본문 바로가기
KERD
논문KCI 등재

Development of a deep learning model for predicting critical events in a pediatric intensive care unit

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Background: Identifying critically ill patients at risk of cardiac arrest is important because it offers the opportunity for early intervention and increased survival. The aim of this study was to develop a deep learning model to predict critical events, such as cardiopulmonary resuscitation or mortality.Methods: This retrospective observational study was conducted at a tertiary university hospital. All patients younger than 18 years who were admitted to the pediatric intensive care unit from January 2010 to May 2023 were included. The main outcome was prediction performance of the deep learning model at forecasting critical events. Long short-term memory was used as a deep learning algorithm. The five-fold cross validation method was employed for model learning and testing.Results: Among the vital sign measurements collected during the study period, 11,660 measurements were used to develop the model after preprocessing; 1,060 of these data points were measurements that corresponded to critical events. The prediction performance of the model was the area under the receiver operating characteristic curve (95% confidence interval) of 0.988 (0.975–1.000), and the area under the precision-recall curve was 0.862 (0.700–1.000).Conclusions: The performance of the developed model at predicting critical events was excellent. However, follow-up research is needed for external validation.

Abstract

Background: Identifying critically ill patients at risk of cardiac arrest is important because it offers the opportunity for early intervention and increased survival. The aim of this study was to develop a deep learning model to predict critical events, such as cardiopulmonary resuscitation or mortality.Methods: This retrospective observational study was conducted at a tertiary university hospital. All patients younger than 18 years who were admitted to the pediatric intensive care unit from January 2010 to May 2023 were included. The main outcome was prediction performance of the deep learning model at forecasting critical events. Long short-term memory was used as a deep learning algorithm. The five-fold cross validation method was employed for model learning and testing.Results: Among the vital sign measurements collected during the study period, 11,660 measurements were used to develop the model after preprocessing; 1,060 of these data points were measurements that corresponded to critical events. The prediction performance of the model was the area under the receiver operating characteristic curve (95% confidence interval) of 0.988 (0.975–1.000), and the area under the precision-recall curve was 0.862 (0.700–1.000).Conclusions: The performance of the developed model at predicting critical events was excellent. However, follow-up research is needed for external validation.

참고문헌 (24)

  1. Buckley TA, "Critical incident reporting in the intensive care unit", Anaesthesia, 52, pp.403~409 (1997)
  2. Berg RA, "Incidence and outcomes of cardiopulmonary resuscitation in PICUs", Crit Care Med, 44, pp.798~808 (2016)
  3. Girotra S, "Trends in survival after in-hospital cardiac arrest", N Engl J Med, 367, pp.1912~1920 (2012)
  4. Sandroni C, "In-hospital cardiac arrest : incidence, prognosis and possible measures to improve survival", Intensive Care Med, 33, pp.237~245 (2007)
  5. Thorén A, "ECG-monitoring of in-hospital cardiac arrest and factors associated with survival", Resuscitation, 150, pp.130~138 (2020)
  6. Pollack MM, "PRISM III : an updated Pediatric Risk of Mortality score", Crit Care Med, 24, pp.743~752 (1996)
  7. Straney L, "Paediatric index of mortality 3 : an updated model for predicting mortality in pediatric intensive care", Pediatr Crit Care Med, 14, pp.673~681 (2013)
  8. Choi RY, "Introduction to machine learning, neural networks, and deep learning", Transl Vis Sci Technol, 9, pp.14~ (2020)
  9. Meiring C, "Optimal intensive care outcome prediction over time using machine learning", PLoS One, 13, pp.e0206862~ (2018)
  10. Delahanty RJ, "Development and evaluation of an automated machine learning algorithm for in-hospital mortality risk adjustment among critical care patients", Crit Care Med, 46, pp.e481~e488 (2018)
  11. Lee B, "Development of a machine learning model for predicting pediatric mortality in the early stages of intensive care unit admission", Sci Rep, 11, pp.1263~ (2021)
  12. Fleming S, "Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age : a systematic review of observational studies", Lancet, 377, pp.1011~1018 (2011)
  13. Bae W, "Distribution of pediatric vital signs in the emergency department : a nationwide study", Children(Basel), 7, pp.89~ (2020)
  14. Hwang S, "Machine learning-based prediction of critical illness in children visiting the emergency department", PLoS One, 17, pp.e0264184~ (2022)
  15. Rigby RA, "Smooth centile curves for skew and kurtotic data modelled using the Box-Cox power exponential distribution", Stat Med, 23, pp.3053~3076 (2004)
  16. Rigby RA, "Automatic smoothing parameter selection in GAMLSS with an application to centile estimation", Stat Methods Med Res, 23, pp.318~332 (2014)
  17. Cole TJ, "SITAR : a useful instrument for growth curve analysis", Int J Epidemiol, 39, pp.1558~1566 (2010)
  18. Pedregosa F, "Scikit-learn : machine learning in Python", J Mach Learn Res, 12, pp.2825~2830 (2011)
  19. Matam BR, "Machine learning based framework to predict cardiac arrests in a paediatric intensive care unit : prediction of cardiac arrests", J Clin Monit Comput, 33, pp.713~724 (2019)
  20. Kennedy CE, "Using time series analysis to predict cardiac arrest in a PICU", Pediatr Crit Care Med, 16, pp.e332~e339 (2015)
  21. Aczon MD, "Continuous prediction of mortality in the PICU : a recurrent neural network model in a single-center dataset", Pediatr Crit Care Med, 22, pp.519~529 (2021)
  22. Rust LO, "The deterioration risk index : developing and piloting a machine learning algorithm to reduce pediatric inpatient deterioration", Pediatr Crit Care Med, 24, pp.322~333 (2023)
  23. Dewan M, "Assessment of a situation awareness quality improvement intervention to reduce cardiac arrests in the PICU", Pediatr Crit Care Med, 23, pp.4~12 (2022)

관련 논문AI추천

Multicenter validation of a deep-learning-based pediatric early-warning system for prediction of deterioration events김여향, 박성종, 신윤섭, 정재화, 최유현, Cho Joongbum, Cho Kyung-Jae, Jhang Won Kyoung, Kim Soo Yeon, Kim Young A, Lee Yeha대한중환자의학회 · Acute and Critical Care2022 · 제37권 제4호Pediatric septic shock estimation using deep learning and electronic medical records박준동, 이봉진, 이지원대한중환자의학회 · Acute and Critical Care2024 · 제39권 제3호Erratum : Development of a deep learning model for predicting critical events in a pediatric intensive care unit박준동, 이봉진, 이인경대한중환자의학회 · Acute and Critical Care2024 · 제39권 제2호A deep learning model for estimating sedation levels using heart rate variability and vital signs: a retrospective cross-sectional study at a center in South Korea김유선, 박준동, 이봉진, 장원진, 전용혁대한중환자의학회 · Acute and Critical Care2024 · 제39권 제4호Early detection of bloodstream infection in critically ill children using artificial intelligence김경훈, 박준동, 한혜지대한중환자의학회 · Acute and Critical Care2024 · 제39권 제4호Validation of an Automatic Tagging System for Identifying Respiratory and Hemodynamic Deterioration Events in the Intensive Care UnitAndrea Forgacs, Ari M. Lipsky, Craig M. Lilly, Danielle Jeddah, Gershon Celniker, Itai M. Pessach, Ofer Chen대한의료정보학회 · Healthcare Informatics Research2021 · 제27권 제3호

이 간행물의 다른 논문 (23건)