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利用人工智能推进医疗器械上市后监测:输液泵案例研究

Advancement of post-market surveillance of medical devices leveraging artificial intelligence: Infusion pumps case study.

作者信息

Merdović Nejra, Spahić Lemana, Hundur Madžida, Pokvić Lejla Gurbeta, Badnjević Almir

机构信息

Research Institute Verlab for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.

Research and Development Center for Bioengineering BioIRC, Kragujevac, Serbia.

出版信息

Technol Health Care. 2025 Mar;33(2):915-921. doi: 10.1177/09287329241291415. Epub 2024 Nov 25.

DOI:10.1177/09287329241291415
PMID:40105162
Abstract

BackgroundAnalysis of data from incident registries such as MAUDE has identified the need to improve surveillance and maintenance strategies for infusion pumps to enhance patient and healthcare staff safety.ObjectiveThe ultimate goal is to enhance infusion pump management strategies in healthcare facilities, thus transforming the current reactive approach to infusion pump management into a proactive and predictive one. This study utilized real data collected from 2015 to 2021 through the inspection of infusion pumps in Bosnia and Herzegovina. Inspections were conducted by the national laboratory in accordance with the Legal Metrology Framework, accredited to ISO 17020 standard. Out of 988 samples, 790 were used for model training, while 198 samples were set aside for validation (20% of the dataset). Various machine learning algorithms for binary classification of samples (pass/fail status) were considered, including Logistic Regression, Decision Tree, Random Forest, Naive Bayes, and Support Vector Machine. These algorithms were chosen for their ability to handle large datasets and potential for high prediction accuracy.ResultsThrough detailed analysis of the achieved results, it was found that all applied machine learning methods yielded satisfactory results, with accuracy ranging from 0.98% to 1.0%, precision from 0.99% to 1%, sensitivity from 0.98% to 1.0%, and specificity from 0.87% to 1.0%. However, Decision Tree and Random Forest methods proved to be the best, both due to their maximum achieved values of accuracy, precision, sensitivity, and specificity, and due to result interpretability.ConclusionIt has been established that machine learning methods are capable of identifying potential issues before they become critical, thus playing a crucial role in predicting the performance of infusion pumps, potentially enhancing the safety, reliability, and efficiency of healthcare delivery. Further research is needed to explore the potential application of machine learning algorithms in various healthcare domains and to address practical issues related to the implementation of these algorithms in real clinical settings.

摘要

背景

对诸如MAUDE等事件登记处的数据进行分析后发现,有必要改进输液泵的监测和维护策略,以提高患者和医护人员的安全。

目的

最终目标是加强医疗机构中的输液泵管理策略,从而将当前输液泵管理的被动方法转变为主动和预测性方法。本研究利用了2015年至2021年期间通过波斯尼亚和黑塞哥维那输液泵检查收集的真实数据。检查由国家实验室按照符合ISO 17020标准的法定计量框架进行。在988个样本中,790个用于模型训练,而198个样本留作验证(占数据集的20%)。考虑了用于样本二元分类(通过/失败状态)的各种机器学习算法,包括逻辑回归、决策树、随机森林、朴素贝叶斯和支持向量机。选择这些算法是因为它们能够处理大型数据集以及具有高预测准确性的潜力。

结果

通过对所得结果的详细分析发现,所有应用的机器学习方法都产生了令人满意的结果,准确率在0.98%至1.0%之间,精确率在0.99%至1%之间,灵敏度在0.98%至1.0%之间,特异性在0.87%至1.0%之间。然而,决策树和随机森林方法被证明是最好的,这既是因为它们在准确率、精确率、灵敏度和特异性方面取得的最大值,也是因为结果的可解释性。

结论

已经确定机器学习方法能够在潜在问题变得严重之前识别它们,从而在预测输液泵的性能方面发挥关键作用,有可能提高医疗服务的安全性、可靠性和效率。需要进一步研究以探索机器学习算法在各种医疗领域的潜在应用,并解决在实际临床环境中实施这些算法相关的实际问题。

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