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Real-Time Accuracy Evaluation of Arterial Catheter Transducer Systems 动脉导管传感器系统的实时精度评估
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-11-04 DOI: 10.1016/j.irbm.2024.100867
Carole Lavault , Lisa Guigue , Daniel Anglade , Francis Grimbert , Yves Lavault , François Boucher , Norbert Noury

Introduction

Arterial pressure is currently monitored in ICU with a catheter–transducer fluid line. This fluid filled tubing line distorts the original waveform due to its dynamic characteristics (natural frequency, Fn, and damping coefficient, z), introducing potentially significant errors when calculating the cardiac output from pulse contour signal analysis.

Methods

In our study, we cross-compared Fn and z obtained with our new Fast External Pressure Test (FEPT) and with the Fast Flush Test (FFLT), to the reference technique (Sine wave variable Frequency Analysis Test - SFAT). It was carried on a testbench for 48 hours. Fn and z were measured using the three techniques with two fluid-filled tubing lines (standard, STD, and blood conserving device, BCD).

Results

Fn measurements with FEPT and FFLT present similar biases (0.79 vs 0.83 Hz), but lower variability for FEPT, with limits of agreement (LOA) ranging from −3.35 to +4.99 Hz for FFLT vs −2.29 to +3.86 Hz (p<0.0001) for FEPT. For the measurement of z, FEPT has a bias of 0.047 and LOA of −0.063 to +0.157, much lower (p<0.0001) than those measured with the FFLT (bias 0.139 and LOA −0.028 to +0.306).

Conclusion

When automated, the FEPT method will detect potential situations of over/under estimations occurrences. This will prevent false alarms, alarm fatigue and therefore consequences on patient care. Eventually, FEPT turns to be more accurate than FFLT, less scattered, less time-consuming, less invasive and so well suited for use in clinical settings.
导言:目前,重症监护室使用导管-传感器液体管路监测动脉压。在我们的研究中,我们将新型快速外部压力测试(FEPT)和快速冲洗测试(FFLT)获得的 Fn 和 z 与参考技术(正弦波变频分析测试 - SFAT)进行了交叉比较。测试在测试台上进行了 48 小时。结果用 FEPT 和 FFLT 测量 Fn 时出现了相似的偏差(0.79 vs 0.83 Hz),但 FEPT 的变异性较低,FFLT 的一致性范围 (LOA) 为 -3.35 至 +4.99 Hz,而 FEPT 为 -2.29 至 +3.86 Hz(p<0.0001)。对于 z 的测量,FEPT 的偏差为 0.047,LOA 为 -0.063 至 +0.157,远低于 FFLT 的测量值(偏差为 0.139,LOA 为 -0.028 至 +0.306)(p<0.0001)。这将防止误报、警报疲劳,从而避免对患者护理造成影响。最终,FEPT 比 FFLT 更准确、更分散、更省时、更具侵入性,因此非常适合在临床环境中使用。
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引用次数: 0
Mechanical Work and Metabolic Cost of Walking with Knee-Foot Prostheses: A Study with a Prosthesis Simulator 膝足假肢行走的机械功和代谢成本:假肢模拟器研究
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-10 DOI: 10.1016/j.irbm.2024.100863
Aurore Bonnet-Lebrun , Lucas Sedran , Cécile Heidsieck , Marie Thomas-Pohl , Hélène Pillet , Xavier Bonnet

Background

At equivalent speeds, above-knee amputee subjects have a higher metabolic cost than non-amputees. Following amputation, the ankle propulsion is reduced, and using other joints to compensate is mechanically less efficient.

Objective

This study investigated the link between mechanical work and metabolic cost in abled-bodied subjects using a prosthesis simulator, and the influence of foot energy restitution by comparing a foot with restitution to one without.

Method

Six volunteers fitted with an orthosis immobilising their ankle and knee, enabling the use of a prosthesis, carried out a gait analysis and an analysis of metabolic cost. The total lower limb mechanical work and works at the hip, knee and ankle were computed.

Results

With an almost twofold increase, metabolic cost and hip work were significantly higher in both configurations with prosthesis than without (p < 0.001 for both variables in both configurations), while total lower limb mechanical work showed no significant difference between configurations. No significant difference was observed between the two prosthetic feet in terms of metabolic cost nor mechanical work performed by the subject.

