基于自监督的一般实验室进展预训练模型的心血管事件检测

IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL IEEE Journal of Translational Engineering in Health and Medicine-Jtehm Pub Date : 2023-03-13 DOI:10.1109/JTEHM.2023.3307794
Li-Chin Chen;Kuo-Hsuan Hung;Yi-Ju Tseng;Hsin-Yao Wang;Tse-Min Lu;Wei-Chieh Huang;Yu Tsao
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引用次数: 0

摘要

目的:通过机器学习技术在疾病护理中利用患者数据提供了许多实质性的好处。尽管如此,患者数据的固有性质带来了一些挑战。流行病例由于其患者数量和一致的随访而积累了大量的纵向数据,然而,纵向实验室数据以其不规则性、时间性、缺勤性和稀疏性而闻名;相比之下,罕见或特殊病例的招募往往受到限制,因为他们的患者规模有限和偶发观察。本研究采用自我监督学习(SSL)来预训练一个广义实验室进展(GLP)模型,该模型捕获了常见心血管病例中常见实验室标志物的总体进展,目的是将这些知识转移到帮助检测特定心血管事件。方法和程序:GLP实现了一种两阶段的训练方法,利用内插数据中嵌入的信息并增强SSL的性能。经过GLP预训练后,转移到TVR检测。结果:提出的两阶段训练提高了纯SSL的性能,并且GLP的可转移性表现出独特性。经过GLP处理后,分类精度明显提高,平均准确率由0.63提高到0.90。与先前的GLP处理相比,所有评估指标都显示出实质性的优势(p < 0.01)。结论:我们的研究有效地进行了转化工程,通过将心血管实验室参数的患者进展从一个患者组转移到另一个患者组,超越了数据可用性的限制。疾病进展的可转移性优化了检查和治疗策略,并在使用常用的实验室参数时改善了患者预后。将这种方法扩展到其他疾病的潜力具有很大的前景。临床影响:我们的研究有效地将患者进展从一个队列转移到另一个队列,超越了偶发性观察的限制。疾病进展的可转移性有助于心血管事件的评估。
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Self-Supervised Learning-Based General Laboratory Progress Pretrained Model for Cardiovascular Event Detection
Objective: Leveraging patient data through machine learning techniques in disease care offers a multitude of substantial benefits. Nonetheless, the inherent nature of patient data poses several challenges. Prevalent cases amass substantial longitudinal data owing to their patient volume and consistent follow-ups, however, longitudinal laboratory data are renowned for their irregularity, temporality, absenteeism, and sparsity; In contrast, recruitment for rare or specific cases is often constrained due to their limited patient size and episodic observations. This study employed self-supervised learning (SSL) to pretrain a generalized laboratory progress (GLP) model that captures the overall progression of six common laboratory markers in prevalent cardiovascular cases, with the intention of transferring this knowledge to aid in the detection of specific cardiovascular event. Methods and procedures: GLP implemented a two-stage training approach, leveraging the information embedded within interpolated data and amplify the performance of SSL. After GLP pretraining, it is transferred for target vessel revascularization (TVR) detection. Results: The proposed two-stage training improved the performance of pure SSL, and the transferability of GLP exhibited distinctiveness. After GLP processing, the classification exhibited a notable enhancement, with averaged accuracy rising from 0.63 to 0.90. All evaluated metrics demonstrated substantial superiority ( ${p} < 0.01$ ) compared to prior GLP processing. Conclusion: Our study effectively engages in translational engineering by transferring patient progression of cardiovascular laboratory parameters from one patient group to another, transcending the limitations of data availability. The transferability of disease progression optimized the strategies of examinations and treatments, and improves patient prognosis while using commonly available laboratory parameters. The potential for expanding this approach to encompass other diseases holds great promise. Clinical impact: Our study effectively transposes patient progression from one cohort to another, surpassing the constraints of episodic observation. The transferability of disease progression contributed to cardiovascular event assessment.
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来源期刊
CiteScore
7.40
自引率
2.90%
发文量
65
审稿时长
27 weeks
期刊介绍: The IEEE Journal of Translational Engineering in Health and Medicine is an open access product that bridges the engineering and clinical worlds, focusing on detailed descriptions of advanced technical solutions to a clinical need along with clinical results and healthcare relevance. The journal provides a platform for state-of-the-art technology directions in the interdisciplinary field of biomedical engineering, embracing engineering, life sciences and medicine. A unique aspect of the journal is its ability to foster a collaboration between physicians and engineers for presenting broad and compelling real world technological and engineering solutions that can be implemented in the interest of improving quality of patient care and treatment outcomes, thereby reducing costs and improving efficiency. The journal provides an active forum for clinical research and relevant state-of the-art technology for members of all the IEEE societies that have an interest in biomedical engineering as well as reaching out directly to physicians and the medical community through the American Medical Association (AMA) and other clinical societies. The scope of the journal includes, but is not limited, to topics on: Medical devices, healthcare delivery systems, global healthcare initiatives, and ICT based services; Technological relevance to healthcare cost reduction; Technology affecting healthcare management, decision-making, and policy; Advanced technical work that is applied to solving specific clinical needs.
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