3.8 Article

Machine Learning Model for the Prediction of Hemorrhage in Intensive Care Units

Journal

HEALTHCARE INFORMATICS RESEARCH
Volume 28, Issue 4, Pages 364-375

Publisher

KOREAN SOC MEDICAL INFORMATICS
DOI: 10.4258/hir.2022.28.4.364

Keywords

Hemorrhage; Prognosis; Intensive Care Units; Monitoring; Physiological; Blood Transfusion

Funding

  1. Korea Medical Device Development Fund - Korea government (the Ministry of Science and ICT) [1711138152, KMDF_ PR_20200901_0095]
  2. Korea Medical Device Development Fund - Korea government (Ministry of Trade, Industry and Energy) [1711138152, KMDF_ PR_20200901_0095]
  3. Korea Medical Device Development Fund - Korea government (Ministry of Health Welfare) [1711138152, KMDF_ PR_20200901_0095]
  4. Korea Medical Device Development Fund - Korea government (Ministry of Food and Drug Safety) [1711138152, KMDF_ PR_20200901_0095]

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The study developed a machine learning model to predict high-risk bleeding patients in the intensive care unit (ICU) by learning patterns from real clinical data.
Objectives: Early hemorrhage detection in intensive care units (ICUs) enables timely intervention and reduces the risk of ir-reversible outcomes. In this study, we aimed to develop a machine learning model to predict hemorrhage by learning the pat-terns of continuously changing, real-world clinical data. Methods: We used the Medical Information Mart for Intensive Care databases (MIMIC-III and MIMIC-IV). A recurrent neural network was used to predict severe hemorrhage in the ICU. We developed three machine learning models with an increasing number of input features and levels of complexity: model 1 (11 features), model 2 (18 features), and model 3 (27 features). MIMIC-III was used for model training, and MIMIC-IV was split for internal validation. Using the model with the highest performance, external verification was performed using data from a subgroup extracted from the eICU Collaborative Research Database. Results: We included 5,670 ICU admissions, with 3,150 in the training set and 2,520 in the internal test set. A positive correlation was found between model complexity and perfor-mance. As a measure of performance, three models developed with an increasing number of features showed area under the receiver operating characteristic (AUROC) curve values of 0.61-0.94 according to the range of input data. In the subgroup extracted from the eICU database for external validation, an AUROC value of 0.74 was observed. Conclusions: Machine learning models that rely on real clinical data can be used to predict patients at high risk of bleeding in the ICU.

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