Discussion

Total lower limb mechanical work alone cannot explain the extra metabolic cost in subjects fitted with a knee-foot prosthesis simulator; internal inefficiencies exist. We also found that metabolic cost and hip work increase and decrease simultaneously, thus studying hip muscles work could be interesting. With no significant difference between the two feet, optimising ankle propulsion seems to be ineffective in improving metabolic cost. These findings should be evaluated in a sample of above-knee amputee subjects.
背景在同等速度下,膝上截肢者的代谢成本高于非截肢者。本研究使用假肢模拟器调查了健全受试者的机械功和代谢成本之间的联系,并通过比较有恢复功能的脚和没有恢复功能的脚,研究了脚部能量恢复的影响。方法六名志愿者安装了固定踝关节和膝关节的矫形器,以便使用假肢,并进行了步态分析和代谢成本分析。结果在两种配置中,安装假肢的代谢成本和髋关节功都明显高于未安装假肢的,几乎增加了两倍(两种配置中两个变量的P均为0.001),而下肢总机械功在不同配置中没有明显差异。讨论单凭下肢总机械功无法解释安装膝足假肢模拟器的受试者的额外代谢成本;内部存在低效率。我们还发现,代谢成本和髋关节做功同时增加和减少,因此研究髋关节肌肉做功可能很有意义。由于两只脚之间没有明显差异,优化踝关节的推进力似乎无法有效改善代谢成本。这些发现应在膝上截肢受试者样本中进行评估。
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引用次数: 0
Corrigendum to “Transition Network-Based Analysis of Electrodermal Activity Signals for Emotion Recognition” [IRBM 45 (2024) 100849] 基于过渡网络的情感识别皮电活动信号分析》更正 [IRBM 45 (2024) 100849]
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-08 DOI: 10.1016/j.irbm.2024.100862
Yedukondala Rao Veeranki , Hugo F. Posada-Quintero , Ramakrishnan Swaminathan
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引用次数: 0
An Ensemble Learning System Based on Stacking Strategy for Survival Risk Prediction of Patients with Esophageal Cancer 基于堆叠策略的食管癌患者生存风险预测集合学习系统
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-11 DOI: 10.1016/j.irbm.2024.100860
Dan Ling , Tengfei Jiang , Junwei Sun , Yanfeng Wang , Yan Wang , Lidong Wang
Background: Predicting the prognosis of esophageal cancer (EC) patients is crucial for optimizing the treatment plan and allocating medical resources effectively.
Methods: This study proposes a novel ensemble learning-based EC survival prediction model. Firstly, recursive feature elimination (RFE) is used to determine the key feature subsets from the dataset. Based on the determined key features, the improved clustering by fast search and find of density peaks (IDPC) is proposed to construct a novel indicator related to EC survival risk. The cosine distance is introduced in IDPC to cluster samples with similar characteristics. Then, the adaptive synthetic (ADASYN) technique is used to generate more high-risk samples to balance high-risk and low-risk samples. Finally, the hyperparameters of the three models, including extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), and random forest (RF), are optimized by whale optimization algorithm (WOA) and a new stacking model is constructed to evaluate the survival risk of patients.
Results: The proposed stacking model achieved an area under the receiver operating characteristic curve (AUC) of 0.952 and Accuracy of 0.899, on the dataset from the First Affiliated Hospital of Zhengzhou University.
Conclusions: The survival prediction model the proposed ensemble learning system is much more accurate and convenient, providing a basis clinical judgment and decision making and improving the survival status of esophageal cancer patients.
背景:预测食管癌患者的预后对优化治疗方案和有效分配医疗资源至关重要:预测食管癌(EC)患者的预后对于优化治疗方案和有效分配医疗资源至关重要:本研究提出了一种基于集合学习的新型食管癌生存预测模型。首先,使用递归特征消除法(RFE)从数据集中确定关键特征子集。根据确定的关键特征,提出了通过快速搜索和寻找密度峰的改进聚类(IDPC)来构建与心血管疾病生存风险相关的新型指标。IDPC 中引入了余弦距离来聚类具有相似特征的样本。然后,使用自适应合成(ADASYN)技术生成更多高风险样本,以平衡高风险和低风险样本。最后,通过鲸鱼优化算法(WOA)对极梯度提升(XGBoost)、自适应提升(AdaBoost)和随机森林(RF)等三种模型的超参数进行优化,构建了新的堆积模型来评估患者的生存风险:在郑州大学第一附属医院的数据集上,所提出的堆积模型的接收者操作特征曲线下面积(AUC)达到0.952,准确率达到0.899:结论:所提出的集合学习系统的生存预测模型更加准确和便捷,为临床判断和决策提供了依据,改善了食管癌患者的生存状况。
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引用次数: 0
Evaluation of a Multimodal Confocal Therapeutic Focused Ultrasound Apparatus: Bridging Cavitation, Thermal Ablation, and Histotripsy in Preclinical Treatments 评估多模式共焦治疗聚焦超声仪器:在临床前治疗中衔接空化、热消融和组织切碎术
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-10 DOI: 10.1016/j.irbm.2024.100861
Myléva Dahan , Maxime Lafond , R. Andrew Drainville , Victor Delattre , Marine Simonneau , Françoise Chavrier , Cyril Lafon , Marion Cortet , Frédéric Padilla

