4.2 Article

Application of Machine Learning Approaches to Predict Postnatal Growth Failure in Very Low Birth Weight Infants

Journal

YONSEI MEDICAL JOURNAL
Volume 63, Issue 7, Pages 640-647

Publisher

YONSEI UNIV COLL MEDICINE
DOI: 10.3349/ymj.2022.63.7.640

Keywords

Growth failure; very low birth weight infants; machine learning; prediction; neonatal intensive care unit

Funding

  1. Korea Medical Device Development Fund - Korea government (Ministry of Science and ICT) [KMMDF_PR_20200901_0057]
  2. Korea Medical Device Development Fund - Korea government (Ministry of Trade, Industry and Energy) [KMMDF_PR_20200901_0057]
  3. Korea Medical Device Development Fund - Korea government (Ministry of Health Welfare) [KMMDF_PR_20200901_0057]
  4. Korea Medical Device Development Fund - Korea government (Ministry of Food and Drug Safety) [KMMDF_PR_20200901_0057]

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The study aimed to develop and evaluate a machine learning model for predicting postnatal growth. Machine learning models built with different techniques showed better performance, especially the XGB algorithm.
Purpose: The aims of the study were to develop and evaluate a machine learning model with which to predict postnatal growth Materials and Methods: Of 10425 VLBW infants registered in the Korean Neonatal Network between 2013 and 2017, 7954 infants were included. PGF was defined as a decrease in Z score >1.28 at discharge, compared to that at birth. Six metrics [area under the receiver operating characteristic curve (AUROC), accuracy, precision, sensitivity, specificity, and F1 score] were obtained at five time points (at birth, 7 days, 14 days, 28 days after birth, and at discharge). Machine learning models were built using four different techniques [extreme gradient boosting (XGB), random forest, support vector machine, and convolutional neural network] to compare against the conventional multiple logistic regression (MLR) model. Results: The XGB algorithm showed the best performance with all six metrics across the board. When compared with MLR, XGB showed a significantly higher AUROC (p=0.03) for Day 7, which was the primary performance metric. Using optimal cut-off points, for Day 7, XGB still showed better performances in terms of AUROC (0.74), accuracy (0.68), and F1 score (0.67). AUROC values seemed to increase slightly from birth to 7 days after birth with significance, almost reaching a plateau after 7 days after birth. Conclusion: We have shown the possibility of predicting PGF through machine learning algorithms, especially XGB. Such models may help neonatologists in the early diagnosis of high-risk infants for PGF for early intervention.

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