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Abdel-Salam M, Hu G, Çelik E, Gharehchopogh FS, El-Hasnony IM. Chaotic RIME optimization algorithm with adaptive mutualism for feature selection problems. Comput Biol Med 2024; 179:108803. [PMID: 38955125 DOI: 10.1016/j.compbiomed.2024.108803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/17/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024]
Abstract
The RIME optimization algorithm is a newly developed physics-based optimization algorithm used for solving optimization problems. The RIME algorithm proved high-performing in various fields and domains, providing a high-performance solution. Nevertheless, like many swarm-based optimization algorithms, RIME suffers from many limitations, including the exploration-exploitation balance not being well balanced. In addition, the likelihood of falling into local optimal solutions is high, and the convergence speed still needs some work. Hence, there is room for enhancement in the search mechanism so that various search agents can discover new solutions. The authors suggest an adaptive chaotic version of the RIME algorithm named ACRIME, which incorporates four main improvements, including an intelligent population initialization using chaotic maps, a novel adaptive modified Symbiotic Organism Search (SOS) mutualism phase, a novel mixed mutation strategy, and the utilization of restart strategy. The main goal of these improvements is to improve the variety of the population, achieve a better balance between exploration and exploitation, and improve RIME's local and global search abilities. The study assesses the effectiveness of ACRIME by using the standard benchmark functions of the CEC2005 and CEC2019 benchmarks. The proposed ACRIME is also applied as a feature selection to fourteen various datasets to test its applicability to real-world problems. Besides, the ACRIME algorithm is applied to the COVID-19 classification real problem to test its applicability and performance further. The suggested algorithm is compared to other sophisticated classical and advanced metaheuristics, and its performance is assessed using statistical tests such as Wilcoxon rank-sum and Friedman rank tests. The study demonstrates that ACRIME exhibits a high level of competitiveness and often outperforms competing algorithms. It discovers the optimal subset of features, enhancing the accuracy of classification and minimizing the number of features employed. This study primarily focuses on enhancing the equilibrium between exploration and exploitation, extending the scope of local search.
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Affiliation(s)
- Mahmoud Abdel-Salam
- Faculty of Computer and Information Science, Mansoura University, Mansoura, 35516, Egypt.
| | - Gang Hu
- Department of Applied Mathematics, Xi'an University of Technology, Xi'an, 710054, PR China
| | - Emre Çelik
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Düzce University, Düzce, Turkey
| | | | - Ibrahim M El-Hasnony
- Faculty of Computer and Information Science, Mansoura University, Mansoura, 35516, Egypt
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2
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Lima TE, Ferraz MVF, Brito CAA, Ximenes PB, Mariz CA, Braga C, Wallau GL, Viana IFT, Lins RD. Determination of prognostic markers for COVID-19 disease severity using routine blood tests and machine learning. AN ACAD BRAS CIENC 2024; 96:e20230894. [PMID: 38922277 DOI: 10.1590/0001-376520242023089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/22/2024] [Indexed: 06/27/2024] Open
Abstract
The need for the identification of risk factors associated to COVID-19 disease severity remains urgent. Patients' care and resource allocation can be potentially different and are defined based on the current classification of disease severity. This classification is based on the analysis of clinical parameters and routine blood tests, which are not standardized across the globe. Some laboratory test alterations have been associated to COVID-19 severity, although these data are conflicting partly due to the different methodologies used across different studies. This study aimed to construct and validate a disease severity prediction model using machine learning (ML). Seventy-two patients admitted to a Brazilian hospital and diagnosed with COVID-19 through RT-PCR and/or ELISA, and with varying degrees of disease severity, were included in the study. Their electronic medical records and the results from daily blood tests were used to develop a ML model to predict disease severity. Using the above data set, a combination of five laboratorial biomarkers was identified as accurate predictors of COVID-19 severe disease with a ROC-AUC of 0.80 ± 0.13. Those biomarkers included prothrombin activity, ferritin, serum iron, ATTP and monocytes. The application of the devised ML model may help rationalize clinical decision and care.
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Affiliation(s)
- Tayná E Lima
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Virologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
| | - Matheus V F Ferraz
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Virologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
- Universidade Federal de Pernambuco, Departamento de Química Fundamental, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-560 Recife, PE, Brazil
| | - Carlos A A Brito
- Universidade Federal de Pernambuco, Hospital das Clínicas, Av. Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
| | - Pamella B Ximenes
- Hospital dos Servidores Públicos do Estado de Pernambuco, Av. Conselheiro Rosa e Silva, s/n, Espinheiro, 52020-020 Recife, PE, Brazil
| | - Carolline A Mariz
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Parasitologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
| | - Cynthia Braga
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Parasitologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
| | - Gabriel L Wallau
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Entomologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
| | - Isabelle F T Viana
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Virologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
| | - Roberto D Lins
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Virologia, Av. Professor Moraes Rego, s/n, Cidade Universitária, 50740-465 Recife, PE, Brazil
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3
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Gomes VMR, Pires MC, Delfino Pereira P, Schwarzbold AV, Gomes AGDR, Pessoa BP, Cimini CCR, Rios DRA, Anschau F, Nascimento FJM, Grizende GMS, Vietta GG, Batista JDL, Ruschel KB, Carneiro M, Reis MA, Bicalho MAC, Porto PF, Reis PPD, Araújo SF, Nobre V, Marcolino MS. AB 2CO risk score for in-hospital mortality of COVID-19 patients admitted to intensive care units. Respir Med 2024; 227:107635. [PMID: 38641122 DOI: 10.1016/j.rmed.2024.107635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 04/07/2024] [Accepted: 04/11/2024] [Indexed: 04/21/2024]
Abstract
PURPOSE To develop a mortality risk score for COVID-19 patients admitted to intensive care units (ICU), and to compare it with other existing scores. MATERIALS AND METHODS This retrospective observational study included consecutive adult patients with laboratory-confirmed COVID-19 admitted to ICUs of 18 hospitals from nine Brazilian cities, from September 2021 to July 2022. Potential predictors were selected based on the literature review. Generalized Additive Models were used to examine outcomes and predictors. LASSO regression was used to derive the mortality score. RESULTS From 558 patients, median age was 69 years (IQR 58-78), 56.3 % were men, 19.7 % required mechanical ventilation (MV), and 44.8 % died. The final model comprised six variables: age, pO2/FiO2, respiratory function (respiratory rate or if in MV), chronic obstructive pulmonary disease, and obesity. The AB2CO had an AUROC of 0.781 (95 % CI 0.744 to 0.819), good overall performance (Brier score = 0.191) and an excellent calibration (slope = 1.063, intercept = 0.015, p-value = 0.834). The model was compared with other scores and displayed better discrimination ability than the majority of them. CONCLUSIONS The AB2CO score is a fast and easy tool to be used upon ICU admission.
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Affiliation(s)
- Virginia Mara Reis Gomes
- Medical School and University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil.
| | - Magda Carvalho Pires
- Statistics Department, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil.
| | - Polianna Delfino Pereira
- Medical School and University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil.
| | | | | | - Bruno Porto Pessoa
- Hospital Julia Kubitschek, R. Dr. Cristiano Rezende, 2745, Belo Horizonte, Brazil.
| | | | - Danyelle Romana Alves Rios
- Hospital São João de Deus, R. Do Cobre, 800, São João de Deus, Brazil; Universidade Federal de São João del-Rei. R. Sebastião Gonçalves Coelho, 400, Divinópolis, Brazil.
| | - Fernando Anschau
- Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil.
| | | | | | | | - Joanna d'Arc Lyra Batista
- Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil; Medical School, Federal University of Fronteira Sul, Rod. SC 484 - Km 02, Chapecó, Brazil; Hospital Regional Do Oeste, R. Florianópolis, 1448 E, Chapecó, Brazil.
| | | | - Marcelo Carneiro
- Hospital Santa Cruz, R. Fernando Abott, 174, Santa Cruz Do Sul, Brazil.
| | - Marco Aurélio Reis
- Hospital Risoleta Tolentino Neves, R. Das Gabirobas, 01, Belo Horizonte, Brazil.
| | - Maria Aparecida Camargos Bicalho
- Medical School and University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil; Fundação Hospitalar Do Estado de Minas Gerais - FHEMIG. Cidade Administrativa de Minas Gerais, Edifício Gerais - 13° Andar, Rod. Papa João Paulo II, 3777, Belo Horizonte, Brazil.
| | - Paula Fonseca Porto
- Hospital Metropolitano Odilon Behrens, R. Formiga, 50, Belo Horizonte, Brazil.
| | | | | | - Vandack Nobre
- Medical School and University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil.
| | - Milena Soriano Marcolino
- Medical School and University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 110, Belo Horizonte, Brazil.
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Natanov D, Avihai B, McDonnell E, Lee E, Cook B, Altomare N, Ko T, Chaia A, Munoz C, Ouellette S, Nyalakonda S, Cederbaum V, Parikh PD, Blaser MJ. Predicting COVID-19 prognosis in hospitalized patients based on early status. mBio 2023; 14:e0150823. [PMID: 37681966 PMCID: PMC10653946 DOI: 10.1128/mbio.01508-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 09/09/2023] Open
Abstract
IMPORTANCE COVID-19 remains the fourth leading cause of death in the United States. Predicting COVID-19 patient prognosis is essential to help efficiently allocate resources, including ventilators and intensive care unit beds, particularly when hospital systems are strained. Our PLABAC and PRABLE models are unique because they accurately assess a COVID-19 patient's risk of death from only age and five commonly ordered laboratory tests. This simple design is important because it allows these models to be used by clinicians to rapidly assess a patient's risk of decompensation and serve as a real-time aid when discussing difficult, life-altering decisions for patients. Our models have also shown generalizability to external populations across the United States. In short, these models are practical, efficient tools to assess and communicate COVID-19 prognosis.