Objectives

The development of versatile and user-friendly preclinical platforms is vital for therapeutic ultrasound research. We introduce a flexible ultrasound-guided focused ultrasound (FUS) platform with two confocal therapeutic transducers, allowing thermal and mechanical modalities, and present its design and, features, with validation of potential applications in preclinical studies.

Methods

The probe's acoustic properties, energy delivery efficiency, and thermal and mechanical modalities are characterized. A computational model predicts thermal effects while optimizing treatment parameters. Ex vivo tissue samples are used to validate system performance, safety, and usability. In vivo experiments on mice with MC38 tumors are presented with immunohistochemistry (IHC) to validate treatment outcomes.

Results

Electroacoustic conversion efficiency levels were 80% and 40% for 1.1 MHz and 3.3 MHz, respectively. Confocal therapy transducers at 1.1 MHz and 3.3 MHz successfully demonstrated cavitation histotripsy and thermal treatments. At 1.1 MHz, for histotripsy, −20 MPa negative peak pressure is achieved, while at 3.3 MHz used for thermal ablation a maximum of 35 MPa is reached for positive peak pressure. Numerical analysis provides thermal treatment planning, aligning with in vitro and in vivo experiments for lesion prediction. Real-time in vivo cavitation monitoring was consistent with in vitro chemical dosimetry, ensuring treatment uniformity.

Conclusion

The ultrasound platform induces thermal or mechanical lesions with precise spatial resolution, validated by IHC tissue characterization. Integrated cavitation monitoring enables real-time treatment monitoring. Coupling with thermal simulations provides optimization of thermal treatment parameters. This versatile “all-in-one” therapeutic platform supports multiple treatment modalities including cavitation, thermal ablation, and histotripsy, facilitating direct comparisons to assess their efficacy in diverse therapeutic settings.
目的开发多功能、用户友好的临床前平台对超声治疗研究至关重要。我们介绍了一种灵活的超声引导聚焦超声(FUS)平台,该平台配有两个共焦治疗换能器,允许热和机械模式,并介绍了其设计和特点,以及在临床前研究中的潜在应用验证。计算模型可预测热效应,同时优化治疗参数。体内外组织样本用于验证系统的性能、安全性和可用性。结果1.1 MHz 和 3.3 MHz 的电声转换效率水平分别为 80% 和 40%。1.1 MHz 和 3.3 MHz 的共聚焦治疗换能器成功地展示了空化组织切削术和热疗。在 1.1 MHz 频率下,组织切削可达到-20 兆帕的负峰值压力,而在 3.3 MHz 频率下,热消融可达到最大 35 兆帕的正峰值压力。数值分析提供了热处理规划,并与体外和体内病变预测实验保持一致。实时体内空化监测与体外化学剂量测定一致,确保了治疗的均匀性。集成空化监测可实现实时治疗监测。与热模拟相结合可优化热处理参数。这种多功能的 "一体化 "治疗平台支持多种治疗模式,包括空化、热消融和组织切削,便于直接比较,以评估它们在不同治疗环境中的疗效。
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引用次数: 0
Electrocardiogram Signal Compression Using Deep Convolutional Autoencoder with Constant Error and Flexible Compression Rate 使用具有恒定误差和灵活压缩率的深度卷积自动编码器压缩心电图信号
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-06 DOI: 10.1016/j.irbm.2024.100859
Tahir Bekiryazıcı, Gürkan Aydemir, Hakan Gürkan

