Mortality prediction enhancement in end-stage renal disease: A machine learning approach

Making the Improbable Possible: Generalizing Models Designed for a Syndrome-Based, Heterogeneous Patient Landscape

Syndromic conditions, such as sepsis, are commonly encountered in the intensive care unit. Although these conditions are easy for clinicians to grasp, these conditions may limit the performance of machine-learning algorithms. Individual hospital practice patterns may limit external generalizability. Data missingness is another barrier to optimal algorithm performance and various strategies exist to mitigate this. Recent advances in data science, such as transfer learning, conformal prediction, and continual learning, may improve generalizability of machine-learning algorithms in critically ill patients. Randomized trials with these approaches are indicated to demonstrate improvements in patient-centered outcomes at this point.

Transfer Learning Improving Predictive Mortality Models for Patients in End-Stage Renal Disease

Deep learning is becoming a fundamental piece in the paradigm shift from evidence-based to data-based medicine. However, its learning capacity is rarely exploited when working with small data sets. Through transfer learning (TL), information from a source domain is transferred to a target one to enhance a learning task in such domain. The proposed TL mechanisms are based on sample and feature space augmentation. Thus, deep autoencoders extract complex representations for the data in the TL approach. Their latent representations, the so-called codes, are handled to transfer information among domains. The transfer of samples is carried out by computing a latent space mapping matrix that links codes from both domains for later reconstruction. The feature space augmentation is based on the computation of the average of the most similar codes from one domain. Such an average augments the features in a target domain. The proposed framework is evaluated in the prediction of mortality in patients in end-stage renal disease, transferring information related to the mortality of patients with acute kidney injury from the massive database MIMIC-III. Compared to other TL mechanisms, the proposed approach improves 6–11% in previous mortality predictive models. The integration of TL approaches into learning tasks in pathologies with data volume issues could encourage the use of data-based medicine in a clinical setting.

Has the Flood Entered the Basement? A Systematic Literature Review about Machine Learning in Laboratory Medicine

This article presents a systematic literature review that expands and updates a previous review on the application of machine learning to laboratory medicine. We used Scopus and PubMed to collect, select and analyse the papers published from 2017 to the present in order to highlight the main studies that have applied machine learning techniques to haematochemical parameters and to review their diagnostic and prognostic performance. In doing so, we aim to address the question we asked three years ago about the potential of these techniques in laboratory medicine and the need to leverage a tool that was still under-utilised at that time.