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机器学习使用患者特征和置管技术特征预测外周置入中心静脉导管相关的深静脉血栓形成。

Machine Learning Predicts Peripherally Inserted Central Catheters-Related Deep Vein Thrombosis Using Patient Features and Catheterization Technology Features.

机构信息

Shandong University, Jinan, China.

Liaocheng University, Liaocheng, China.

出版信息

Clin Nurs Res. 2024 Jul;33(6):460-469. doi: 10.1177/10547738241260947. Epub 2024 Jul 30.

DOI:10.1177/10547738241260947
PMID:39076023
Abstract

This study aims to use patient feature and catheterization technology feature variables to train the corresponding machine learning (ML) models to predict peripherally inserted central catheters-deep vein thrombosis (PICCs-DVT) and analyze the importance of the two types of features to PICCs-DVT from the aspect of "input-output" correlation. To comprehensively and systematically summarize the variables used to describe patient features and catheterization technical features, this study combined 18 literature involving the two types of features in predicting PICCs-DVT. A total of 21 variables used to describe the two types of features were summarized, and feature values were extracted from the data of 1,065 PICCs patients from January 1, 2021 to August 31, 2022, to construct a data sample set. Then, 70% of the sample set is used for model training and hyperparameter optimization, and 30% of the sample set is used for PICCs-DVT prediction and feature importance analysis of three common ML classification models (i.e. support vector classifier [SVC], random forest [RF], and artificial neural network [ANN]). In terms of prediction performance, this study selected four metrics to evaluate the prediction performance of the model: precision (), recall (), accuracy (), and area under the curve (). In terms of feature importance analysis, this study chooses a single feature analysis method based on the "input-output" sensitivity principle-Permutation Importance. For the mean model performance, the three ML models on the test set are  = 0.92,  = 0.95,  = 0.88, and  = 0.81. Specifically, the RF model is  = 0.95,  = 0.96,  = 0.92,  = 0.86; the ANN model is  = 0.92,  = 0.95,  = 0.88,  = 0.81; the SVC model is  = 0.88,  = 0.94,  = 0.85,  = 0.77. For feature importance analysis, Catheter-to-vein rate (RF: 91.55%, ANN: 82.25%, SVC: 87.71%), Zubrod-ECOG-WHO score (RF: 66.35%, ANN: 82.25%, SVC: 44.35%), and insertion attempt (RF: 44.35%, ANN: 37.65%, SVC: 65.80%) all occupy the top three in the ML models prediction task of PICCs-DVT, showing relatively consistent ranking results. The ML models show good performance in predicting PICCs-DVT and reveal a relatively consistent ranking of feature importance from the data. The important features revealed might help clinical medical staff to better understand and analyze the formation mechanism of PICCs-DVT from a data-driven perspective.

摘要

本研究旨在利用患者特征和导管技术特征变量来训练相应的机器学习 (ML) 模型,以预测外周静脉置入中心静脉导管-深静脉血栓形成 (PICCs-DVT),并从“输入-输出”相关性的角度分析这两种特征的重要性。为了全面系统地总结描述患者特征和导管技术特征的变量,本研究结合了 18 篇涉及两种特征预测 PICCs-DVT 的文献。总结了 21 个用于描述两种特征的变量,并从 2021 年 1 月 1 日至 2022 年 8 月 31 日期间 1065 名 PICCs 患者的数据中提取特征值,构建了一个数据样本集。然后,使用样本集的 70%进行模型训练和超参数优化,使用 30%进行 PICCs-DVT 预测和三种常见 ML 分类模型(支持向量分类器 [SVC]、随机森林 [RF] 和人工神经网络 [ANN])的特征重要性分析。在预测性能方面,本研究选择了四个指标来评估模型的预测性能:精度()、召回率()、准确率()和曲线下面积()。在特征重要性分析方面,本研究选择了一种基于“输入-输出”敏感性原理的单特征分析方法——置换重要性。对于平均模型性能,三个 ML 模型在测试集上的表现分别为 = 0.92、 = 0.95、 = 0.88 和 = 0.81。具体来说,RF 模型的表现为 = 0.95、 = 0.96、 = 0.92、 = 0.86;ANN 模型的表现为 = 0.92、 = 0.95、 = 0.88、 = 0.81;SVC 模型的表现为 = 0.88、 = 0.94、 = 0.85、 = 0.77。对于特征重要性分析,导管-静脉比(RF:91.55%、ANN:82.25%、SVC:87.71%)、Zubrod-ECOG-WHO 评分(RF:66.35%、ANN:82.25%、SVC:44.35%)和插入尝试(RF:44.35%、ANN:37.65%、SVC:65.80%)在 PICCs-DVT 的 ML 模型预测任务中均排名前三,呈现出相对一致的排名结果。ML 模型在预测 PICCs-DVT 方面表现良好,从数据角度揭示了相对一致的特征重要性排名。揭示的重要特征可能有助于临床医务人员从数据驱动的角度更好地理解和分析 PICCs-DVT 的形成机制。

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