Nursing Department, The Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Basic Teaching Department, Zhuhai Campus of Zunyi Medical University, Zhu Hai, China.
Medicine (Baltimore). 2024 Aug 30;103(35):e39217. doi: 10.1097/MD.0000000000039217.
Ischemic stroke (IS) has a high recurrence rate. Machine learning (ML) models have been developed based on single-modal biochemical tests, and imaging data have been used to predict stroke recurrence. However, the prediction accuracy of these models is not sufficiently high. Therefore, this study aimed to collect biochemical detection and magnetic resonance imaging (MRI) data to establish a dataset and propose a high-performance heterogeneous multimodal IS recurrence prediction model based on deep learning. This is a retrospective cohort study. Data were retrospectively collected from 634 IS patients in Zhuhai, China, a 12-month follow-up was conducted to determine stroke recurrence. We propose the ischemic stroke multi-group learning (ISGL) model, an integrated model for predicting the recurrence risk of multimodal IS in patients, based on a capsule neural network and a linear support vector machine (SVM). Two capsule neural network prediction models based on T1 and T2 signals in the MRI data and a SVM prediction model based on biochemical test data were established. Finally, a vote was conducted on the final judgment of the integrated model. The ISGL model was compared with 6 classical ML and deep learning models: k-nearest neighbors, SVM, logistic regression, random forest, eXtreme Gradient Boosting, and visual geometry group. The results revealed that the accuracy, specificity, sensitivity and the area under the curve of the ISGL model were 95%, 96%, 94%, and 95%, respectively. Among the comparison models, the visual geometry group method exhibited the best performance, but it much lower than those of the ISGL model. Analysis of the importance of biochemical test data revealed that low-density lipoprotein, smoking, and heart disease history were the positively correlated factors, and total cholesterol, high-density lipoprotein, and diabetes were and the negatively correlated factors. This study proposes the ISGL model can be used simultaneously with MRI and biochemical data to predict IS recurrence. This combination resulted in higher rate of performance than that of the other ML models. Additionally, this study found related risk factors affected recurrence, which can be used to intervene in high-risk patients' recurrence as early as possible and promote the development of secondary prevention of stroke.
缺血性脑卒中(IS)具有较高的复发率。已经基于单模态生化测试开发了机器学习(ML)模型,并利用影像学数据来预测脑卒中复发。然而,这些模型的预测准确性还不够高。因此,本研究旨在收集生化检测和磁共振成像(MRI)数据,建立数据集,并提出一种基于深度学习的高性能异质多模态 IS 复发预测模型。这是一项回顾性队列研究。研究数据来自中国珠海的 634 例 IS 患者,对患者进行了 12 个月的随访以确定脑卒中复发情况。我们提出了基于胶囊神经网络和线性支持向量机(SVM)的缺血性脑卒中多组学习(ISGL)模型,这是一种综合模型,可以预测患者多模态 IS 的复发风险。该模型建立了基于 MRI 数据中 T1 和 T2 信号的两个胶囊神经网络预测模型,以及一个基于生化检测数据的 SVM 预测模型。最后,对综合模型的最终判断进行投票。ISGL 模型与 6 种经典的 ML 和深度学习模型进行了比较:k-最近邻、SVM、逻辑回归、随机森林、极端梯度提升和视觉几何组。结果表明,ISGL 模型的准确性、特异性、敏感性和曲线下面积分别为 95%、96%、94%和 95%。在比较模型中,视觉几何组方法的性能最好,但明显低于 ISGL 模型。对生化检测数据重要性的分析表明,低密度脂蛋白、吸烟和心脏病史是正相关因素,总胆固醇、高密度脂蛋白和糖尿病是负相关因素。本研究提出的 ISGL 模型可以同时使用 MRI 和生化数据来预测 IS 复发。这种组合的性能优于其他 ML 模型。此外,本研究发现相关的风险因素会影响复发,这可以尽早对高危患者的复发进行干预,并促进脑卒中二级预防的发展。