Rueda Ramón, Fabello Esteban, Silva Tatiana, Genzor Samuel, Mizera Jan, Stanke Ladislav
Tree Technology, Asturias, Spain.
Department of Pulmonary Diseases and Tuberculosis, University Hospital Olomouc, Zdravotníků 248/7, 77900 Olomuc, Czech Republic.
Health Inf Sci Syst. 2024 Oct 23;12(1):50. doi: 10.1007/s13755-024-00308-4. eCollection 2024 Dec.
Chronic obstructive pulmonary disease (COPD) is a prevalent and preventable condition that typically worsens over time. Acute exacerbations of COPD significantly impact disease progression, underscoring the importance of prevention efforts. This observational study aimed to achieve two main objectives: (1) identify patients at risk of exacerbations using an ensemble of clustering algorithms, and (2) classify patients into distinct clusters based on disease severity.
Data from portable medical devices were analyzed post-hoc using hyperparameter optimization with Self-Organizing Maps (SOM), Density-Based Spatial Clustering of Applications with Noise (DBSCAN), Isolation Forest, and Support Vector Machine (SVM) algorithms, to detect flare-ups. Principal Component Analysis (PCA) followed by KMeans clustering was applied to categorize patients by severity.
25 patients were included within the study population, data from 17 patients had the required reliability. Five patients were identified in the highest deterioration group, with one clinically confirmed exacerbation accurately detected by our ensemble algorithm. Then, PCA and KMeans clustering grouped patients into three clusters based on severity: Cluster 0 started with the least severe characteristics but experienced decline, Cluster 1 consistently showed the most severe characteristics, and Cluster 2 showed slight improvement.
Our approach effectively identified patients at risk of exacerbations and classified them by disease severity. Although promising, the approach would need to be verified on a larger sample with a larger number of recorded clinically verified exacerbations.
慢性阻塞性肺疾病(COPD)是一种常见且可预防的疾病,通常会随着时间的推移而恶化。COPD急性加重会显著影响疾病进展,这凸显了预防措施的重要性。这项观察性研究旨在实现两个主要目标:(1)使用聚类算法组合识别有加重风险的患者,以及(2)根据疾病严重程度将患者分为不同的类别。
对来自便携式医疗设备的数据进行事后分析,使用自组织映射(SOM)、基于密度的带有噪声的空间聚类应用(DBSCAN)、孤立森林和支持向量机(SVM)算法进行超参数优化,以检测病情发作。应用主成分分析(PCA),然后进行K均值聚类,按严重程度对患者进行分类。
研究人群纳入了25名患者,17名患者的数据具有所需的可靠性。在恶化程度最高的组中识别出5名患者,我们的算法组合准确检测到1例临床确诊的加重病例。然后,PCA和K均值聚类根据严重程度将患者分为三类:第0组开始时特征最不严重,但病情出现下降;第1组始终表现出最严重的特征;第2组显示出轻微改善。
我们的方法有效地识别了有加重风险的患者,并根据疾病严重程度对他们进行了分类。尽管前景乐观,但该方法需要在更大样本、有更多记录的临床确诊加重病例的情况下进行验证。