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Affiliation(s)
- David Natanov
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Byron Avihai
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Erin McDonnell
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Eileen Lee
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Brennan Cook
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Nicole Altomare
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Tomohiro Ko
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Angelo Chaia
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Carolayn Munoz
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | | | - Suraj Nyalakonda
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Vanessa Cederbaum
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Payal D. Parikh
- Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Martin J. Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey, USA
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Thakur A, Sharma V, Averbek S, Liang L, Pandya N, Kumar G, Cili A, Zhang K. Immune landscape and redox imbalance during neurological disorders in COVID-19. Cell Death Dis 2023; 14:593. [PMID: 37673862 PMCID: PMC10482955 DOI: 10.1038/s41419-023-06102-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19) has prompted the scientific community to explore potential treatments or vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the illness. While SARS-CoV-2 is mostly considered a respiratory pathogen, several neurological complications have been reported, raising questions about how it may enter the Central Nervous System (CNS). Receptors such as ACE2, CD147, TMPRSS2, and NRP1 have been identified in brain cells and may be involved in facilitating SARS-CoV-2 entry into the CNS. Moreover, proteins like P2X7 and Panx-1 may contribute to the pathogenesis of COVID-19. Additionally, the role of the immune system in the gravity of COVID-19 has been investigated with respect to both innate and adaptive immune responses caused by SARS-CoV-2 infection, which can lead to a cytokine storm, tissue damage, and neurological manifestations. A redox imbalance has also been linked to the pathogenesis of COVID-19, potentially causing mitochondrial dysfunction, and generating proinflammatory cytokines. This review summarizes different mechanisms of reactive oxygen species and neuro-inflammation that may contribute to the development of severe COVID-19, and recent progress in the study of immunological events and redox imbalance in neurological complications of COVID-19, and the role of bioinformatics in the study of neurological implications of COVID-19.
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Affiliation(s)
- Abhimanyu Thakur
- Centre for Regenerative Medicine and Health, Hong Kong Institute of Science and Innovation-CAS Limited, Hong Kong SAR, Hong Kong.
| | - Vartika Sharma
- Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sera Averbek
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- Technische Universität Darmstadt, Darmstadt, Germany
| | - Lifan Liang
- University of Pittsburgh, Pittsburgh, PA, USA
| | - Nirali Pandya
- Department of Chemistry, Faculty of Sciences, National University of Singapore, Singapore, Singapore
| | - Gaurav Kumar
- School of Biosciences and Biomedical Engineering, Department of Clinical Research, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Alma Cili
- Clinic of Hematology, University of Medicine, University Hospital center "Mother Teresa", Tirane, Albania
| | - Kui Zhang
- State Key Laboratory of Resource Insects, College of Sericulture, Textile and Biomass sciences, Southwest University, Chongqing, China.
- Cancer Centre, Medical Research Institute, Southwest University, Chongqing, China.
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6
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Chen R, Chen J, Yang S, Luo S, Xiao Z, Lu L, Liang B, Liu S, Shi H, Xu J. Prediction of prognosis in COVID-19 patients using machine learning: A systematic review and meta-analysis. Int J Med Inform 2023; 177:105151. [PMID: 37473658 DOI: 10.1016/j.ijmedinf.2023.105151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/07/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Accurate prediction of prognostic outcomes in patients with COVID-19 could facilitate clinical decision-making and medical resource allocation. However, little is known about the ability of machine learning (ML) to predict prognosis in COVID-19 patients. OBJECTIVE This study aimed to systematically examine the prognostic value of ML in patients with COVID-19. METHODS A systematic search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and IEEE Xplore up to December 15, 2021. Studies predicting the prognostic outcomes of COVID-19 patients using ML were eligible for inclusion. Risk of bias was evaluated by a tailored checklist based on Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Pooled sensitivity, specificity, and area under the receiver operating curve (AUC) were calculated to evaluate model performance. RESULTS A total of 33 studies that described 35 models were eligible for inclusion, with 27 models presenting mortality, four intensive care unit (ICU) admission, and four use of ventilation. For predicting mortality, ML gave a pooled sensitivity of 0.86 (95% CI, 0.79-0.90), a specificity of 0.87 (95% CI, 0.80-0.92), and an AUC of 0.93 (95% CI, 0.90-0.95). For the prediction of ICU admission, ML had a sensitivity of 0.86 (95% CI, 0.78-0.92), a specificity of 0.81 (95% CI, 0.66-0.91), and an AUC of 0.91 (95% CI, 0.88-0.93). For the prediction of ventilation, ML had a sensitivity of 0.81 (95% CI, 0.68-0.90), a specificity of 0.78 (95% CI, 0.66-0.87), and an AUC of 0.87 (95% CI, 0.83-0.89). Meta-regression analyses indicated that algorithm, population, study design, and source of dataset influenced the pooled estimate. CONCLUSION This meta-analysis demonstrated the satisfactory performance of ML in predicting prognostic outcomes in patients with COVID-19, suggesting the potential value of ML to support clinical decision-making. However, improvements to methodology and validation are still necessary before its application in routine clinical practice.
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Affiliation(s)
- Ruiyao Chen
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Jiayuan Chen
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Sen Yang
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Shuqing Luo
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Zhongzhou Xiao
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Lu Lu
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Bilin Liang
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | | | - Huwei Shi
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Jie Xu
- Shanghai Artificial Intelligence Laboratory, Shanghai, China.
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7
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Mehrpour O, Saeedi F, Abdollahi J, Amirabadizadeh A, Goss F. The value of machine learning for prognosis prediction of diphenhydramine exposure: National analysis of 50,000 patients in the United States. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2023; 28:49. [PMID: 37496638 PMCID: PMC10366979 DOI: 10.4103/jrms.jrms_602_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/14/2023] [Accepted: 03/27/2023] [Indexed: 07/28/2023]
Abstract
Background Diphenhydramine (DPH) is an antihistamine medication that in overdose can result in anticholinergic symptoms and serious complications, including arrhythmia and coma. We aimed to compare the value of various machine learning (ML) models, including light gradient boosting machine (LGBM), logistic regression (LR), and random forest (RF), in the outcome prediction of DPH poisoning. Materials and Methods We used the National Poison Data System database and included all of the human exposures of DPH from January 01, 2017 to December 31, 2017, and excluded those cases with missing information, duplicated cases, and those who reported co-ingestion. Data were split into training and test datasets, and three ML models were compared. We developed confusion matrices for each, and standard performance metrics were calculated. Results Our study population included 53,761 patients with DPH exposure. The most common reasons for exposure, outcome, chronicity of exposure, and formulation were captured. Our results showed that the average precision-recall area under the curve (AUC) of 0.84. LGBM and RF had the highest performance (average AUC of 0.91), followed by LR (average AUC of 0.90). The specificity of the models was 87.0% in the testing groups. The precision of models was 75.0%. Recall (sensitivity) of models ranged between 73% and 75% with an F1 score of 75.0%. The overall accuracy of LGBM, LR, and RF models in the test dataset was 74.8%, 74.0%, and 75.1%, respectively. In total, just 1.1% of patients (mostly those with major outcomes) received physostigmine. Conclusion Our study demonstrates the application of ML in the prediction of DPH poisoning.
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Affiliation(s)
- Omid Mehrpour
- Michigan Poison & Drug Information Center, Wayne State University School of Medicine, Detroit, Michigan, United States
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Farhad Saeedi
- Medical Toxicology and Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Jafar Abdollahi
- Department of Computer Engineering, Ardabil Branch, Islamic Azad University, Ardabil, Iran
| | - Alireza Amirabadizadeh
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Foster Goss
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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8
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Abbasi Habashi S, Koyuncu M, Alizadehsani R. A Survey of COVID-19 Diagnosis Using Routine Blood Tests with the Aid of Artificial Intelligence Techniques. Diagnostics (Basel) 2023; 13:1749. [PMID: 37238232 PMCID: PMC10217633 DOI: 10.3390/diagnostics13101749] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), causing a disease called COVID-19, is a class of acute respiratory syndrome that has considerably affected the global economy and healthcare system. This virus is diagnosed using a traditional technique known as the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. However, RT-PCR customarily outputs a lot of false-negative and incorrect results. Current works indicate that COVID-19 can also be diagnosed using imaging resolutions, including CT scans, X-rays, and blood tests. Nevertheless, X-rays and CT scans cannot always be used for patient screening because of high costs, radiation doses, and an insufficient number of devices. Therefore, there is a requirement for a less expensive and faster diagnostic model to recognize the positive and negative cases of COVID-19. Blood tests are easily performed and cost less than RT-PCR and imaging tests. Since biochemical parameters in routine blood tests vary during the COVID-19 infection, they may supply physicians with exact information about the diagnosis of COVID-19. This study reviewed some newly emerging artificial intelligence (AI)-based methods to diagnose COVID-19 using routine blood tests. We gathered information about research resources and inspected 92 articles that were carefully chosen from a variety of publishers, such as IEEE, Springer, Elsevier, and MDPI. Then, these 92 studies are classified into two tables which contain articles that use machine Learning and deep Learning models to diagnose COVID-19 while using routine blood test datasets. In these studies, for diagnosing COVID-19, Random Forest and logistic regression are the most widely used machine learning methods and the most widely used performance metrics are accuracy, sensitivity, specificity, and AUC. Finally, we conclude by discussing and analyzing these studies which use machine learning and deep learning models and routine blood test datasets for COVID-19 detection. This survey can be the starting point for a novice-/beginner-level researcher to perform on COVID-19 classification.
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Affiliation(s)
| | - Murat Koyuncu
- Department of Information Systems Engineering, Atilim University, 06830 Ankara, Turkey;
| | - Roohallah Alizadehsani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Waurn Ponds, Geelong, VIC 3216, Australia
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9
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Cabrera Alvargonzález J, Larrañaga Janeiro A, Pérez Castro S, Martínez Torres J, Martínez Lamas L, Daviña Nuñez C, Del Campo-Pérez V, Suarez Luque S, Regueiro García B, Porteiro Fresco J. Proof of concept of the potential of a machine learning algorithm to extract new information from conventional SARS-CoV-2 rRT-PCR results. Sci Rep 2023; 13:7786. [PMID: 37179356 PMCID: PMC10182547 DOI: 10.1038/s41598-023-34882-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/09/2023] [Indexed: 05/15/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been and remains one of the major challenges modern society has faced thus far. Over the past few months, large amounts of information have been collected that are only now beginning to be assimilated. In the present work, the existence of residual information in the massive numbers of rRT-PCRs that tested positive out of the almost half a million tests that were performed during the pandemic is investigated. This residual information is believed to be highly related to a pattern in the number of cycles that are necessary to detect positive samples as such. Thus, a database of more than 20,000 positive samples was collected, and two supervised classification algorithms (a support vector machine and a neural network) were trained to temporally locate each sample based solely and exclusively on the number of cycles determined in the rRT-PCR of each individual. Overall, this study suggests that there is valuable residual information in the rRT-PCR positive samples that can be used to identify patterns in the development of the SARS-CoV-2 pandemic. The successful application of supervised classification algorithms to detect these patterns demonstrates the potential of machine learning techniques to aid in understanding the spread of the virus and its variants.
