Outcome Prediction in Critically-Ill Patients with Venous Thromboembolism and/or Cancer Using Machine Learning Algorithms: External Validation and Comparison with Scoring Systems.
Viasiliki DanilatouStylianos NikolakakisDespoina AntonakakiChristos TzagkarakisDimitrios MavroidisTheodoros KostoulasSotirios IoannidisPublished in: International journal of molecular sciences (2022)
Intensive care unit (ICU) patients with venous thromboembolism (VTE) and/or cancer suffer from high mortality rates. Mortality prediction in the ICU has been a major medical challenge for which several scoring systems exist but lack in specificity. This study focuses on two target groups, namely patients with thrombosis or cancer. The main goal is to develop and validate interpretable machine learning (ML) models to predict early and late mortality, while exploiting all available data stored in the medical record. To this end, retrospective data from two freely accessible databases, MIMIC-III and eICU, were used. Well-established ML algorithms were implemented utilizing automated and purposely built ML frameworks for addressing class imbalance. Prediction of early mortality showed excellent performance in both disease categories, in terms of the area under the receiver operating characteristic curve ( AUC - ROC ): VTE-MIMIC-III 0.93, eICU 0.87, cancer-MIMIC-III 0.94. On the other hand, late mortality prediction showed lower performance, i.e., AUC - ROC : VTE 0.82, cancer 0.74 - 0.88. The predictive model of early mortality developed from 1651 VTE patients (MIMIC-III) ended up with a signature of 35 features and was externally validated in 2659 patients from the eICU dataset. Our model outperformed traditional scoring systems in predicting early as well as late mortality. Novel biomarkers, such as red cell distribution width, were identified.
Keyphrases
- venous thromboembolism
- machine learning
- papillary thyroid
- intensive care unit
- cardiovascular events
- squamous cell
- risk factors
- direct oral anticoagulants
- end stage renal disease
- healthcare
- newly diagnosed
- big data
- ejection fraction
- deep learning
- coronary artery disease
- stem cells
- chronic kidney disease
- type diabetes
- prognostic factors
- artificial intelligence
- mechanical ventilation
- pulmonary embolism
- peritoneal dialysis
- atrial fibrillation
- young adults
- high throughput
- room temperature
- cell therapy