用机器学习整合临床与超声心动图数据,精准识别心衰高风险患者。
Machine Learning Solutions Integrated in an IoT Healthcare Platform for Heart Failure Risk Stratification
- 分两阶段建模:先分别处理临床和超声数据,再用元模型融合预测
- 敏感度达95%,几乎能全数找出高风险患者,准确率84%
- 适合需早期干预的心衰管理场景,尤其适用于远程监测项目
慢性心力衰竭(HF)的管理在现代医疗中面临持续监测、早期发现恶化及个性化治疗策略等挑战。本文提出一种基于机器学习的预测模型,用于识别心衰高风险患者。该模型采用改进的堆叠集成学习方法,先用两个专用模型分别处理临床特征与超声心动图特征,再通过元模型融合两者预测结果。我们在真实数据集上评估该模型,结果显示其在高风险患者分层方面表现良好:敏感度达95%,确保绝大多数高风险患者被识别;准确率为84%,在某些机器学习场景中属中等水平,但考虑到本研究以识别高风险患者为核心目标,此结果可接受。这些患者将参与由部分作者参与的PrediHealth研究项目中的远程监测计划。初步结果还表明,基于机器学习的风险分层模型不仅可用于PrediHealth项目,也可作为临床决策支持工具,助力早期干预与个性化管理。我们进一步对比了三种基础模型,结果显示,本模型优于那些未对特征进行临床与超声心动图分组处理的基线模型。
原文摘要 · Abstract (English)
The management of chronic Heart Failure (HF) presents significant challenges in modern healthcare, requiring continuous monitoring, early detection of exacerbations, and personalized treatment strategies. In this paper, we present a predictive model founded on Machine Learning (ML) techniques to identify patients at HF risk. This model is an ensemble learning approach, a modified stacking technique, that uses two specialized models leveraging clinical and echocardiographic features and then a meta-model to combine the predictions of these two models. We initially assess the model on a real dataset and the obtained results suggest that it performs well in the stratification of patients at HR risk. Specifically, we obtained high sensitivity (95\%), ensuring that nearly all high-risk patients are identified. As for accuracy, we obtained 84\%, which can be considered moderate in some ML contexts. However, it is acceptable given our priority of identifying patients at risk of HF because they will be asked to participate in the telemonitoring program of the PrediHealth research project on which some of the authors of this paper are working. The initial findings also suggest that ML-based risk stratification models can serve as valuable decision-support tools not only in the PrediHealth project but also for healthcare professionals, aiding in early intervention and personalized patient management. To have a better understanding of the value and of potentiality of our predictive model, we also contrasted its results with those obtained by using three baseline models. The preliminary results indicate that our predictive model outperforms these baselines that flatly consider features, \ie not grouping them in clinical and echocardiographic features.
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