Objectives

Electrocardiogram (ECG) signals are beneficial for diagnosing cardiac diseases. The cardiac patients' life quality likely increases with continuous or long-period recording and monitoring of ECG signals, leading to better and early diagnosis of disease and heart attacks. However, continuous ECG recording necessitates high data rates and storage, which means high costs. Therefore, ECG compression is a handy concept that facilitates continuous monitoring of ECG signals. Deep neural networks open up new horizons for compression and also for ECG compression by providing high compression rates and quality. Although they bring constant compression ratios with better average quality, the compression quality of individual samples is not guaranteed, which may lead to misdiagnoses. This study aims to investigate the effect of compression quality on the diagnoses and to develop a deep neural network-based compression strategy that guarantees a quality-bound in return for varying compression ratios.

Materials and methods

The effect of the compression quality on the arrhythmia diagnoses is tested by comparing the performance of the deep learning-based ECG classifier on the original ECG recordings and the distorted recordings using a lossy compression algorithm with different compression error levels. Then, a compression error upper limit is calculated in terms of normalized percent root mean square difference (PRDN) error, which also coincides with the findings of the previous studies in the literature. Lastly, to enable deep learning in ECG compression, a single encoder-multi-decoder convolutional autoencoder architecture, and multiple quantization levels are proposed to guarantee a desired upper limit on the error rate.

Results

The efficiency of the proposed method is demonstrated on a popular benchmark data set for ECG compression methods using a transfer learning approach. The PRDN error is fixed to various values, and the average compression rates are reported. An average of 13.019:1 compression is achieved for a 10% PRDN error rate, assessed as a fair quality threshold for reconstruction error. It has also been shown that the compression model has a runtime that can be run in real-time on wearable devices such as commercial smartwatches.

Conclusion

This study proposes a deep learning-based ECG compression algorithm that guarantees a desired upper limit on the compression error. This model may facilitate an eHealth solution for continuous monitoring of ECG signals of individuals, especially cardiac patients.

目的心电图(ECG)信号有利于诊断心脏疾病。连续或长期记录和监测心电信号可提高心脏病患者的生活质量,从而更好地及早诊断疾病和心脏病发作。然而,连续心电图记录需要很高的数据传输率和存储量,这意味着高昂的成本。因此,心电图压缩是一个方便的概念,有助于对心电图信号进行连续监测。深度神经网络通过提供高压缩率和高质量,为压缩和心电图压缩开辟了新天地。虽然深度神经网络能带来恒定的压缩率和更好的平均质量,但单个样本的压缩质量却无法保证,这可能会导致误诊。本研究旨在研究压缩质量对诊断的影响,并开发一种基于深度神经网络的压缩策略,在不同的压缩率下保证质量上限。材料与方法通过比较基于深度学习的心电图分类器在原始心电图记录和使用有损压缩算法的失真记录上的性能,以及不同的压缩误差水平,测试压缩质量对心律失常诊断的影响。然后,根据归一化均方根差值(PRDN)误差计算出压缩误差上限,这也与之前文献中的研究结果相吻合。最后,为了在心电图压缩中实现深度学习,提出了单编码器-多解码器卷积自动编码器架构和多量化级别,以保证达到所需的误差率上限。PRDN 误差被固定为不同的值,并报告了平均压缩率。在 PRDN 误差率为 10% 的情况下,平均压缩率为 13.019:1,这被认为是重建误差的合理质量阈值。研究还表明,该压缩模型的运行时间可在商用智能手表等可穿戴设备上实时运行。 结论 本研究提出了一种基于深度学习的心电图压缩算法,它能保证压缩误差达到理想的上限。该模型可为电子医疗解决方案提供便利,用于持续监测个人(尤其是心脏病患者)的心电图信号。
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引用次数: 0
A Nonlinear Analysis of Nociceptive Flexion Reflex Changes Before and After Acute Inflammation 急性炎症前后痛觉屈曲反射变化的非线性分析
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-02 DOI: 10.1016/j.irbm.2024.100858
Grant A. Chesbro , Jessica A. Peterson , Rebecca D. Larson , Christopher D. Black

