispose patients to cardiovascular disease. However, it is difficult to provide a personalized risk assessment in the context of "having acute coronary syndrome (ACS) and stroke." This study aimed to develop an artificial intelligence (AI)-based prediction model for patients with LUTS.

MATERIAL AND METHODS

We retrospectively reviewed the electronic medical records of 1799 patients with LUTS at Chi Mei Medical Center between January 1, 2001 and December, 31, 2018. Features with >10 cases and high correlations with outcomes were imported into six machine learning algorithms. The study outcomes included ACS and stroke. Model performances was evaluated using the area under the receiver operating characteristic curve (AUC). The model with the highest AUC was used to implement the clinical risk prediction application.

RESULTS

Age, systemic blood pressure, diastolic blood pressure, creatinine, glycated hemoglobin, hypertension, diabetes mellitus and hyperlipidemia were the most relevant features that affect the outcomes. Based on the AUC, our optimal model was built using multilayer perception (AUC = 0.803) to predict ACS and stroke events within 3 years.

CONCLUSION

We successfully built an AI-based prediction system that can be used as a prediction model to achieve time-saving, precise, personalized risk evaluation; it can also be used to offer warning, enhance patient adherence, early intervention and better health care outcomes.

摘要

目的

全球人口老龄化,下尿路症状(LUTS)负担预计将增加。根据国家健康保险研究数据库,我们之前的研究表明,LUTS 可能使患者易患心血管疾病。然而,在“患有急性冠状动脉综合征(ACS)和中风”的情况下,很难提供个性化的风险评估。本研究旨在开发一种基于人工智能(AI)的 LUTS 患者预测模型。

材料和方法

我们回顾性分析了 2001 年 1 月 1 日至 2018 年 12 月 31 日奇美医疗中心 1799 例 LUTS 患者的电子病历。将具有> 10 例且与结局高度相关的特征导入到 6 种机器学习算法中。研究结果包括 ACS 和中风。使用接收者操作特征曲线下面积(AUC)评估模型性能。使用具有最高 AUC 的模型实现临床风险预测应用程序。

结果

年龄、全身血压、舒张压、肌酐、糖化血红蛋白、高血压、糖尿病和高血脂是影响结局的最相关特征。基于 AUC,我们使用多层感知器(AUC=0.803)构建了最佳模型,用于预测 3 年内 ACS 和中风事件。

结论

我们成功构建了一种基于 AI 的预测系统,可作为预测模型,实现省时、精确、个性化的风险评估;还可以提供预警、提高患者依从性、早期干预和改善医疗保健结果。

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