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Affiliation(s)
- Jorge Cabrera Alvargonzález
- Microbiology and Infectology Research Group, Galicia sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Microbiology Department, Complexo Hospitalario Universitario de Vigo (CHUVI), Sergas, Vigo, Spain
- Universidade de Vigo, Vigo, Spain
| | | | - Sonia Pérez Castro
- Microbiology and Infectology Research Group, Galicia sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Microbiology Department, Complexo Hospitalario Universitario de Vigo (CHUVI), Sergas, Vigo, Spain
- Universidade de Vigo, Vigo, Spain
| | - Javier Martínez Torres
- Applied Mathematics I, Telecommunications Engineering School, Universidad de Vigo, 36310, Vigo, Spain
| | - Lucía Martínez Lamas
- Microbiology and Infectology Research Group, Galicia sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Microbiology Department, Complexo Hospitalario Universitario de Vigo (CHUVI), Sergas, Vigo, Spain
| | - Carlos Daviña Nuñez
- Microbiology and Infectology Research Group, Galicia sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Víctor Del Campo-Pérez
- Department of Preventive Medicine and Public Health, Álvaro Cunqueiro Hospital, Vigo, Pontevedra, Spain
| | - Silvia Suarez Luque
- Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, A Coruña, Spain
| | - Benito Regueiro García
- Microbiology and Infectology Research Group, Galicia sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Microbiology Department, Complexo Hospitalario Universitario de Vigo (CHUVI), Sergas, Vigo, Spain
- Microbiology and Parasitology Department, Medicine and Odontology, Universidade de Santiago, Santiago de Compostela, Spain
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10
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Ortiz-Barrios M, Arias-Fonseca S, Ishizaka A, Barbati M, Avendaño-Collante B, Navarro-Jiménez E. Artificial intelligence and discrete-event simulation for capacity management of intensive care units during the Covid-19 pandemic: A case study. JOURNAL OF BUSINESS RESEARCH 2023; 160:113806. [PMID: 36895308 PMCID: PMC9981538 DOI: 10.1016/j.jbusres.2023.113806] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/18/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The Covid-19 pandemic has pushed the Intensive Care Units (ICUs) into significant operational disruptions. The rapid evolution of this disease, the bed capacity constraints, the wide variety of patient profiles, and the imbalances within health supply chains still represent a challenge for policymakers. This paper aims to use Artificial Intelligence (AI) and Discrete-Event Simulation (DES) to support ICU bed capacity management during Covid-19. The proposed approach was validated in a Spanish hospital chain where we initially identified the predictors of ICU admission in Covid-19 patients. Second, we applied Random Forest (RF) to predict ICU admission likelihood using patient data collected in the Emergency Department (ED). Finally, we included the RF outcomes in a DES model to assist decision-makers in evaluating new ICU bed configurations responding to the patient transfer expected from downstream services. The results evidenced that the median bed waiting time declined between 32.42 and 48.03 min after intervention.
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Affiliation(s)
- Miguel Ortiz-Barrios
- Department of Productivity and Innovation, Universidad de la Costa CUC, Barranquilla 080002, Colombia
| | - Sebastián Arias-Fonseca
- Department of Productivity and Innovation, Universidad de la Costa CUC, Barranquilla 080002, Colombia
| | - Alessio Ishizaka
- NEOMA Business School, 1 rue du Maréchal Juin, Mont-Saint-Aignan 76130, France
| | - Maria Barbati
- Department of Economics, University Ca' Foscari, Cannaregio 873, Fondamenta San Giobbe, 30121 Venice, Italy
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11
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Buttia C, Llanaj E, Raeisi-Dehkordi H, Kastrati L, Amiri M, Meçani R, Taneri PE, Ochoa SAG, Raguindin PF, Wehrli F, Khatami F, Espínola OP, Rojas LZ, de Mortanges AP, Macharia-Nimietz EF, Alijla F, Minder B, Leichtle AB, Lüthi N, Ehrhard S, Que YA, Fernandes LK, Hautz W, Muka T. Prognostic models in COVID-19 infection that predict severity: a systematic review. Eur J Epidemiol 2023; 38:355-372. [PMID: 36840867 PMCID: PMC9958330 DOI: 10.1007/s10654-023-00973-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/28/2023] [Indexed: 02/26/2023]
Abstract
Current evidence on COVID-19 prognostic models is inconsistent and clinical applicability remains controversial. We performed a systematic review to summarize and critically appraise the available studies that have developed, assessed and/or validated prognostic models of COVID-19 predicting health outcomes. We searched six bibliographic databases to identify published articles that investigated univariable and multivariable prognostic models predicting adverse outcomes in adult COVID-19 patients, including intensive care unit (ICU) admission, intubation, high-flow nasal therapy (HFNT), extracorporeal membrane oxygenation (ECMO) and mortality. We identified and assessed 314 eligible articles from more than 40 countries, with 152 of these studies presenting mortality, 66 progression to severe or critical illness, 35 mortality and ICU admission combined, 17 ICU admission only, while the remaining 44 studies reported prediction models for mechanical ventilation (MV) or a combination of multiple outcomes. The sample size of included studies varied from 11 to 7,704,171 participants, with a mean age ranging from 18 to 93 years. There were 353 prognostic models investigated, with area under the curve (AUC) ranging from 0.44 to 0.99. A great proportion of studies (61.5%, 193 out of 314) performed internal or external validation or replication. In 312 (99.4%) studies, prognostic models were reported to be at high risk of bias due to uncertainties and challenges surrounding methodological rigor, sampling, handling of missing data, failure to deal with overfitting and heterogeneous definitions of COVID-19 and severity outcomes. While several clinical prognostic models for COVID-19 have been described in the literature, they are limited in generalizability and/or applicability due to deficiencies in addressing fundamental statistical and methodological concerns. Future large, multi-centric and well-designed prognostic prospective studies are needed to clarify remaining uncertainties.
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Affiliation(s)
- Chepkoech Buttia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Emergency Department, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16C, 3010 Bern, Switzerland
- Epistudia, Bern, Switzerland
| | - Erand Llanaj
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
- ELKH-DE Public Health Research Group of the Hungarian Academy of Sciences, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Epistudia, Bern, Switzerland
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Hamidreza Raeisi-Dehkordi
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lum Kastrati
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mojgan Amiri
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Renald Meçani
- Department of Pediatrics, “Mother Teresa” University Hospital Center, Tirana, University of Medicine, Tirana, Albania
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Petek Eylul Taneri
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- HRB-Trials Methodology Research Network College of Medicine, Nursing and Health Sciences University of Galway, Galway, Ireland
| | | | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences, University of Lucerne, Lucerne, Switzerland
| | - Faina Wehrli
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Farnaz Khatami
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Octavio Pano Espínola
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Preventive Medicine and Public Health, University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Lyda Z. Rojas
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Center, Cardiovascular Foundation of Colombia, Floridablanca, Santander, Colombia
| | | | | | - Fadi Alijla
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Beatrice Minder
- Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Alexander B. Leichtle
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, and Center for Artificial Intelligence in Medicine (CAIM), University of Bern, Bern, Switzerland
| | - Nora Lüthi
- Emergency Department, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16C, 3010 Bern, Switzerland
| | - Simone Ehrhard
- Emergency Department, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16C, 3010 Bern, Switzerland
| | - Yok-Ai Que
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Laurenz Kopp Fernandes
- Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Wolf Hautz
- Emergency Department, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16C, 3010 Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
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12
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Gürsoy E, Kaya Y. An overview of deep learning techniques for COVID-19 detection: methods, challenges, and future works. MULTIMEDIA SYSTEMS 2023; 29:1603-1627. [PMID: 37261262 PMCID: PMC10039775 DOI: 10.1007/s00530-023-01083-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/20/2023] [Indexed: 06/02/2023]
Abstract
The World Health Organization (WHO) declared a pandemic in response to the coronavirus COVID-19 in 2020, which resulted in numerous deaths worldwide. Although the disease appears to have lost its impact, millions of people have been affected by this virus, and new infections still occur. Identifying COVID-19 requires a reverse transcription-polymerase chain reaction test (RT-PCR) or analysis of medical data. Due to the high cost and time required to scan and analyze medical data, researchers are focusing on using automated computer-aided methods. This review examines the applications of deep learning (DL) and machine learning (ML) in detecting COVID-19 using medical data such as CT scans, X-rays, cough sounds, MRIs, ultrasound, and clinical markers. First, the data preprocessing, the features used, and the current COVID-19 detection methods are divided into two subsections, and the studies are discussed. Second, the reported publicly available datasets, their characteristics, and the potential comparison materials mentioned in the literature are presented. Third, a comprehensive comparison is made by contrasting the similar and different aspects of the studies. Finally, the results, gaps, and limitations are summarized to stimulate the improvement of COVID-19 detection methods, and the study concludes by listing some future research directions for COVID-19 classification.