Objectives: The nociceptive flexion reflex (NFR) is used as a pseudo-objective measure of pain that is measured using electromyography (EMG). EMG signals can be analyzed using nonlinear methods to identify complex changes in physiological systems. Physiological complexity has been shown to allow a wider range of adaptable states for the system to deal with stressors. The purpose of this study was to examine changes in complexity and entropy of EMG signals from the biceps femoris during non-noxious stimuli and noxious stimuli that evoked the NFR before and after acute inflammation. Methods and Materials: Twelve healthy participants (25.17y ± 3.43) underwent the NFR protocol. EMG signal complexity was calculated using Hurst Exponent (H), determinism (DET), and recurrence rate (RR), and Sample Entropy (SampEn). Results: RR (∼200%), DET (∼70%), and H (∼35%) were higher and SampEn was reduced (∼50%) during the noxious stimulus that evoked the NFR compared to non-noxious stimuli. No significant differences were found for any of the complexity and entropy measures before and after exercise-induced inflammation (p<0.05). Reduced complexity (increased H, DET, and RR) and increased regularity (SampEn) reflect reduced adaptability to stressors. Conclusions: Nonlinear methods such as complexity and entropy measures could be useful in understanding how a healthy neuromuscular system responds to disturbances. The reductions in complexity following a noxious stimulus could reflect the neuromuscular system adapting to environmental conditions to prevent damage or injury to the body.

目的:痛觉屈曲反射(NFR)是利用肌电图(EMG)测量疼痛的一种伪客观测量方法。肌电图信号可通过非线性方法进行分析,以确定生理系统的复杂变化。生理复杂性已被证明允许系统有更广泛的适应状态来应对压力。本研究的目的是研究股二头肌在急性炎症前后受到非毒性刺激和毒性刺激时,诱发 NFR 的 EMG 信号的复杂性和熵的变化。方法和材料:12 名健康参与者(25.17 岁 ± 3.43)接受了 NFR 方案。使用赫斯特指数(H)、确定性(DET)、复发率(RR)和样本熵(SampEn)计算肌电信号复杂性。结果如下与非毒性刺激相比,在诱发 NFR 的毒性刺激中,RR(∼200%)、DET(∼70%)和 H(∼35%)更高,SampEn 降低(∼50%)。在运动诱发炎症前后,复杂性和熵的测量结果均无明显差异(p<0.05)。复杂性降低(H、DET 和 RR 增加)和规则性增加(SampEn)反映了对压力的适应性降低。结论复杂性和熵测量等非线性方法有助于了解健康的神经肌肉系统如何应对干扰。神经肌肉系统在受到有害刺激后复杂性降低,这可能反映出神经肌肉系统正在适应环境条件,以防止身体受损或受伤。
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引用次数: 0
Predicting the Shape of Corneas from Clinical Data with Machine Learning Models 利用机器学习模型从临床数据中预测角膜形状
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-21 DOI: 10.1016/j.irbm.2024.100853
Hala Bouazizi , Isabelle Brunette , Jean Meunier

Objective

In ophthalmology, there is a need to explore the relationships between clinical parameters of the cornea and the corneal shape. This study explores the paradigm of machine learning with nonlinear regression methods to verify whether corneal shapes can effectively be predicted from clinical data only, in an attempt to better assess and visualize their effects on the corneal shape.

Methods

The dimensionality of a database of normal anterior corneal surfaces was first reduced by Zernike modeling into short vectors of 12 to 20 coefficients used as targets. The associated structural, refractive and demographic corneal parameters were used as predictors. The nonlinear regression methods were borrowed from the scikit-learn library. All possible regression models (method + predictors + targets) were pre-tested in an exploratory step and those that performed better than linear regression were fully tested with 10-fold validation. The best model was selected based on mean RMSE scores measuring the distance between the predicted corneal surfaces of a model and the raw (non-modeled) true surfaces. The quality of the best model's predictions was visually assessed thanks to atlases of average elevation maps that displayed the centroids of the predicted and true surfaces on a number of clinical variables.

Results

The best model identified was gradient boosting regression using all available clinical parameters to predict 16 Zernike coefficients. The predicted and true corneal surfaces represented in average elevation maps were remarkably similar. The most explicative predictor was the radius of the best-fit sphere, and departures from that sphere were mostly explained by the eye side and by refractive parameters (axis and cylinder).

