Prognostic Model of ICU Admission Risk in Patients with COVID-19 Infection Using Machine Learning (original) (raw)
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Annals of Operations Research
The recent COVID-19 pandemic has affected health systems across the world. Especially, Intensive Care Units (ICUs) have played a pivotal role in the treatment of critically-ill patients. At the same time however, the increasing number of admissions due to the vast prevalence of the virus have caused several problems for ICU wards such as overburdening of staff and shortages of medical resources. These issues might have affected the quality of healthcare services provided directly impacting a patient's survival. The objective of this research is to leverage Machine Learning (ML) on hospital data in order to support hospital managers and practitioners with the treatment of COVID-19 patients. This is accomplished by providing more detailed inference about a patient's likelihood of ICU admission, mortality and in case of hospitalization the length of stay (LOS). In this pursuit, the outcome variables are in B Khodakaram Salimifard
A robust and parsimonious machine learning method to predict ICU admission of COVID-19 patients
Medical & Biological Engineering & Computing, 2022
In this article, we discuss the development of prognostic machine learning (ML) models for COVID-19 progression, by focusing on the task of predicting ICU admission within (any of) the next 5 days. On the basis of 6,625 complete blood count (CBC) tests from 1,004 patients, of which 18% were admitted to intensive care unit (ICU), we created four ML models, by adopting a robust development procedure which was designed to minimize risks of bias and over-fitting, according to reference guidelines. The best model, a support vector machine, had an AUC of .85, a Brier score of .14, and a standardized net benefit of .69: these scores indicate that the model performed well over a variety of prediction criteria. We also conducted an interpretability study to back up our findings, showing that the data on which the developed model is based is consistent with the current medical literature. This also demonstrates that CBC data and ML methods can be used to predict COVID-19 patients' ICU admission at a relatively low cost: in particular, since CBC data can be quickly obtained by means of routine blood exams, our models could be used in resource-constrained settings and provide health practitioners with rapid and reliable indications.
Diagnostics
We conducted a statistical study and developed a machine learning model to triage COVID-19 patients affected during the height of the COVID-19 pandemic in Hong Kong based on their medical records and test results (features) collected during their hospitalization. The correlation between the values of these features is studied against discharge status and disease severity as a preliminary step to identify those features with a more pronounced effect on the patient outcome. Once identified, they constitute the inputs of four machine learning models, Decision Tree, Random Forest, Gradient and RUSBoosting, which predict both the Mortality and Severity associated with the disease. We test the accuracy of the models when the number of input features is varied, demonstrating their stability; i.e., the models are already highly predictive when run over a core set of (6) features. We show that Random Forest and Gradient Boosting classifiers are highly accurate in predicting patients’ Mortali...
Prediction of COVID-19 Mortality in the Intensive Care Unit Using Machine Learning
Studies in health technology and informatics, 2023
Since its emergence, the COVID-19 pandemic still poses a major global health threat. In this setting, a number of useful machine learning applications have been explored to assist clinical decision-making, predict the severity of disease and admission to the intensive care unit, and also to estimate future demand for hospital beds, equipment, and staff. The present study examined demographic data, hematological and biochemical markers routinely measured in Covid-19 patients admitted to the intensive care unit (ICU) of a public tertiary hospital, in relation to the ICU outcome, during the second and third Covid-19 waves, from October 2020 until February 2022. In this dataset, we applied eight well-known classifiers of the caret package for machine learning of the R programming language, to evaluate their performance in forecasting ICU mortality. The best performance regarding area under the receiver operating characteristic curve (AUC-ROC) was observed with Random Forest (0.82), while k-nearest neighbors (k-NN) were the lowest performing machine learning algorithm (AUC-ROC: 0.59). However, in terms of sensitivity, XGB outperformed the other classifiers (max Sens: 0.7). The six most important predictors of mortality in the Random Forest model were serum urea, age, hemoglobin, C-reactive protein, platelets, and lymphocyte count.
