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Yonsei Med J. 2022;63(5):422-429.

Validation of Machine Learning Models to Predict Adverse Outcomes in Patients with COVID-19: A Prospective Pilot Study.

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제1저자 김형준 · 교신저자 오홍상

소속 (5)
  1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  2. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
  3. The Armed Forces Medical Command, Seongnam, Korea.
  4. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.
  5. Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea. elvis_presly@naver.com.

Abstract

PURPOSE We previously developed learning models for predicting the need for intensive care and oxygen among patients with coronavirus disease (COVID-19). Here, we aimed to prospectively validate the accuracy of these models.

MATERIALS AND METHODS Probabilities of the need for intensive care [intensive care unit (ICU) score] and oxygen (oxygen score) were calculated from information provided by hospitalized COVID-19 patients (n=44) via a web-based application. The performance of baseline scores to predict 30-day outcomes was assessed.

RESULTS Among 44 patients, 5 and 15 patients needed intensive care and oxygen, respectively. The area under the curve of ICU score and oxygen score to predict 30-day outcomes were 0.774 [95% confidence interval (CI): 0.614-0.934] and 0.728 (95% CI: 0.559-0.898), respectively. The ICU scores of patients needing intensive care increased daily by 0.71 points (95% CI: 0.20-1.22) after hospitalization and by 0.85 points (95% CI: 0.36-1.35) after symptom onset, which were significantly different from those in individuals not needing intensive care (p=0.002 and <0.001, respectively). Trends in daily oxygen scores overall were not markedly different; however, when the scores were evaluated within <7 days after symptom onset, the patients needing oxygen showed a higher daily increase in oxygen scores [1.81 (95% CI: 0.48-3.14) vs. -0.28 (95% CI: 1.00-0.43), p=0.007].

CONCLUSION Our machine learning models showed good performance for predicting the outcomes of COVID-19 patients and could thus be useful for patient triage and monitoring.

© Copyright: Yonsei University College of Medicine 2022.

Keywords

COVID-19machine learningprognosisprospective studiesvalidation study

Figures

Fig. 1
Fig. 1 Top 20 features with high feature importance to (A) ICU score and (B) oxygen score. ICU, intensive care unit.
Fig. 2
Fig. 2 Hospital course of the included patients.
Fig. 3
Fig. 3 ROC curve of each score for predicting 30-day outcomes. (A) ROC curve of ICU score to predict the need for intensive care within 30 days of hospitalization. (B) ROC curve of oxygen score to predict the need for oxygen supplementation within 30 days of hospitalization. ROC, receiver operating characteristics; ICU, intensive care unit; AUC, area under the receiver operating characteristics curve.
Fig. 4
Fig. 4 Changes in scores according to disease course and 30-day outcome. Change in ICU score (A) after hospitalization and (B) after symptom onset according to the need for intensive care. Change in oxygen score (C) after hospitalization and (D) after symptom onset according to the need for oxygen supplementation. ICU, intensive care unit.

그림 출처: PubMed Central 공개 논문 (PMC9086701)

Conflict of interest statement

JoonNyung Heo and Deokjae Han each own stock in the software company Doctors on the Cloud and have received a grant as a team from Tides Foundation, on the recommendation from the Google.org Charitable Giving Fund. Hyung-Jun Kim and Hong Sang Oh do not have any conflicts of interest to declare.

그 밖의 정보
출판 형태
Journal Article
저널
Yonsei medical journal · eISSN 1976-2437
MeSH
COVID-19* · Hospitalization · Humans · Intensive Care Units · Machine Learning · Oxygen · Pilot Projects · Prospective Studies · Retrospective Studies
Substances
Oxygen
참고문헌
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