Conclusion

It is possible to make a reasonably good prediction of the normal corneal shape solely from a set of clinical parameters. In so doing, one can visualize their effects on the corneal shape and identify its most important contributors.

目的在眼科领域,需要探索角膜临床参数与角膜形状之间的关系。本研究利用非线性回归方法探索机器学习的范例,以验证是否能仅根据临床数据有效预测角膜形状,从而更好地评估和直观显示临床数据对角膜形状的影响。方法首先通过 Zernike 建模将正常角膜前表面数据库的维度降低为 12 到 20 个系数的短向量作为目标。相关的结构、屈光和人口统计学角膜参数被用作预测因子。非线性回归方法借用了 scikit-learn 库。在探索步骤中对所有可能的回归模型(方法 + 预测因子 + 目标)进行了预先测试,并对性能优于线性回归的模型进行了 10 倍验证的全面测试。根据测量模型预测角膜表面与原始(非建模)真实表面之间距离的平均 RMSE 分数,选出最佳模型。最佳模型的预测质量可通过平均高程图来直观评估,平均高程图显示了预测角膜表面和真实角膜表面在一些临床变量上的中心点。平均高程图所代表的预测角膜表面和真实角膜表面非常相似。最能说明问题的预测因子是最佳拟合球面的半径,而偏离该球面的情况主要由眼侧和屈光参数(轴和圆柱)来解释。通过这种方法,我们可以直观地看到这些参数对角膜形状的影响,并找出最重要的影响因素。
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引用次数: 0
AI-Enabled Clinical Decision Support System Modeling for the Prediction of Cirrhosis Complications 用于肝硬化并发症预测的人工智能临床决策支持系统建模
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-20 DOI: 10.1016/j.irbm.2024.100854
Vivian Chia-Rong Hsieh, Meng-Yu Liu, Hsueh-Chun Lin

Background and Objective

Utilizing artificial intelligence (AI), a clinical decision support system (CDSS), can help physicians anticipate possible complications of cirrhosis patients before prescribing more accurate treatments. This study aimed to establish a prototype of AI-CDSS modeling using electronic health records to predict five complications for cirrhosis patients who were controlled for oral antiviral drugs, lamivudine (LAM) or entecavir (ETV).

Methods

Our modeling attained a web-based AI-CDSS with four steps – data extraction, sample normalization, AI-enabled machine learning (ML), and system integration. We designed the extract-transform-load (ETL) procedure to filter the analytics features from a clinical database. The data training process applied 10-fold cross-validation to verify diverse ML models due to possible feature patterns with medications for predicting the complications. In addition, we applied both statistical means and standard deviations of the realistic datasets to create the simulative datasets, which contained sufficient and balanced data to train the most efficient models for evaluation. The modeling combined multiple ML methods, such as support vector machine (SVM), random forest (RF), extreme gradient boosting, naive Bayes, and logistic regression, for training fourteen features to generate the AI-CDSS's prediction functionality.

Results

The models achieving an accuracy of 0.8 after cross-validations would be qualified for the AI-CDSS. SVM and RF models using realistic data predicted jaundice with an accuracy of over 0.82. Furthermore, the SVM models using simulative data reached an accuracy of over 0.85 when predicting patients with jaundice. Our approaches implied that the simulative datasets based on the same distributions as that of the features in the realistic dataset were adequate for training the ML models. The RF model could reach an AUC of up to 0.82 for multiple complications by testing with the un-trained data. Finally, we successfully installed twenty models of the suitable ML methods in the AI-CDSS to predict five complications for cirrhosis patients prescribed with LAM or ETV.

Conclusions

Our modeling integrated a self-developed AI-CDSS with the approved ML models to predict cirrhosis complications for aiding clinical decision making.

