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基于机器学习构建辅助生殖技术下胚胎反复种植失败患者睡眠质量预测模型:一项单中心回顾性研究

Construction of a Prediction Model for Sleep Quality in Embryo Repeated Implantation Failure Patients Undergoing Assisted Reproductive Technology Based on Machine Learning: A Single-Center Retrospective Study.

作者信息

Zhao Yanjun, Xu Chenying, Qin Ningxin, Bai Lina, Wang Xuelu, Wang Ke

机构信息

Operating Room, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.

Reproductive Medicine Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.

出版信息

J Multidiscip Healthc. 2025 Jul 12;18:3977-3988. doi: 10.2147/JMDH.S521085. eCollection 2025.

Abstract

OBJECTIVE

Constructing a predictive model for sleep quality in embryo Repeated Implantation Failure(RIF) patients using multiple machine learning algorithms, verifying its performance, and selecting the optimal model.

METHODS

Retrospective collection of clinical data from RIF patients who underwent assisted reproductive technology at the Reproductive Medicine Center of Tongji University Affiliated Obstetrics and Gynecology Hospital from January 2022 to June 2022, divided into a training set and a validation set in an 8:2 ratio. Use Lasso regression to screen variables and construct a risk prediction model using six machine learning algorithms. Evaluate the validity of the model using the area under the curve (AUC), and comprehensively evaluate the performance of the model based on F1 score, accuracy, sensitivity, and specificity. Use SHAP method to explain the contribution of each variable in the optimal model to the occurrence of sleep disorders.

RESULTS

A total of 404 RIF patients were included in the study. The incidence of sleep disturbances was 48.76%. After LASSO regression analysis, nine variables were selected for inclusion in the model. The RF model has an AUC of 0.941, Accuracy of 0.938, Specification of 0.950, and F1 score of 0.938 in the validation set, making it the optimal model for this study. According to the SHAP feature importance ranking of the RF model, the factors influencing sleep quality in RIF patients were E2, SDS, Fertiqol, FSH, daily exercise time, weekly shift work hours, coffee consumption, sunbathing, and SAS.

CONCLUSION

The RF model is the optimal model for predicting the sleep quality of RIF patients. Its sleep quality is not only affected by physiological factors, but also by psychological and lifestyle factors. Medical personnel should implement intervention strategies as early as possible based on relevant risk factors to improve the sleep quality of this population.

摘要

目的

运用多种机器学习算法构建胚胎反复种植失败(RIF)患者睡眠质量的预测模型,验证其性能并选择最优模型。

方法

回顾性收集2022年1月至2022年6月在同济大学附属第一妇婴保健院生殖医学中心接受辅助生殖技术的RIF患者的临床资料,按8:2比例分为训练集和验证集。采用Lasso回归筛选变量,运用六种机器学习算法构建风险预测模型。使用曲线下面积(AUC)评估模型的有效性,并基于F1分数、准确率、敏感性和特异性综合评估模型性能。采用SHAP方法解释最优模型中各变量对睡眠障碍发生的贡献。

结果

本研究共纳入404例RIF患者。睡眠障碍发生率为48.76%。经LASSO回归分析,选取9个变量纳入模型。验证集中随机森林(RF)模型的AUC为0.941,准确率为0.938,特异性为0.950,F1分数为0.938,为该研究的最优模型。根据RF模型的SHAP特征重要性排序,影响RIF患者睡眠质量的因素为雌二醇(E2)、抑郁自评量表(SDS)、受精液量(Fertiqol)、促卵泡生成素(FSH)、每日运动时间、每周轮班工作时长、咖啡摄入量、日光浴和焦虑自评量表(SAS)。

结论

RF模型是预测RIF患者睡眠质量的最优模型。其睡眠质量不仅受生理因素影响,还受心理和生活方式因素影响。医务人员应尽早基于相关危险因素实施干预策略,以改善该人群的睡眠质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a67/12267823/5870a290e297/JMDH-18-3977-g0001.jpg

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