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Affiliation(s)
- Ercan Gürsoy
- Department of Computer Engineering, Adana Alparslan Turkes Science and Technology University, 01250 Adana, Turkey
| | - Yasin Kaya
- Department of Computer Engineering, Adana Alparslan Turkes Science and Technology University, 01250 Adana, Turkey
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13
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Ceccon DM, Amaral PHR, Andrade LM, da Silva MIN, Andrade LAF, Moraes TFS, Bagno FF, Rocha RP, de Almeida Marques DP, Ferreira GM, Lourenço AA, Ribeiro ÁL, Coelho-dos-Reis JGA, da Fonseca FG, Gonzalez JC. New, fast, and precise method of COVID-19 detection in nasopharyngeal and tracheal aspirate samples combining optical spectroscopy and machine learning. Braz J Microbiol 2023:10.1007/s42770-023-00923-5. [PMID: 36854899 PMCID: PMC9974055 DOI: 10.1007/s42770-023-00923-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
Fast, precise, and low-cost diagnostic testing to identify persons infected with SARS-CoV-2 virus is pivotal to control the global pandemic of COVID-19 that began in late 2019. The gold standard method of diagnostic recommended is the RT-qPCR test. However, this method is not universally available, and is time-consuming and requires specialized personnel, as well as sophisticated laboratories. Currently, machine learning is a useful predictive tool for biomedical applications, being able to classify data from diverse nature. Relying on the artificial intelligence learning process, spectroscopic data from nasopharyngeal swab and tracheal aspirate samples can be used to leverage characteristic patterns and nuances in healthy and infected body fluids, which allows to identify infection regardless of symptoms or any other clinical or laboratorial tests. Hence, when new measurements are performed on samples of unknown status and the corresponding data is submitted to such an algorithm, it will be possible to predict whether the source individual is infected or not. This work presents a new methodology for rapid and precise label-free diagnosing of SARS-CoV-2 infection in clinical samples, which combines spectroscopic data acquisition and analysis via artificial intelligence algorithms. Our results show an accuracy of 85% for detection of SARS-CoV-2 in nasopharyngeal swab samples collected from asymptomatic patients or with mild symptoms, as well as an accuracy of 97% in tracheal aspirate samples collected from critically ill COVID-19 patients under mechanical ventilation. Moreover, the acquisition and processing of the information is fast, simple, and cheaper than traditional approaches, suggesting this methodology as a promising tool for biomedical diagnosis vis-à-vis the emerging and re-emerging viral SARS-CoV-2 variant threats in the future.
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Affiliation(s)
- Denny M. Ceccon
- Departamento de Física, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Campus Pampulha 31270-901, Belo Horizonte, Minas Gerais 6627 Brazil
| | - Paulo Henrique R. Amaral
- Departamento de Física, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Campus Pampulha 31270-901, Belo Horizonte, Minas Gerais 6627 Brazil
| | - Lídia M. Andrade
- Departamento de Física, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Campus Pampulha 31270-901, Belo Horizonte, Minas Gerais 6627 Brazil
| | - Maria I. N. da Silva
- Departamento de Física, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Campus Pampulha 31270-901, Belo Horizonte, Minas Gerais 6627 Brazil
| | - Luis A. F. Andrade
- Centro de Tecnologia Em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thais F. S. Moraes
- Laboratório de Virologia Básica E Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Flavia F. Bagno
- Centro de Tecnologia Em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raissa P. Rocha
- Centro de Tecnologia Em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Geovane Marques Ferreira
- Laboratório de Virologia Básica E Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alice Aparecida Lourenço
- Laboratório de Virologia Básica E Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ágata Lopes Ribeiro
- Laboratório de Virologia Básica E Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jordana G. A. Coelho-dos-Reis
- Laboratório de Virologia Básica E Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Flavio G. da Fonseca
- Centro de Tecnologia Em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil ,Laboratório de Virologia Básica E Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - J. C. Gonzalez
- Departamento de Física, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Campus Pampulha 31270-901, Belo Horizonte, Minas Gerais 6627 Brazil
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14
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Barough SS, Safavi-Naini SAA, Siavoshi F, Tamimi A, Ilkhani S, Akbari S, Ezzati S, Hatamabadi H, Pourhoseingholi MA. Generalizable machine learning approach for COVID-19 mortality risk prediction using on-admission clinical and laboratory features. Sci Rep 2023; 13:2399. [PMID: 36765157 PMCID: PMC9911952 DOI: 10.1038/s41598-023-28943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/27/2023] [Indexed: 02/12/2023] Open
Abstract
We aimed to propose a mortality risk prediction model using on-admission clinical and laboratory predictors. We used a dataset of confirmed COVID-19 patients admitted to three general hospitals in Tehran. Clinical and laboratory values were gathered on admission. Six different machine learning models and two feature selection methods were used to assess the risk of in-hospital mortality. The proposed model was selected using the area under the receiver operator curve (AUC). Furthermore, a dataset from an additional hospital was used for external validation. 5320 hospitalized COVID-19 patients were enrolled in the study, with a mortality rate of 17.24% (N = 917). Among 82 features, ten laboratories and 27 clinical features were selected by LASSO. All methods showed acceptable performance (AUC > 80%), except for K-nearest neighbor. Our proposed deep neural network on features selected by LASSO showed AUC scores of 83.4% and 82.8% in internal and external validation, respectively. Furthermore, our imputer worked efficiently when two out of ten laboratory parameters were missing (AUC = 81.8%). We worked intimately with healthcare professionals to provide a tool that can solve real-world needs. Our model confirmed the potential of machine learning methods for use in clinical practice as a decision-support system.
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Affiliation(s)
- Siavash Shirzadeh Barough
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Ahmad Safavi-Naini
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Siavoshi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atena Tamimi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Ilkhani
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Setareh Akbari
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadaf Ezzati
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Hatamabadi
- Department of Emergency Medicine, School of Medicine, Safety Promotion and Injury Prevention Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Amin Pourhoseingholi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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15
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Cardiovascular and Renal Comorbidities Included into Neural Networks Predict the Outcome in COVID-19 Patients Admitted to an Intensive Care Unit: Three-Center, Cross-Validation, Age- and Sex-Matched Study. J Cardiovasc Dev Dis 2023; 10:jcdd10020039. [PMID: 36826535 PMCID: PMC9967447 DOI: 10.3390/jcdd10020039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Here, we performed a multicenter, age- and sex-matched study to compare the efficiency of various machine learning algorithms in the prediction of COVID-19 fatal outcomes and to develop sensitive, specific, and robust artificial intelligence tools for the prompt triage of patients with severe COVID-19 in the intensive care unit setting. In a challenge against other established machine learning algorithms (decision trees, random forests, extra trees, neural networks, k-nearest neighbors, and gradient boosting: XGBoost, LightGBM, and CatBoost) and multivariate logistic regression as a reference, neural networks demonstrated the highest sensitivity, sufficient specificity, and excellent robustness. Further, neural networks based on coronary artery disease/chronic heart failure, stage 3-5 chronic kidney disease, blood urea nitrogen, and C-reactive protein as the predictors exceeded 90% sensitivity and 80% specificity, reaching AUROC of 0.866 at primary cross-validation and 0.849 at secondary cross-validation on virtual samples generated by the bootstrapping procedure. These results underscore the impact of cardiovascular and renal comorbidities in the context of thrombotic complications characteristic of severe COVID-19. As aforementioned predictors can be obtained from the case histories or are inexpensive to be measured at admission to the intensive care unit, we suggest this predictor composition is useful for the triage of critically ill COVID-19 patients.
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16
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Wichmann RM, Fernandes FT, Chiavegatto Filho ADP, de Brito AMES, Nunes BP, Silva DLE, Anschau F, de Castro Rodrigues H, Rocha HAL, dos Reis JCB, de Oliveira Cavalcante L, de Oliveira LP, dos Santos Andrade LS, Nasi LA, de Maria Felix M, Mimica MJ, de Almeida Araujo ME, Arnoni MV, Vianna RB, Junior RMM, da Penha RV, Vicente RN, de Lima RF, Batista SR, Nunes SF, de Macedo TTS, Nuno VLES. Improving the performance of machine learning algorithms for health outcomes predictions in multicentric cohorts. Sci Rep 2023; 13:1022. [PMID: 36658181 PMCID: PMC9849836 DOI: 10.1038/s41598-022-26467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
Machine learning algorithms are being increasingly used in healthcare settings but their generalizability between different regions is still unknown. This study aims to identify the strategy that maximizes the predictive performance of identifying the risk of death by COVID-19 in different regions of a large and unequal country. This is a multicenter cohort study with data collected from patients with a positive RT-PCR test for COVID-19 from March to August 2020 (n = 8477) in 18 hospitals, covering all five Brazilian regions. Of all patients with a positive RT-PCR test during the period, 2356 (28%) died. Eight different strategies were used for training and evaluating the performance of three popular machine learning algorithms (extreme gradient boosting, lightGBM, and catboost). The strategies ranged from only using training data from a single hospital, up to aggregating patients by their geographic regions. The predictive performance of the algorithms was evaluated by the area under the ROC curve (AUROC) on the test set of each hospital. We found that the best overall predictive performances were obtained when using training data from the same hospital, which was the winning strategy for 11 (61%) of the 18 participating hospitals. In this study, the use of more patient data from other regions slightly decreased predictive performance. However, models trained in other hospitals still had acceptable performances and could be a solution while data for a specific hospital is being collected.
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Affiliation(s)
- Roberta Moreira Wichmann
- School of Public Health, University of São Paulo, São Paulo, SP, Brazil. .,Brazilian Institute of Education, Development and Research-IDP, Economics Graduate Program, Brasilia, DF, Brazil.
| | - Fernando Timoteo Fernandes
- School of Public Health, University of São Paulo, São Paulo, SP, Brazil.,Fundacentro, São Paulo, SP, Brazil
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17
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Jeyananthan P. SARS-CoV-2 Diagnosis Using Transcriptome Data: A Machine Learning Approach. SN COMPUTER SCIENCE 2023; 4:218. [PMID: 36844504 PMCID: PMC9936926 DOI: 10.1007/s42979-023-01703-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 01/24/2023] [Indexed: 05/02/2023]
Abstract
SARS-CoV-2 pandemic is the big issue of the whole world right now. The health community is struggling to rescue the public and countries from this spread, which revives time to time with different waves. Even the vaccination seems to be not prevents this spread. Accurate identification of infected people on time is essential these days to control the spread. So far, Polymerase chain reaction (PCR) and rapid antigen tests are widely used in this identification, accepting their own drawbacks. False negative cases are the menaces in this scenario. To avoid these problems, this study uses machine learning techniques to build a classification model with higher accuracy to filter the COVID-19 cases from the non-COVID individuals. Transcriptome data of the SARS-CoV-2 patients along with the control are used in this stratification using three different feature selection algorithms and seven classification models. Differently expressed genes also studied between these two groups of people and used in this classification. Results shows that mutual information (or DEGs) along with naïve Bayes (or SVM) gives the best accuracy (0.98 ± 0.04) among these methods. Supplementary Information The online version contains supplementary material available at 10.1007/s42979-023-01703-6.