背景和目的利用人工智能(AI)--临床决策支持系统(CDSS),可以帮助医生在开出更准确的治疗处方之前预测肝硬化患者可能出现的并发症。本研究旨在利用电子健康记录建立人工智能-CDSS建模原型,以预测接受口服抗病毒药物拉米夫定(LAM)或恩替卡韦(ETV)治疗的肝硬化患者的五种并发症。方法我们的建模实现了基于网络的人工智能-CDSS,包括四个步骤--数据提取、样本规范化、人工智能机器学习(ML)和系统集成。我们设计了提取-转换-加载(ETL)程序,从临床数据库中筛选分析特征。在数据训练过程中,我们采用了 10 倍交叉验证,以验证因可能的特征模式而产生的多种 ML 模型,这些特征模式与预测并发症的药物有关。此外,我们还采用了现实数据集的统计均值和标准差来创建模拟数据集,其中包含足够且均衡的数据,以训练最有效的评估模型。建模结合了多种 ML 方法,如支持向量机 (SVM)、随机森林 (RF)、极梯度提升、天真贝叶斯和逻辑回归,用于训练 14 个特征,以生成 AI-CDSS 的预测功能。使用现实数据的 SVM 和 RF 模型预测黄疸的准确率超过了 0.82。此外,使用模拟数据的 SVM 模型预测黄疸患者的准确率超过了 0.85。我们的方法表明,基于与现实数据集特征相同分布的模拟数据集足以训练 ML 模型。通过使用未训练数据进行测试,射频模型对多种并发症的 AUC 可高达 0.82。最后,我们成功地在 AI-CDSS 中安装了 20 个合适的 ML 方法模型,用于预测肝硬化患者服用 LAM 或 ETV 后的五种并发症。
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引用次数: 0
Synchronized Diabetes Monitoring System: Development of Smart Mobile Apparatus for Diabetes Using Insulin 同步糖尿病监测系统:开发使用胰岛素的糖尿病智能移动设备
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-02 DOI: 10.1016/j.irbm.2024.100852
Mustafa Kahraman , Hatice Vildan Dudukcu , Serkan Kurt , Huseyin Yildiz , Nizamettin Aydin , Ummu Mutlu , Ramazan Cakmak , Elif Beyza Boz , Hasan Ediz Ozbek , Mehmet Ali Erturk , Gokhan Ozogur , Hatice Nizam Ozogur , Muhammed Ali Aydin , Kubilay Karsidag , Sukru Ozturk , Ilhan Satman , Mehmet Akif Karan

Accurate and timely injection of insulin doses in accordance with the treatment protocol is very important in the follow-up of insulin-dependent diabetes patients. In this study, a new smart mobile apparatus (SMA) has been developed. The SMA can be attached to insulin pens and record and transfer data by detecting the patient's dose of insulin and the time at which it was provided. The SMA can detect the dose determined in the insulin pen through linear capacitive sensors. Electronic parts and sensor mechanism are located on the designed SMA body. The insulin pen's two-part mechanical construction of the body senses movement during dosage adjustment while also making sure the dose information is recorded in the control unit. The dose and time information recorded in the SMA internal memory are transmitted to the patient's smartphone via the developed mobile application. The developed SMA prototypes were evaluated by a team of doctors in a hospital setting for three months. As a result of the three-month study, it was observed that the insulin dose and administration times could be accurately sent to the smartphone application via SMA. The SMA was created in the laboratory environment and was prepared for pilot research with insulin-dependent diabetes patients in a hospital setting. It was observed that the SMA prototype successfully identified and recorded the dose and timing of the patient's self-administered insulin.

在胰岛素依赖型糖尿病患者的随访过程中,按照治疗方案准确及时地注射胰岛素剂量非常重要。本研究开发了一种新型智能移动设备(SMA)。SMA 可以安装在胰岛素笔上,通过检测病人的胰岛素剂量和注射时间来记录和传输数据。SMA 可通过线性电容传感器检测胰岛素笔中确定的剂量。电子部件和传感器机构位于设计的 SMA 本体上。胰岛素笔的笔身由两部分机械结构组成,可在调整剂量时感知移动,同时确保剂量信息被记录到控制单元中。记录在 SMA 内部存储器中的剂量和时间信息将通过开发的移动应用程序传输到患者的智能手机上。一个医生团队在医院环境中对所开发的 SMA 原型进行了为期三个月的评估。三个月的研究结果表明,胰岛素剂量和给药时间可通过 SMA 准确发送到智能手机应用程序。SMA 是在实验室环境中创建的,准备在医院环境中对胰岛素依赖型糖尿病患者进行试点研究。据观察,SMA 原型成功识别并记录了患者自行注射胰岛素的剂量和时间。
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