Improving clinical decision making by creating surrogate models from health technology assessment models: A case study on Type 1 Diabetes Melitus

IF 4.8 2区 医学 Q1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Computer methods and programs in biomedicine Pub Date : 2025-02-10 DOI:10.1016/j.cmpb.2025.108646
Rafael Arnay del Arco, Iván Castilla Rodríguez, Marco A. Cabrera Hernández
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Abstract

Background and Objective:

Computerized clinical decision support systems (CDSS) that incorporate the latest scientific evidence are essential for enhancing patient care quality. Such systems typically rely on some kind of model to accurately represent the knowledge required to assess the clinicians. Although the use of complex and computationally demanding simulation models is common in this field, such models limit the potential applications of CDSSs, both in real-time applications and in simulation-in-the-loop optimization tools. This paper presents a case study on Type 1 Diabetes Mellitus (T1DM) to demonstrate the development of surrogate models from health technology assessment models, with the aim of enhancing the potential of CDSSs.

Methods:

The paper details the process of developing machine learning (ML) based surrogate models, including the generation of a dataset for training and testing, and the comparison of different ML techniques. A number of distinct groupings of comorbidities were utilized in the creation of models, which were trained to predict confidence intervals for the time to develop each complication.

Results:

The results of the intersection over union (IoU) analysis between the simulation model output and the surrogate models output for the comorbidities under study were greater than 0.9.

Conclusion:

The study concludes that ML-based surrogate models are a viable solution for real-time clinical decision-making, offering a substantial speedup in execution time compared to traditional simulation models.
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通过从卫生技术评估模型中创建替代模型来改进临床决策:以1型糖尿病为例
背景与目的:采用最新科学证据的计算机临床决策支持系统(CDSS)对提高患者护理质量至关重要。这样的系统通常依赖于某种模型来准确地表示评估临床医生所需的知识。尽管在该领域使用复杂且计算要求高的仿真模型是常见的,但这些模型限制了cdss在实时应用和仿真环优化工具中的潜在应用。本文以1型糖尿病(T1DM)为例,介绍了卫生技术评估模型替代模型的发展,旨在提高cdss的潜力。方法:本文详细介绍了开发基于机器学习(ML)的代理模型的过程,包括生成用于训练和测试的数据集,以及不同ML技术的比较。在模型的创建中使用了许多不同的合并症分组,这些模型经过训练以预测每种并发症发生时间的置信区间。结果:研究共病的模拟模型输出与替代模型输出的IoU (intersection over union)分析结果大于0.9。结论:该研究得出基于ml的代理模型是实时临床决策的可行解决方案,与传统仿真模型相比,执行时间大大加快。
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来源期刊
Computer methods and programs in biomedicine
Computer methods and programs in biomedicine 工程技术-工程:生物医学
CiteScore
12.30
自引率
6.60%
发文量
601
审稿时长
135 days
期刊介绍: To encourage the development of formal computing methods, and their application in biomedical research and medical practice, by illustration of fundamental principles in biomedical informatics research; to stimulate basic research into application software design; to report the state of research of biomedical information processing projects; to report new computer methodologies applied in biomedical areas; the eventual distribution of demonstrable software to avoid duplication of effort; to provide a forum for discussion and improvement of existing software; to optimize contact between national organizations and regional user groups by promoting an international exchange of information on formal methods, standards and software in biomedicine. Computer Methods and Programs in Biomedicine covers computing methodology and software systems derived from computing science for implementation in all aspects of biomedical research and medical practice. It is designed to serve: biochemists; biologists; geneticists; immunologists; neuroscientists; pharmacologists; toxicologists; clinicians; epidemiologists; psychiatrists; psychologists; cardiologists; chemists; (radio)physicists; computer scientists; programmers and systems analysts; biomedical, clinical, electrical and other engineers; teachers of medical informatics and users of educational software.
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