arXiv:2411.17645cs.LGcs.AI2024-11中稿 · Health Intelligenc…被引 1

用真实医疗数据构建可解释的尿路感染风险分类模型

Explainable AI for Classifying UTI Risk Groups Using a Real-World Linked EHR and Pathology Lab Dataset

  • 基于百万级匿名患者数据,构建分时风险预测框架
  • 通过可解释机器学习识别不同风险组的关键临床特征
  • 适合关注医疗AI可解释性与临床落地的研究者

利用电子健康记录(EHR)开展机器学习和人工智能研究具有巨大临床潜力,但面临数据异质性、稀疏性、时间错位及标注结果有限等挑战。本文基于英国布里斯托、北萨默塞特和南格洛斯特郡约一百万例匿名个体的整合式EHR与病理实验室数据,研究尿路感染(UTI)的特征。我们设计了数据预处理与清洗流程,将原始EHR转化为适用于预测模型开发的结构化格式,并强调数据公平性、可问责性和透明性。由于真实诊断结果稀缺且存在偏倚,我们引入由临床专家指导的UTI风险估计框架,用于评估个体患者时间序列中的风险水平。采用成对XGBoost模型进行训练,结合可解释人工智能技术识别关键预测因子,提升模型可解释性。研究发现不同风险群体的临床与人口统计学预测因子存在差异。该工作展示了人工智能驱动的洞察在支持尿路感染临床决策方面的潜力,但仍需进一步探索患者亚群并进行广泛验证,以确保模型在临床实践中的稳健性与适用性。

原文摘要 · Abstract (English)

The use of machine learning and AI on electronic health records (EHRs) holds substantial potential for clinical insight. However, this approach faces challenges due to data heterogeneity, sparsity, temporal misalignment, and limited labeled outcomes. In this context, we leverage a linked EHR dataset of approximately one million de-identified individuals from Bristol, North Somerset, and South Gloucestershire, UK, to characterize urinary tract infections (UTIs). We implemented a data pre-processing and curation pipeline that transforms the raw EHR data into a structured format suitable for developing predictive models focused on data fairness, accountability and transparency. Given the limited availability and biases of ground truth UTI outcomes, we introduce a UTI risk estimation framework informed by clinical expertise to estimate UTI risk across individual patient timelines. Pairwise XGBoost models are trained using this framework to differentiate UTI risk categories with explainable AI techniques applied to identify key predictors and support interpretability. Our findings reveal differences in clinical and demographic predictors across risk groups. While this study highlights the potential of AI-driven insights to support UTI clinical decision-making, further investigation of patient sub-strata and extensive validation are needed to ensure robustness and applicability in clinical practice.

可解释AI尿路感染电子病历风险预测

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