Machine learning risk prediction model for bloodstream infections related to totally implantable venous access ports in patients with cancer

IF 2.4 3区 医学 Q1 NURSING Asia-Pacific Journal of Oncology Nursing Pub Date : 2024-06-22 DOI:10.1016/j.apjon.2024.100546
Fan Wang , Yanyi Zhu , Lijuan Wang , Caiying Huang , Ranran Mei , Li-e Deng , Xiulan Yang , Yan Xu , Lingling Zhang , Min Xu
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Abstract

Objective

This study aimed to develop and validate a machine learning-based risk prediction model for catheter-related bloodstream infection (CRBSI) following implantation of totally implantable venous access ports (TIVAPs) in patients.

Methods

A retrospective cohort study design was employed, utilizing the R software package mlr3. Various algorithms including logistic regression, naive Bayes, K nearest neighbor, classification tree, and random forest were applied. Addressing class imbalance, benchmarks were used, and model performance was assessed using the area under the curve (AUC). The final model, chosen for its superior performance, was interpreted using variable importance scores. Additionally, a nomogram was developed to calculate individualized risk probabilities, enhancing clinical utility.

Results

The study involved 755 patients across both development and validation cohorts, with a TIVAP-CRBSI rate of 14.17%. The random forest model demonstrated the highest discrimination ability, achieving a validated AUC of 0.94, which was consistent in the validation cohort.

Conclusions

This study successfully developed a robust predictive model for TIVAP-CRBSI risk post-implantation. Implementation of this model may aid healthcare providers in making informed decisions, thereby potentially improving patient outcomes.

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癌症患者全植入式静脉通路端口相关血流感染的机器学习风险预测模型
目的 本研究旨在开发并验证一种基于机器学习的导管相关血流感染(CRBSI)风险预测模型,该模型适用于植入全植入式静脉通路端口(TIVAP)的患者。应用了多种算法,包括逻辑回归、天真贝叶斯、K 近邻、分类树和随机森林。为解决类不平衡问题,使用了基准,并通过曲线下面积(AUC)评估模型性能。最终的模型因其卓越的性能而被选中,并使用变量重要性得分进行解释。此外,还开发了一个提名图来计算个体化风险概率,从而提高临床实用性。结果该研究涉及开发和验证队列中的 755 名患者,TIVAP-CRBSI 感染率为 14.17%。随机森林模型表现出了最高的辨别能力,验证的AUC为0.94,这在验证队列中是一致的。该模型的实施可帮助医疗服务提供者做出明智的决策,从而改善患者的预后。
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来源期刊
CiteScore
2.80
自引率
11.10%
发文量
136
审稿时长
31 days
期刊最新文献
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