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18
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Foucrier A, Perrio J, Grisel J, Crépey P, Gayat E, Vieillard-Baron A, Batteux F, Gauss T, Squara P, Lo SH, Wargon M, Hellmann R. Transition matrices model as a way to better understand and predict intra-hospital pathways of covid-19 patients. Sci Rep 2022; 12:17508. [PMID: 36266423 PMCID: PMC9584905 DOI: 10.1038/s41598-022-22227-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 10/11/2022] [Indexed: 01/12/2023] Open
Abstract
Since January 2020, the SARS-CoV-2 pandemic has severely affected hospital systems worldwide. In Europe, the first 3 epidemic waves (periods) have been the most severe in terms of number of infected and hospitalized patients. There are several descriptions of the demographic and clinical profiles of patients with COVID-19, but few studies of their hospital pathways. We used transition matrices, constructed from Markov chains, to illustrate the transition probabilities between different hospital wards for 90,834 patients between March 2020 and July 2021 managed in Paris area. We identified 3 epidemic periods (waves) during which the number of hospitalized patients was significantly high. Between the 3 periods, the main differences observed were: direct admission to ICU, from 14 to 18%, mortality from ICU, from 28 to 24%, length of stay (alive patients), from 9 to 7 days from CH and from 18 to 10 days from ICU. The proportion of patients transferred from CH to ICU remained stable. Understanding hospital pathways of patients is crucial to better monitor and anticipate the impact of SARS-CoV-2 pandemic on health system.
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Affiliation(s)
- Arnaud Foucrier
- Ile-de-France Regional Health Agency, Paris, France ,grid.508487.60000 0004 7885 7602Hôpital Beaujon, DMU PARABOL, University of Paris, APHP, Paris, France
| | - Jules Perrio
- Data Science and Analytics Department, SESAN, Paris, France
| | - Johann Grisel
- Data Science and Analytics Department, SESAN, Paris, France
| | - Pascal Crépey
- grid.410368.80000 0001 2191 9284Ecole des Hautes Etudes en Santé Publique, REPERES (Recherche en Pharmaco-Epidémiologie et Recours Aux Soins), University of Rennes, EA 7449, Rennes, France
| | - Etienne Gayat
- grid.508487.60000 0004 7885 7602Department of Anaesthesiology and Critical Care, Hôpital Lariboisière, DMU PARABOL, University of Paris, Paris, France ,grid.508487.60000 0004 7885 7602Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions (MASCOT), University of Paris, Paris, France
| | - Antoine Vieillard-Baron
- grid.50550.350000 0001 2175 4109University Hospital Ambroise Paré, APHP, Boulogne-Billancourt, and Université de Versailles Saint Quentin en Yvelines UMR 1018, Boulogne-Billancourt, France
| | - Frédéric Batteux
- grid.508487.60000 0004 7885 7602Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Tobias Gauss
- grid.410529.b0000 0001 0792 4829Grenoble Alpes Trauma Centre, Pôle Anesthésie-Réanimation, CHU de Grenoble, La Tronche, France
| | - Pierre Squara
- grid.477172.0Department of Intensive Care and Cardiology, Clinique Ambroise Paré, Neuilly-Sur-Seine, France
| | - Seak-Hy Lo
- Ile-de-France Regional Health Agency, Paris, France
| | - Matthias Wargon
- grid.413961.80000 0004 0443 544XEmergency Department, Hôpital Delafontaine, Saint-Denis, France ,Observatoire Regional Des Soins Non Programmés-Ile-de-France, Saint-Denis, France
| | - Romain Hellmann
- Ile-de-France Regional Health Agency, Paris, France ,grid.50550.350000 0001 2175 4109Emergency Department, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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19
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Characteristics and risk factors for mortality in critically ill patients with COVID-19 receiving invasive mechanical ventilation: the experience of a private network in Sao Paulo, Brazil. J Crit Care Med (Targu Mures) 2022; 8:165-175. [PMID: 36062038 PMCID: PMC9396953 DOI: 10.2478/jccm-2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 06/12/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Introduction
The use of invasive mechanical ventilation (IMV) in COVID-19 represents in an incremental burden to healthcare systems.
Aim of the study
We aimed to characterize patients hospitalized for COVID-19 who received IMV and identify risk factors for mortality in this population.
Material and Methods
A retrospective cohort study including consecutive adult patients admitted to a private network in Brazil who received IMV from March to October, 2020. A bidirectional stepwise logistic regression analysis was used to determine the risk factors for mortality.
Results
We included 215 patients, of which 96 died and 119 were discharged from ICU. The mean age was 62.7 ± 15.4 years and the most important comorbidities were hypertension (62.8%), obesity (50.7%) and diabetes (40%). Non-survivors had lower body mass index (BMI) (28.3 [25.5; 31.6] vs. 31.2 [28.3; 35], p<0.001, and a shorter duration from symptom onset to intubation (8.5 [6.0; 12] days vs. 10 [8.0; 12.5] days, p = 0.005). Multivariable regression analysis showed that the risk factors for mortality were age (OR: 1.07, 95% CI: 1.03 to 1.1, p < 0.001), creatinine level at the intubation date (OR: 3.28, 95% CI: 1.47 to 7.33, p = 0.004), BMI (OR: 0.91, 95% CI: 0.84 to 0.99, p = 0.033), lowest PF ratio within 48 hours post-intubation (OR: 0.988, 95% CI: 0.979 to 0.997, p = 0.011), barotrauma (OR: 5.18, 95% CI: 1.14 to 23.65, p = 0.034) and duration from symptom onset to intubation (OR: 0.76, 95% CI: 0.76 to 0.95, p = 0.006).
Conclusion
In our retrospective cohort we identified the main risk factors for mortality in COVID-19 patients receiving IMV: age, creatinine at the day of intubation, BMI, lowest PF ratio 48-hours post-intubation, barotrauma and duration from symptom onset to intubation.
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20
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Gomes R, Kamrowski C, Langlois J, Rozario P, Dircks I, Grottodden K, Martinez M, Tee WZ, Sargeant K, LaFleur C, Haley M. A Comprehensive Review of Machine Learning Used to Combat COVID-19. Diagnostics (Basel) 2022; 12:diagnostics12081853. [PMID: 36010204 PMCID: PMC9406981 DOI: 10.3390/diagnostics12081853] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 12/19/2022] Open
Abstract
Coronavirus disease (COVID-19) has had a significant impact on global health since the start of the pandemic in 2019. As of June 2022, over 539 million cases have been confirmed worldwide with over 6.3 million deaths as a result. Artificial Intelligence (AI) solutions such as machine learning and deep learning have played a major part in this pandemic for the diagnosis and treatment of COVID-19. In this research, we review these modern tools deployed to solve a variety of complex problems. We explore research that focused on analyzing medical images using AI models for identification, classification, and tissue segmentation of the disease. We also explore prognostic models that were developed to predict health outcomes and optimize the allocation of scarce medical resources. Longitudinal studies were conducted to better understand COVID-19 and its effects on patients over a period of time. This comprehensive review of the different AI methods and modeling efforts will shed light on the role that AI has played and what path it intends to take in the fight against COVID-19.
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Affiliation(s)
- Rahul Gomes
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
- Correspondence:
| | - Connor Kamrowski
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Jordan Langlois
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Papia Rozario
- Department of Geography and Anthropology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA;
| | - Ian Dircks
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Keegan Grottodden
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Matthew Martinez
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Wei Zhong Tee
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Kyle Sargeant
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Corbin LaFleur
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
| | - Mitchell Haley
- Department of Computer Science, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (C.K.); (J.L.); (I.D.); (K.G.); (M.M.); (W.Z.T.); (K.S.); (C.L.); (M.H.)
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21
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Araújo DC, Veloso AA, Borges KBG, Carvalho MDG. Prognosing the risk of COVID-19 death through a machine learning-based routine blood panel: A retrospective study in Brazil. Int J Med Inform 2022; 165:104835. [PMID: 35908372 PMCID: PMC9327247 DOI: 10.1016/j.ijmedinf.2022.104835] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 01/08/2023]
Abstract
Background: Despite an extensive network of primary care availability, Brazil has suffered profoundly during the COVID-19 pandemic, experiencing the greatest sanitary collapse in its history. Thus, it is important to understand phenotype risk factors for SARS-CoV-2 infection severity in the Brazilian population in order to provide novel insights into the pathogenesis of the disease. Objective: This study proposes to predict the risk of COVID-19 death through machine learning, using blood biomarkers data from patients admitted to two large hospitals in Brazil. Methods: We retrospectively collected blood biomarkers data in a 24-h time window from 6,979 patients with COVID-19 confirmed by positive RT-PCR admitted to two large hospitals in Brazil, of whom 291 (4.2%) died and 6,688 (95.8%) were discharged. We then developed a large-scale exploration of risk models to predict the probability of COVID-19 severity, finally choosing the best performing model regarding the average AUROC. To improve generalizability, for each model five different testing scenarios were conducted, including two external validations. Results: We developed a machine learning-based panel composed of parameters extracted from the complete blood count (lymphocytes, MCV, platelets and RDW), in addition to C-Reactive Protein, which yielded an average AUROC of 0.91 ± 0.01 to predict death by COVID-19 confirmed by positive RT-PCR within a 24-h window. Conclusion: Our study suggests that routine laboratory variables could be useful to identify COVID-19 patients under higher risk of death using machine learning. Further studies are needed for validating the model in other populations and contexts, since the natural history of SARS-CoV-2 infection and its consequences on the hematopoietic system and other organs is still quite recent.
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Affiliation(s)
- Daniella Castro Araújo
- Huna, São Paulo, SP, Brazil; Departamento de Ciência da Computação, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Adriano Alonso Veloso
- Departamento de Ciência da Computação, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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22
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Clinical and Laboratory Approach to Diagnose COVID-19 Using Machine Learning. Interdiscip Sci 2022; 14:452-470. [PMID: 35133633 PMCID: PMC8846962 DOI: 10.1007/s12539-021-00499-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 12/18/2022]
Abstract
Coronavirus 2 (SARS-CoV-2), often known by the name COVID-19, is a type of acute respiratory syndrome that has had a significant influence on both economy and health infrastructure worldwide. This novel virus is diagnosed utilising a conventional method known as the RT-PCR (Reverse Transcription Polymerase Chain Reaction) test. This approach, however, produces a lot of false-negative and erroneous outcomes. According to recent studies, COVID-19 can also be diagnosed using X-rays, CT scans, blood tests and cough sounds. In this article, we use blood tests and machine learning to predict the diagnosis of this deadly virus. We also present an extensive review of various existing machine-learning applications that diagnose COVID-19 from clinical and laboratory markers. Four different classifiers along with a technique called Synthetic Minority Oversampling Technique (SMOTE) were used for classification. Shapley Additive Explanations (SHAP) method was utilized to calculate the gravity of each feature and it was found that eosinophils, monocytes, leukocytes and platelets were the most critical blood parameters that distinguished COVID-19 infection for our dataset. These classifiers can be utilized in conjunction with RT-PCR tests to improve sensitivity and in emergency situations such as a pandemic outbreak that might happen due to new strains of the virus. The positive results indicate the prospective use of an automated framework that could help clinicians and medical personnel diagnose and screen patients.
