基于人工智能的COVID-19患者临床纵向评价及器官特异性恢复预测

IF 5.1 4区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Precision Clinical Medicine Pub Date : 2020-12-28 DOI:10.1093/pcmedi/pbaa040
Winston Wang, Charlotte L Zhang, K. Wei, Ye Sang, Jun Shen, Guangyu Wang, Alexander X. Lozano
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引用次数: 0

摘要

在COVID-19中,迫切需要在入院时预测哪些COVID-19患者将从疾病中康复,以及他们恢复的速度,以提供个性化治疗并适当分配医院资源,从而使医疗保健系统不会不堪重负。为此,我们将临床显著的CT成像数据与实验室检测数据协同结合在一个综合机器学习模型中,以预测COVID-19患者的器官特异性恢复。我们在285名患者中对受COVID-19影响的每个主要器官系统进行了训练和验证,包括肾脏、肺、免疫、心脏和肝脏系统。为了大大提高模型的速度和实用性,我们应用人工智能方法对CT图像区域进行分割和分类,从中可解释的数据可以直接输入到预测机器学习模型中,以实现整体恢复。在所有器官系统中,我们获得了接受者操作员特征曲线(AUC)值下的验证集面积,器官特异性恢复范围为0.80至0.89,并在Kaplan-Meier分析中实现了显著的总体恢复预测。这表明,将应用于CT肺部成像的人工智能(AI)框架与将实验室测试数据与成像数据集成的机器学习模型协同使用,可以从基线特征准确预测COVID-19患者的整体恢复情况。
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Clinical longitudinal evaluation of COVID-19 patients and prediction of organ-specific recovery using artificial intelligence
Abstract Within COVID-19 there is an urgent unmet need to predict at the time of hospital admission which COVID-19 patients will recover from the disease, and how fast they recover to deliver personalized treatments and to properly allocate hospital resources so that healthcare systems do not become overwhelmed. To this end, we have combined clinically salient CT imaging data synergistically with laboratory testing data in an integrative machine learning model to predict organ-specific recovery of patients from COVID-19. We trained and validated our model in 285 patients on each separate major organ system impacted by COVID-19 including the renal, pulmonary, immune, cardiac, and hepatic systems. To greatly enhance the speed and utility of our model, we applied an artificial intelligence method to segment and classify regions on CT imaging, from which interpretable data could be directly fed into the predictive machine learning model for overall recovery. Across all organ systems we achieved validation set area under the receiver operator characteristic curve (AUC) values for organ-specific recovery ranging from 0.80 to 0.89, and significant overall recovery prediction in Kaplan-Meier analyses. This demonstrates that the synergistic use of an artificial intelligence (AI) framework applied to CT lung imaging and a machine learning model that integrates laboratory test data with imaging data can accurately predict the overall recovery of COVID-19 patients from baseline characteristics.
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来源期刊
Precision Clinical Medicine
Precision Clinical Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
10.80
自引率
0.00%
发文量
26
审稿时长
5 weeks
期刊介绍: Precision Clinical Medicine (PCM) is an international, peer-reviewed, open access journal that provides timely publication of original research articles, case reports, reviews, editorials, and perspectives across the spectrum of precision medicine. The journal's mission is to deliver new theories, methods, and evidence that enhance disease diagnosis, treatment, prevention, and prognosis, thereby establishing a vital communication platform for clinicians and researchers that has the potential to transform medical practice. PCM encompasses all facets of precision medicine, which involves personalized approaches to diagnosis, treatment, and prevention, tailored to individual patients or patient subgroups based on their unique genetic, phenotypic, or psychosocial profiles. The clinical conditions addressed by the journal include a wide range of areas such as cancer, infectious diseases, inherited diseases, complex diseases, and rare diseases.
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