用生理数据预测突发事故中低氧血症严重程度,提升急救分诊效率。
Development and Comparative Analysis of Machine Learning Models for Hypoxemia Severity Triage in CBRNE Emergency Scenarios Using Physiological and Demographic Data from Medical-Grade Devices
- 采用梯度提升模型融合六项生理指标评分,提升预测准确率。
- 五分钟后预测窗口内模型准确率显著,且训练速度比序列模型快。
- 适合急诊场景实时决策,可减少医护人员误报疲劳。
本文开发了机器学习模型,用于在化学、生物、辐射、核与爆炸(CBRNE)应急场景中,基于医疗级设备采集的生理与人口统计学数据预测低氧血症严重程度。使用MIMIC-III和IV数据集,训练了梯度提升模型(XGBoost、LightGBM、CatBoost)与序列模型(LSTM、GRU)。通过稳健的数据预处理流程解决缺失值与类别不平衡问题,并引入掩码标记的合成数据。梯度提升模型在训练速度、可解释性与可靠性方面优于序列模型,尤其在5分钟预测窗口内表现优异。该模型采用改进的国家早期预警评分2(NEWS2+),整合六项生理变量得分,显著提升预测精度。尽管序列模型能捕捉时间依赖性,但其性能增益无法覆盖更高计算开销。特征重要性分析显示,掩码与评分特征对模型透明度与性能均有关键作用。时间依赖性并非决定因素,梯度提升模型无需依赖时间序列即可有效捕捉关键模式。研究证实机器学习可优化应急分诊并缓解报警疲劳。未来将整合多院数据以增强模型泛化能力。
原文摘要 · Abstract (English)
This paper presents the development of machine learning (ML) models to predict hypoxemia severity during emergency triage, especially in Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) events, using physiological data from medical-grade sensors. Gradient Boosting Models (XGBoost, LightGBM, CatBoost) and sequential models (LSTM, GRU) were trained on physiological and demographic data from the MIMIC-III and IV datasets. A robust preprocessing pipeline addressed missing data, class imbalances, and incorporated synthetic data flagged with masks. Gradient Boosting Models (GBMs) outperformed sequential models in terms of training speed, interpretability, and reliability, making them well-suited for real-time decision-making. While their performance was comparable to that of sequential models, the GBMs used score features from six physiological variables derived from the enhanced National Early Warning Score (NEWS) 2, which we termed NEWS2+. This approach significantly improved prediction accuracy. While sequential models handled temporal data well, their performance gains did not justify the higher computational cost. A 5-minute prediction window was chosen for timely intervention, with minute-level interpolations standardizing the data. Feature importance analysis highlighted the significant role of mask and score features in enhancing both transparency and performance. Temporal dependencies proved to be less critical, as Gradient Boosting Models were able to capture key patterns effectively without relying on them. This study highlights ML's potential to improve triage and reduce alarm fatigue. Future work will integrate data from multiple hospitals to enhance model generalizability across clinical settings.
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