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23
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Wang Y, Yan Z, Wang D, Yang M, Li Z, Gong X, Wu D, Zhai L, Zhang W, Wang Y. Prediction and analysis of COVID-19 daily new cases and cumulative cases: times series forecasting and machine learning models. BMC Infect Dis 2022; 22:495. [PMID: 35614387 PMCID: PMC9131989 DOI: 10.1186/s12879-022-07472-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND COVID-19 poses a severe threat to global human health, especially the USA, Brazil, and India cases continue to increase dynamically, which has a far-reaching impact on people's health, social activities, and the local economic situation. METHODS The study proposed the ARIMA, SARIMA and Prophet models to predict daily new cases and cumulative confirmed cases in the USA, Brazil and India over the next 30 days based on the COVID-19 new confirmed cases and cumulative confirmed cases data set(May 1, 2020, and November 30, 2021) published by the official WHO, Three models were implemented in the R 4.1.1 software with forecast and prophet package. The performance of different models was evaluated by using root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). RESULTS Through the fitting and prediction of daily new case data, we reveal that the Prophet model has more advantages in the prediction of the COVID-19 of the USA, which could compose data components and capture periodic characteristics when the data changes significantly, while SARIMA is more likely to appear over-fitting in the USA. And the SARIMA model captured a seven-day period hidden in daily COVID-19 new cases from 3 countries. While in the prediction of new cumulative cases, the ARIMA model has a better ability to fit and predict the data with a positive growth trend in different countries(Brazil and India). CONCLUSIONS This study can shed light on understanding the outbreak trends and give an insight into the epidemiological control of these regions. Further, the prediction of the Prophet model showed sufficient accuracy in the daily COVID-19 new cases of the USA. The ARIMA model is suitable for predicting Brazil and India, which can help take precautions and policy formulation for this epidemic in other countries.
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Affiliation(s)
- Yanding Wang
- School of Public Health, China Medical University, Shenyang, 110122, China.,Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Zehui Yan
- School of Public Health, China Medical University, Shenyang, 110122, China
| | - Ding Wang
- School of Science, Beijing University of Posts and Telecommunications, Beijing, China
| | - Meitao Yang
- School of Public Health, China Medical University, Shenyang, 110122, China.,Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Zhiqiang Li
- School of Public Health, China Medical University, Shenyang, 110122, China.,Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Xinran Gong
- School of Public Health, China Medical University, Shenyang, 110122, China.,Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Di Wu
- School of Public Health, China Medical University, Shenyang, 110122, China.,Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Lingling Zhai
- School of Public Health, China Medical University, Shenyang, 110122, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China.
| | - Yong Wang
- School of Public Health, China Medical University, Shenyang, 110122, China. .,Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China.
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24
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Sansone NMS, Boschiero MN, Ortega MM, Ribeiro IA, Peixoto AO, Mendes RT, Marson FAL. Severe Acute Respiratory Syndrome by SARS-CoV-2 Infection or Other Etiologic Agents Among Brazilian Indigenous Population: An Observational Study from the First Year of Coronavirus Disease (COVID)-19 Pandemic. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100177. [PMID: 35018359 PMCID: PMC8739500 DOI: 10.1016/j.lana.2021.100177] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Indigenous peoples are vulnerable to pandemics, including to the coronavirus disease (COVID)-19, since it causes high mortality and specially, the loss of elderly Indigenous individuals. Methods The epidemiological data of severe acute respiratory syndrome (SARS) by SARS-CoV-2 infection or other etiologic agents (OEA) among Brazilian Indigenous peoples during the first year of COVID-19 pandemic was obtained from a Brazilian Ministry of Health open-access database to perform an observational study. Considering only Indigenous individuals diagnosed with SARS by COVID-19, the epidemiology data were also evaluated as risk of death. The type of sample collection for virus screening, demographic profile, clinical symptoms, comorbidities, and clinical evolution were evaluated. The primary outcome was considered the death in the Brazilian Indigenous individuals and the secondary outcome, the characteristics of Brazilian Indigenous infected by SARS-CoV-2 or OEA, as the need for intensive care unit admission or the need for mechanical ventilation support. The statistical analysis was done using Logistic Regression Model. Alpha of 0.05. Findings A total of 3,122 cases of Indigenous individuals with SARS in Brazil were reported during the first year of the COVID-19 pandemic. Of these, 1,994 were diagnosed with COVID-19 and 730/1,816 (40.2%) of them died. The death rate among individuals with SARS-CoV-2 was three-fold increased when compared to the group of individuals with OEA. Several symptoms (myalgia, loss of smell, and sore throat) and comorbidities (cardiopathy, systemic arterial hypertension, and diabetes mellitus) were more prevalent in the COVID-19 group when compared to Indigenous individuals with OEA. Similar profile was observed considering the risk of death among the Indigenous individuals with COVID-19 who presented several symptoms (oxygen saturation <95%, dyspnea, and respiratory distress) and comorbidities (renal disorders, cardiopathy, and diabetes mellitus). The multivariate analysis was significant in differentiating between the COVID-19-positive and non-COVID-19 patients [X2(7)=65.187; P-value<0.001]. Among the patients’ features, the following contributed in relation to the diagnosis of COVID-19: age [≥43 years-old [y.o.]; OR=1.984 (95%CI=1.480-2.658)]; loss of smell [OR=2.373 (95%CI=1.461-3.854)]; presence of previous respiratory disorders [OR=0.487; 95%CI=0.287-0.824)]; and fever [OR=1.445 (95%CI=1.082-1.929)]. Also, the multivariate analysis was able to predict the risk of death [X2(9)=293.694; P-value<0.001]. Among the patients’ features, the following contributed in relation to the risk of death: male gender [OR=1.507 (95%CI=1.010-2.250)]; age [≥60 y.o.; OR=3.377 (95%CI=2.292-4.974)]; the need for ventilatory support [invasive mechanical ventilation; OR=24.050 (95%CI=12.584-45.962) and non-invasive mechanical ventilation; OR=2.249 (95%CI=1.378-3.671)]; dyspnea [OR=2.053 (95%CI=1.196-3.522)]; oxygen saturation <95% [OR=1.691 (95%CI=1.050-2.723)]; myalgia [OR=0.423 (95%CI=0.191-0.937)]; and the presence of kidney disorders [OR=3.135 (95%CI=1.144-8.539)]. Interpretation The Brazilian Indigenous peoples are in a vulnerable situation during the COVID-19 pandemic and presented an increased risk of death due to COVID-19. Several factors were associated with enhanced risk of death, as male sex, older age (≥60 y.o.), and need for ventilatory support; also, other factors might help to differentiate SARS by COVID-19 or by OEA, as older age (≥43 y.o.), loss of smell, and fever. Funding Fundação de Amparo à Pesquisa do Estado de São Paulo (Foundation for Research Support of the State of São Paulo; #2021/05810-7).
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Key Words
- %, Percentage
- 95%CI, 95% Confidence Interval
- COVID-19
- COVID-19, Coronavirus Disease (2019)
- Ethnicity
- H1N1, H1N1 Strain of the Flu (Influenzae) virus
- HRCT, High-Resolution Computed Tomography
- ICU, Intensive Care Unit
- Indigenous
- Intensive Care Unit
- MV, Mechanical Ventilation
- NA, Not Applicable
- OEA, Other Etiologic Agents
- OR, Odds Ratio
- Pandemic
- RT-PCR, Real Time-Polymerase Chain Reaction
- Race
- Respiratory Disease
- SAH, Systemic Arterial Hypertension
- SARS, Severe Acute Respiratory Syndrome
- SARS-CoV, Severe Acute Respiratory Syndrome Coronavirus
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- SIVEP-Gripe, Information System for Epidemiological Surveillance of Influenza (Sistema de Informação de Vigilância Epidemiológica da Gripe)
- SUS, Sistema Único de Saúde (Brazilian Public Health System)
- Severe Acute Respiratory Syndrome
- Virus
- y.o., Years Old
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Affiliation(s)
- Nathália M S Sansone
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Matheus N Boschiero
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil
| | - Manoela M Ortega
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Isadora A Ribeiro
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Andressa O Peixoto
- Laboratory of Translational Medicine, Center for Investigation in Pediatrics, School of Medical Sciences, University of Campinas. Campinas, SP, Brazil
| | - Roberto T Mendes
- Laboratory of Translational Medicine, Center for Investigation in Pediatrics, School of Medical Sciences, University of Campinas. Campinas, SP, Brazil
| | - Fernando A L Marson
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
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25
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Roland T, Böck C, Tschoellitsch T, Maletzky A, Hochreiter S, Meier J, Klambauer G. Domain Shifts in Machine Learning Based Covid-19 Diagnosis From Blood Tests. J Med Syst 2022. [PMID: 35348909 DOI: 10.1101/2021.04.06.21254997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Many previous studies claim to have developed machine learning models that diagnose COVID-19 from blood tests. However, we hypothesize that changes in the underlying distribution of the data, so called domain shifts, affect the predictive performance and reliability and are a reason for the failure of such machine learning models in clinical application. Domain shifts can be caused, e.g., by changes in the disease prevalence (spreading or tested population), by refined RT-PCR testing procedures (way of taking samples, laboratory procedures), or by virus mutations. Therefore, machine learning models for diagnosing COVID-19 or other diseases may not be reliable and degrade in performance over time. We investigate whether domain shifts are present in COVID-19 datasets and how they affect machine learning methods. We further set out to estimate the mortality risk based on routinely acquired blood tests in a hospital setting throughout pandemics and under domain shifts. We reveal domain shifts by evaluating the models on a large-scale dataset with different assessment strategies, such as temporal validation. We present the novel finding that domain shifts strongly affect machine learning models for COVID-19 diagnosis and deteriorate their predictive performance and credibility. Therefore, frequent re-training and re-assessment are indispensable for robust models enabling clinical utility.
