在本地医疗保健网络中利用机器学习和电子病历数据特征改进心血管疾病预测

Mrs. Sapana Bhushan Raghuwanshi, Dr. Nilesh Ashok Suryawanshi
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引用次数: 0

摘要

美国经常使用由 ACC/AHA 开发的 PCE 风险计算器,目的是通过一线防御策略避免动脉粥样硬化性心血管疾病 (ASCVD) 的发生。然而,该计算器可能无法准确估计某些人群的风险,从而可能导致风险估计不足或估计过高。我们利用先进的机器学习(ML)技术和电子病历(EMR)数据创建了针对特定人群的 ASCVD 风险计算器。我们的研究包括比较我们的计算器和 PCE 计算器的预测准确性。在 2009 年 1 月 1 日至 2020 年 4 月 30 日期间,我们从 101,110 份不同的 EMR 中收集了积极接受治疗的患者数据。患者数据集采用了机器学习技术,其中包含纵向(LT)和横断面(CS)特征,或仅包含由实验室值和生命统计数据得出的横断面特征。模型的有效性使用新鲜价格指标(筛选病例百分比 @ 敏感度水平)进行评估。在预测准确性方面,每个接受测试的 ML 模型都优于 PCE 风险计算器。当结合 CS 和 LT 特征(RF-LTC)时,随机森林(RF)ML 技术的曲线下面积(AUC)得分为 0.902。我们的机器学习模型只需筛查43%的患者就能识别90%的ASCVD阳性病例,而PCE风险计算器则需要筛查69%的患者。与单独使用 PCE 计算器相比,使用 ML 技术创建的预测模型减少了预测 ASCVD 所需的检查次数,提高了 ASCVD 预测的准确性。在这些 ML 模型中结合了 LT 和 CS 特征,与仅使用 CS 特征相比,ASCVD 预测效果显著提高。
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Improving Cardiovascular Disease Forecasting with Machine Learning and Electronic Medical Record Data Characteristics Within a Local Healthcare Network
The PCE Risk Calculator, developed by the ACC/AHA, is frequently utilized in the United States for the purpose of averting the onset of Atherosclerotic cardiovascular disease (ASCVD) via first-line defense strategies. However, this calculator may not accurately estimate risk for certain populations, potentially leading to either under- or over-estimation of risk. We have created calculator for ASCVD risk specific to a population by leveraging advanced Machine Learning (ML) techniques and Electronic Medical Record (EMR) data. Our study involved comparing predictive accuracy of our calculator with PCE calculator. Between January 1, 2009, and April 30, 2020, data was gathered from 101,110 distinct EMRs of patients who were actively receiving treatment. Patient datasets underwent machine learning techniques containing Longitudinal (LT) and Cross-Sectional (CS) features, or solely CS features, derived from laboratory values and vital statistics. The models' effectiveness was assessed using fresh price metric (Screened Cases Percentage @Sensitivity level). In terms of prediction accuracy, every ML model that was tested performed better than the PCE risk calculator. Area Under Curve (AUC) score of 0.902 was obtained by Random Forest (RF) ML technique when CS and LT characteristics were combined (RF-LTC). Our machine learning model only needed to screen 43% of patients in order to identify 90% of positive ASCVD cases, in contrast to the PCE risk calculator, which required screening 69% of patients. Prediction models created using ML techniques reduce the amount number of tests necessary to forecast ASCVD and increase the accuracy of ASCVD prediction when compared to using PCE calculator alone. The combination of LT and CS features in these ML models leads to a significant enhancement in comparing the ASCVD prediction to utilizing CS features exclusively.
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