Bo-Hao Tang, Qiu-Yue Li, Hui-Xin Liu, Yi Zheng, Yue-E Wu, John van den Anker, Guo-Xiang Hao, Wei Zhao
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引用次数: 0
摘要
细菌感染是全球新生儿发病和死亡的主要原因之一。找到快速、可靠的方法来早期识别和诊断细菌感染,并及早进行个体化的抗菌药物治疗,对于根除这些感染和预防严重并发症至关重要。然而,由于非特异性的临床表现、现有诊断方法的低准确性以及对新生儿药代动力学的有限了解,这往往难以实现。虽然新生儿医学对机器学习(ML)的益处了解相对较晚,但在新生儿败血症的早期预测和抗生素的个体化方面已初步应用了 ML。本文简要介绍了机器学习,并讨论了诊断和治疗新生儿细菌感染的技术现状、差距、机器学习的潜在用途以及解决当前研究局限性的未来方向。新生儿细菌感染涉及生理发育、疾病表达和治疗反应结果的综合因素。为了解决这种复杂的关系,未来的模型可以考虑采用适当的 ML 算法来捕捉时间序列特征,同时整合宿主、微生物和药物的影响因素,以优化新生儿的抗菌药物使用。所有模型在临床使用前都需要进行前瞻性临床试验以验证其临床实用性。
Machine Learning: A Potential Therapeutic Tool to Facilitate Neonatal Therapeutic Decision Making.
Bacterial infection is one of the major causes of neonatal morbidity and mortality worldwide. Finding rapid and reliable methods for early recognition and diagnosis of bacterial infections and early individualization of antibacterial drug administration are essential to eradicate these infections and prevent serious complications. However, this is often difficult to perform due to non-specific clinical presentations, low accuracy of current diagnostic methods, and limited knowledge of neonatal pharmacokinetics. Although neonatal medicine has been relatively late to embrace the benefits of machine learning (ML), there have been some initial applications of ML for the early prediction of neonatal sepsis and individualization of antibiotics. This article provides a brief introduction to ML and discusses the current state of the art in diagnosing and treating neonatal bacterial infections, gaps, potential uses of ML, and future directions to address the limitations of current studies. Neonatal bacterial infections involve a combination of physiologic development, disease expression, and treatment response outcomes. To address this complex relationship, future models could consider appropriate ML algorithms to capture time series features while integrating influences from the host, microbes, and drugs to optimize antimicrobial drug use in neonates. All models require prospective clinical trials to validate their clinical utility before clinical use.
期刊介绍:
Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes:
-overviews of contentious or emerging issues.
-comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development.
-practical reviews covering optimum drug management of specific clinical situations.
-systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement.
-Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population.
-original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies.
Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.