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Affiliation(s)
- Theresa Roland
- ELLIS Unit Linz, LIT AI Lab, Institute for Machine Learning, Johannes Kepler University Linz, Linz, Austria.
| | - Carl Böck
- Department of Anesthesiology and Critical Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Thomas Tschoellitsch
- Department of Anesthesiology and Critical Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | | | - Sepp Hochreiter
- ELLIS Unit Linz, LIT AI Lab, Institute for Machine Learning, Johannes Kepler University Linz, Linz, Austria
| | - Jens Meier
- Department of Anesthesiology and Critical Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - Günter Klambauer
- ELLIS Unit Linz, LIT AI Lab, Institute for Machine Learning, Johannes Kepler University Linz, Linz, Austria
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26
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Modelli de Andrade LG, de Sandes-Freitas TV, Requião-Moura LR, Viana LA, Cristelli MP, Garcia VD, Alcântara ALC, Esmeraldo RDM, Abbud Filho M, Pacheco-Silva A, de Lima Carneiro ECR, Manfro RC, Costa KMAH, Simão DR, de Sousa MV, Santana VBBDM, Noronha IL, Romão EA, Zanocco JA, Arimatea GGQ, De Boni Monteiro de Carvalho D, Tedesco-Silva H, Medina-Pestana J. Development and validation of a simple web-based tool for early prediction of COVID-19-associated death in kidney transplant recipients. Am J Transplant 2022; 22:610-625. [PMID: 34416075 PMCID: PMC8441938 DOI: 10.1111/ajt.16807] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 01/25/2023]
Abstract
This analysis, using data from the Brazilian kidney transplant (KT) COVID-19 study, seeks to develop a prediction score to assist in COVID-19 risk stratification in KT recipients. In this study, 1379 patients (35 sites) were enrolled, and a machine learning approach was used to fit models in a derivation cohort. A reduced Elastic Net model was selected, and the accuracy to predict the 28-day fatality after the COVID-19 diagnosis, assessed by the area under the ROC curve (AUC-ROC), was confirmed in a validation cohort. The better calibration values were used to build the applicable ImAgeS score. The 28-day fatality rate was 17% (n = 235), which was associated with increasing age, hypertension and cardiovascular disease, higher body mass index, dyspnea, and use of mycophenolate acid or azathioprine. Higher kidney graft function, longer time of symptoms until COVID-19 diagnosis, presence of anosmia or coryza, and use of mTOR inhibitor were associated with reduced risk of death. The coefficients of the best model were used to build the predictive score, which achieved an AUC-ROC of 0.767 (95% CI 0.698-0.834) in the validation cohort. In conclusion, the easily applicable predictive model could assist health care practitioners in identifying non-hospitalized kidney transplant patients that may require more intensive monitoring. Trial registration: ClinicalTrials.gov NCT04494776.
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Affiliation(s)
| | - Tainá Veras de Sandes-Freitas
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil,Hospital Universitário Walter Cantídio, Fortaleza, Brazil,Hospital Geral de Fortaleza, Fortaleza, Brazil
| | - Lúcio R. Requião-Moura
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, Brazil,Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil,Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil,Correspondence Lúcio R. Requião-Moura, Nephrology Division – Department of Medicine, Federal University of São Paulo. Rua Botucatu, São Paulo – SP, Brazil.
| | - Laila Almeida Viana
- Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil
| | | | | | | | | | - Mario Abbud Filho
- Hospital de Base, Medical School FAMERP, São José do Rio Preto, Brazil
| | | | | | - Roberto Ceratti Manfro
- Hospital de Clínicas de Porto Alegre, Federal Univertisy of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Marcos Vinicius de Sousa
- Division of Nephrology, School of Medical Sciences, Renal Transplant Unit, Renal Transplant Research Laboratoy, University of Campinas – UNICAMP, Campinas, Brazil
| | | | - Irene L. Noronha
- Hospital Beneficência Portuguesa de São Paulo (BP), São Paulo, Brazil
| | - Elen Almeida Romão
- Division of Nephrology, School of Medicine of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto, Brazil
| | | | | | | | - Helio Tedesco-Silva
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, Brazil,Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil
| | - José Medina-Pestana
- Department of Medicine, Nephrology Division, Federal University of São Paulo, São Paulo, Brazil,Department of Transplantation, Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil
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ICU admission and mortality classifiers for COVID-19 patients based on subgroups of dynamically associated profiles across multiple timepoints. Comput Biol Med 2022; 141:105176. [PMID: 35007991 PMCID: PMC8711179 DOI: 10.1016/j.compbiomed.2021.105176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) which is caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is consistently causing profound wounds in the global healthcare system due to its increased transmissibility. Currently, there is an urgent unmet need to identify the underlying dynamic associations among COVID-19 patients and distinguish patient subgroups with common clinical profiles towards the development of robust classifiers for ICU admission and mortality. To address this need, we propose a four step pipeline which: (i) enhances the quality of multiple timeseries clinical data through an automated data curation workflow, (ii) deploys Dynamic Bayesian Networks (DBNs) for the detection of features with increased connectivity based on dynamic association analysis across multiple points, (iii) utilizes Self Organizing Maps (SOMs) and trajectory analysis for the early identification of COVID-19 patients with common clinical profiles, and (iv) trains robust multiple additive regression trees (MART) for ICU admission and mortality classification based on the extracted homogeneous clusters, to identify risk factors and biomarkers for disease progression. The contribution of the extracted clusters and the dynamically associated clinical data improved the classification performance for ICU admission to sensitivity 0.83 and specificity 0.83, and for mortality to sensitivity 0.74 and specificity 0.76. Additional information was included to enhance the performance of the classifiers yielding an increase by 4% in sensitivity and specificity for mortality. According to the risk factor analysis, the number of lymphocytes, SatO2, PO2/FiO2, and O2 supply type were highlighted as risk factors for ICU admission and the percentage of neutrophils and lymphocytes, PO2/FiO2, LDH, and ALP for mortality, among others. To our knowledge, this is the first study that combines dynamic modeling with clustering analysis to identify homogeneous groups of COVID-19 patients towards the development of robust classifiers for ICU admission and mortality.
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Nazir A, Ampadu HK. Interpretable deep learning for the prediction of ICU admission likelihood and mortality of COVID-19 patients. PeerJ Comput Sci 2022; 8:e889. [PMID: 35494832 PMCID: PMC9044277 DOI: 10.7717/peerj-cs.889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/24/2022] [Indexed: 05/09/2023]
Abstract
The global healthcare system is being overburdened by an increasing number of COVID-19 patients. Physicians are having difficulty allocating resources and focusing their attention on high-risk patients, partly due to the difficulty in identifying high-risk patients early. COVID-19 hospitalizations require specialized treatment capabilities and can cause a burden on healthcare resources. Estimating future hospitalization of COVID-19 patients is, therefore, crucial to saving lives. In this paper, an interpretable deep learning model is developed to predict intensive care unit (ICU) admission and mortality of COVID-19 patients. The study comprised of patients from the Stony Brook University Hospital, with patient information such as demographics, comorbidities, symptoms, vital signs, and laboratory tests recorded. The top three predictors of ICU admission were ferritin, diarrhoea, and alamine aminotransferase, and the top predictors for mortality were COPD, ferritin, and myalgia. The proposed model predicted ICU admission with an AUC score of 88.3% and predicted mortality with an AUC score of 96.3%. The proposed model was evaluated against existing model in the literature which achieved an AUC of 72.8% in predicting ICU admission and achieved an AUC of 84.4% in predicting mortality. It can clearly be seen that the model proposed in this paper shows superiority over existing models. The proposed model has the potential to provide tools to frontline doctors to help classify patients in time-bound and resource-limited scenarios.
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Affiliation(s)
- Amril Nazir
- Department of Information Systems and Technology Management, College of Technological Innovation Zayed University, Abu Dhabi, United Arab Emirates
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Nwanosike EM, Conway BR, Merchant HA, Hasan SS. Potential applications and performance of machine learning techniques and algorithms in clinical practice: A systematic review. Int J Med Inform 2021; 159:104679. [PMID: 34990939 DOI: 10.1016/j.ijmedinf.2021.104679] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/08/2021] [Accepted: 12/27/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE The advent of clinically adapted machine learning algorithms can solve numerous problems ranging from disease diagnosis and prognosis to therapy recommendations. This systematic review examines the performance of machine learning (ML) algorithms and evaluates the progress made to date towards their implementation in clinical practice. METHODS Systematic searching of databases (PubMed, MEDLINE, Scopus, Google Scholar, Cochrane Library and WHO Covid-19 database) to identify original articles published between January 2011 and October 2021. Studies reporting ML techniques in clinical practice involving humans and ML algorithms with a performance metric were considered. RESULTS Of 873 unique articles identified, 36 studies were eligible for inclusion. The XGBoost (extreme gradient boosting) algorithm showed the highest potential for clinical applications (n = 7 studies); this was followed jointly by random forest algorithm, logistic regression, and the support vector machine, respectively (n = 5 studies). Prediction of outcomes (n = 33), in particular Inflammatory diseases (n = 7) received the most attention followed by cancer and neuropsychiatric disorders (n = 5 for each) and Covid-19 (n = 4). Thirty-three out of the thirty-six included studies passed more than 50% of the selected quality assessment criteria in the TRIPOD checklist. In contrast, none of the studies could achieve an ideal overall bias rating of 'low' based on the PROBAST checklist. In contrast, only three studies showed evidence of the deployment of ML algorithm(s) in clinical practice. CONCLUSIONS ML is potentially a reliable tool for clinical decision support. Although advocated widely in clinical practice, work is still in progress to validate clinically adapted ML algorithms. Improving quality standards, transparency, and interpretability of ML models will further lower the barriers to acceptability.
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Affiliation(s)
- Ezekwesiri Michael Nwanosike
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate Huddersfield HD1 3DH, West Yorkshire, United Kingdom
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate Huddersfield HD1 3DH, West Yorkshire, United Kingdom
| | - Hamid A Merchant
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate Huddersfield HD1 3DH, West Yorkshire, United Kingdom
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate Huddersfield HD1 3DH, West Yorkshire, United Kingdom; School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, Australia.