2021 IEEE 34th International Symposium on Computer-Based Medical Systems (CBMS), 2021
In this article we discuss the development of prognostic Machine Learning (ML) models for COVID-19 progression: specifically, we address the task of predicting intensive care unit (ICU) admission in the next 5 days. We developed three ML models on the basis of 4995 Complete Blood Count (CBC) tests. We propose three ML models that differ in terms of interpretability: two fully interpretable models and a blackbox one. We report an AUC of .81 and .83 for the interpretable models (the decision tree and logistic regression, respectively), and an AUC of .88 for the black-box model (an ensemble). This shows that CBC data and ML methods can be used for costeffective prediction of ICU admission of COVID-19 patients: in particular, as the CBC can be acquired rapidly through routine blood exams, our models could also be applied in resource-limited settings and to get fast indications at triage and daily rounds.
Automated ML Techniques for Predicting COVID-19 Mortality in the ICU
Studies in health technology and informatics, 2023
The COVID-19 infection is still a serious threat to public health and healthcare systems. Numerous practical machine learning applications have been investigated in this context to support clinical decision-making, forecast disease severity and admission to the intensive care unit, as well as to predict the demand for hospital beds, equipment, and staff in the future. We retrospectively analyzed demographics, and routine blood biomarkers from consecutive Covid-19 patients admitted to the intensive care unit (ICU) of a public tertiary hospital, during a 17month period, relative to the outcome, in order to build a prognostic model. We used the Google Vertex AI platform, on the one hand, to evaluate its performance in predicting ICU mortality, and on the other hand to show the ease with which even non-experts can make prognostic models. The model's performance regarding the area under the receiver operating characteristic curve (AUC-ROC) was 0.955. The six highest-ranked predictors of mortality in the prognostic model were age, serum urea, platelets, C-reactive protein, hemoglobin, and SGOT.
BackgroundThe spread of COVID-19 has led to a severe strain on hospital capacity in many countries. There is a need for a model to help planners assess expected COVID-19 hospital resource utilization.MethodsRetrospective nationwide cohort study following the day-by-day clinical status of all hospitalized COVID-19 patients in Israel from March 1st to May 2nd, 2020. Patient clinical course was modelled with a machine learning approach based on a set of multistate Cox regression-based models with adjustments for right censoring, recurrent events, competing events, left truncation, and time-dependent covariates. The model predicts the patient’s entire disease course in terms of clinical states, from which we derive the patient’s hospital length-of-stay, length-of-stay in critical state, the risk of in-hospital mortality, and total and critical care hospital-bed utilization. Accuracy assessed over eight cross-validation cohorts of size 330, using per-day Mean Absolute Error (MAE) of pred...
Machine learning prediction for COVID-19 disease severity at hospital admission
BMC Medical Informatics and Decision Making
Importance Early prognostication of patients hospitalized with COVID-19 who may require mechanical ventilation and have worse outcomes within 30 days of admission is useful for delivering appropriate clinical care and optimizing resource allocation. Objective To develop machine learning models to predict COVID-19 severity at the time of the hospital admission based on a single institution data. Design, setting, and participants We established a retrospective cohort of patients with COVID-19 from University of Texas Southwestern Medical Center from May 2020 to March 2022. Easily accessible objective markers including basic laboratory variables and initial respiratory status were assessed using Random Forest’s feature importance score to create a predictive risk score. Twenty-five significant variables were identified to be used in classification models. The best predictive models were selected with repeated tenfold cross-validation methods. Main outcomes and measures Among patients w...
An ICU Admission Predictive Model for COVID-19 Patients in Saudi Arabia
International Journal of Advanced Computer Science and Applications
Globally, COVID-19 already emerged in around 170 million confirmed cases of infected people and, as of May 31, 2021, affected more than 3.54 million deaths. This pandemic has given rise to numerous public health and socioeconomic issues, emphasizing the significance of unraveling the epidemic's history and forecasting the disease's potential dynamics. A variety of mathematical models have been proposed to obtain a deeper understanding of disease transmission mechanisms. Machine Learning (ML) models have been used in the last decade to identify patterns and enhance prediction efficiency in healthcare applications. This paper proposes a model to predict COVID-19 patients admission to the intensive care unit (ICU). The model is built upon robust known classification algorithms, including classic Machine Learning Classifiers (MLCs), an Artificial Neural Network (ANN) and ensemble learning. This model's strength in predicting COVID-19 infected patients is shown by performance analysis of various MLCs and error metrics. Among other used ML models, the ANN model resulted in the highest accuracy, 97.9% over other models. Mean Squared Error showed that the ANN method had the lowest error (0.0809). In conclusion, this paper could be beneficial to ICU staff to predict ICU admission based on COVID-19 patients' clinical characteristics.