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Parthiban K, Pandey D, Pandey BK. Impact of SARS-CoV-2 in Online Education, Predicting and Contrasting Mental Stress of Young Students: A Machine Learning Approach. AUGMENTED HUMAN RESEARCH 2021. [PMCID: PMC8184403 DOI: 10.1007/s41133-021-00048-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The nation has already had to contend with such a major public health issue when this COVID-19 disease was propagated in March 2020. The corona's propagation does have an effect on all areas of people's lives. The hostile effect on education systems throughout all locations is indeed a diverse expansion impact. A complete shutdown keeps adding fresh problems for students to learn and also for educators to effectively manage the class, likely to result in the conversion of such an offline education system into a virtual class. This study investigated and described various online learning platforms, as well as teaching resource distribution technology and modern technologies used to ensure that students can study. Overall, this relates to channels that can be used to create a confidential environment in order to prevent copying in online tests. This also outlines so many difficulties in managing online teaching methods, like learners' perceptions of e-learning being more traumatic and having a negative impact on general wellbeing and social relationships. So, a technique has been proposed to provide learners with a superior online classroom teaching experience, allowing the online classroom to be as good as, if not better than, a single online classroom. This study focused on daily teaching methods that employ online learning supported by a machine teaching approach to provide an individual with a relevant stress-free solution.
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Affiliation(s)
- K. Parthiban
- Department of Computer Science and Systems Engineering, SreeVidyanikethan Engineering College (Autonomous), Tirupati, Andhra Pradesh India
| | - Digvijay Pandey
- Department of Technical Education, IET, Dr. A.P.J.Abdul Kalam Technical University Uttar Pradesh, Lucknow, 226021 India
| | - Binay Kumar Pandey
- Department of Information Technology, College of Technology, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, US Nagar, Uttarakhand India
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Cushnan D, Bennett O, Berka R, Bertolli O, Chopra A, Dorgham S, Favaro A, Ganepola T, Halling-Brown M, Imreh G, Jacob J, Jefferson E, Lemarchand F, Schofield D, Wyatt JC. An overview of the National COVID-19 Chest Imaging Database: data quality and cohort analysis. Gigascience 2021; 10:giab076. [PMID: 34849869 PMCID: PMC8633457 DOI: 10.1093/gigascience/giab076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The National COVID-19 Chest Imaging Database (NCCID) is a centralized database containing mainly chest X-rays and computed tomography scans from patients across the UK. The objective of the initiative is to support a better understanding of the coronavirus SARS-CoV-2 disease (COVID-19) and the development of machine learning technologies that will improve care for patients hospitalized with a severe COVID-19 infection. This article introduces the training dataset, including a snapshot analysis covering the completeness of clinical data, and availability of image data for the various use-cases (diagnosis, prognosis, longitudinal risk). An additional cohort analysis measures how well the NCCID represents the wider COVID-19-affected UK population in terms of geographic, demographic, and temporal coverage. FINDINGS The NCCID offers high-quality DICOM images acquired across a variety of imaging machinery; multiple time points including historical images are available for a subset of patients. This volume and variety make the database well suited to development of diagnostic/prognostic models for COVID-associated respiratory conditions. Historical images and clinical data may aid long-term risk stratification, particularly as availability of comorbidity data increases through linkage to other resources. The cohort analysis revealed good alignment to general UK COVID-19 statistics for some categories, e.g., sex, whilst identifying areas for improvements to data collection methods, particularly geographic coverage. CONCLUSION The NCCID is a growing resource that provides researchers with a large, high-quality database that can be leveraged both to support the response to the COVID-19 pandemic and as a test bed for building clinically viable medical imaging models.
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Affiliation(s)
- Dominic Cushnan
- AI Lab, NHSX, Skipton House, 80 London Road, London SE1 6LH,
UK
| | | | | | | | | | | | | | | | - Mark Halling-Brown
- Scientific Computing, Royal Surrey NHS Foundation Trust,
Egerton Road, Guildford GU2 7XX, UK
| | | | - Joseph Jacob
- UCL Respiratory, 1st Floor, Rayne Institute, University College
London, London WC1E 6JF, UK
| | - Emily Jefferson
- Health Data Research UK, Gibbs Building, 215 Euston Road,
London NW1 2BE, UK
- Health Informatics Centre (HIC), School of Medicine, University of
Dundee, DD1 4HN, Dundee, UK
| | | | | | - Jeremy C Wyatt
- Emeritus Professor of Digital Healthcare, University of
Southampton, Southampton SO17 1BJ, UK
- NHSX, Skipton House, 80 London Road, London SE1 6LH, UK
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Kocadagli O, Baygul A, Gokmen N, Incir S, Aktan C. Clinical prognosis evaluation of COVID-19 patients: An interpretable hybrid machine learning approach. Curr Res Transl Med 2021; 70:103319. [PMID: 34768217 PMCID: PMC8577545 DOI: 10.1016/j.retram.2021.103319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/12/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
This retrospective cohort study deals with evaluating severity of COVID-19 cases on the first symptoms and blood-test results of infected patients admitted to Emergency Department of Koc University Hospital (Istanbul, Turkey). To figure out remarkable hematological characteristics and risk factors in the prognosis evaluation of COVID-19 cases, the hybrid machine learning (ML) approaches integrated with feature selection procedure based Genetic Algorithms and information complexity were used in addition to the multivariate statistical analysis. Specifically, COVID-19 dataset includes demographic features, symptoms, blood test results and disease histories of total 166 inpatients with different age and gender groups. Analysis results point out that the hybrid ML methods has brought out potential risk factors on the severity of COVID-19 cases and their impacts on the prognosis evaluation, accurately.
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Affiliation(s)
- Ozan Kocadagli
- Department of Statistics, Mimar Sinan University, Silahsör Cad. No. 71, 34380 Bomonti/Sisli, Istanbul, Turkey.
| | - Arzu Baygul
- Department of Biostatistics, Faculty of Medicine, Koc University, Turkey.
| | - Neslihan Gokmen
- Neslihan Gokmen, Department of Basic Sciences, Istanbul Technical University, Turkey.
| | - Said Incir
- Said Incir, Department of Biochemistry, Koc University Hospital, Turkey.
| | - Cagdas Aktan
- Department of Medical Biology, Beykent University, Turkey.
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33
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Murri R, Lenkowicz J, Masciocchi C, Iacomini C, Fantoni M, Damiani A, Marchetti A, Sergi PDA, Arcuri G, Cesario A, Patarnello S, Antonelli M, Bellantone R, Bernabei R, Boccia S, Calabresi P, Cambieri A, Cauda R, Colosimo C, Crea F, De Maria R, De Stefano V, Franceschi F, Gasbarrini A, Parolini O, Richeldi L, Sanguinetti M, Urbani A, Zega M, Scambia G, Valentini V. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19. Sci Rep 2021; 11:21136. [PMID: 34707184 PMCID: PMC8551240 DOI: 10.1038/s41598-021-99905-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home.
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Affiliation(s)
- Rita Murri
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Jacopo Lenkowicz
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Chiara Iacomini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Massimo Fantoni
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | - Giovanni Arcuri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alfredo Cesario
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Massimo Antonelli
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rocco Bellantone
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberto Bernabei
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Cambieri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberto Cauda
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cesare Colosimo
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Crea
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Valerio De Stefano
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Franceschi
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Luca Richeldi
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Sanguinetti
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Urbani
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Zega
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- Sezione di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Amin MS, Wozniak M, Barbaric L, Pickard S, Yerrabelli RS, Christensen A, Coiado OC. Experimental Technologies in the Diagnosis and Treatment of COVID-19 in Patients with Comorbidities. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2021; 6:48-71. [PMID: 34541448 PMCID: PMC8442516 DOI: 10.1007/s41666-021-00106-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic has impacted the whole world and raised concerns about its effects on different human organ systems. Early detection of COVID-19 may significantly increase the rate of survival; thus, it is critical that the disease is detected early. Emerging technologies have been used to prevent, diagnose, and manage COVID-19 among the populace in the USA and globally. Numerous studies have revealed the growing implementation of novel engineered systems during the intervention at various points of the disease’s pathogenesis, especially as it relates to comorbidities and complications related to cardiovascular and respiratory organ systems. In this review, we provide a succinct, but extensive, review of the pathogenesis of COVID-19, particularly as it relates to angiotensin-converting enzyme 2 (ACE2) as a viral entry point. This is followed by a comprehensive analysis of cardiovascular and respiratory comorbidities of COVID-19 and novel technologies that are used to diagnose and manage hospitalized patients. Continuous cardiorespiratory monitoring systems, novel machine learning algorithms for rapidly triaging patients, various imaging modalities, wearable immunosensors, hotspot tracking systems, and other emerging technologies are reviewed. COVID-19 effects on the immune system, associated inflammatory biomarkers, and innovative therapies are also assessed. Finally, with emphasis on the impact of wearable and non-wearable systems, this review highlights future technologies that could help diagnose, monitor, and mitigate disease progression. Technologies that account for an individual’s health conditions, comorbidities, and even socioeconomic factors can drastically reduce the high mortality seen among many COVID-19 patients, primarily via disease prevention, early detection, and pertinent management.
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Affiliation(s)
- Md Shahnoor Amin
- Carle Illinois College of Medicine, University of Illinois At Urbana-Champaign, Champaign, IL 61820 USA
| | - Marcin Wozniak
- Beckman Institute for Advanced Science and Technology, Urbana, IL 61801 USA.,Department of Medical Laboratory Diagnostics - Biobank, Medical University of Gdansk, Gdansk, Poland
| | - Lidija Barbaric
- Carle Illinois College of Medicine, University of Illinois At Urbana-Champaign, Champaign, IL 61820 USA
| | - Shanel Pickard
- Carle Illinois College of Medicine, University of Illinois At Urbana-Champaign, Champaign, IL 61820 USA
| | - Rahul S Yerrabelli
- Carle Illinois College of Medicine, University of Illinois At Urbana-Champaign, Champaign, IL 61820 USA
| | - Anton Christensen
- Carle Illinois College of Medicine, University of Illinois At Urbana-Champaign, Champaign, IL 61820 USA
| | - Olivia C Coiado
- Carle Illinois College of Medicine, University of Illinois At Urbana-Champaign, Champaign, IL 61820 USA.,Department of Bioengineering, University of Illinois At Urbana-Champaign, Urbana, IL 61801 USA.,Carle Illinois College of Medicine, 1406 W. Green St, Urbana, IL 61801 USA
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35
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Pulgar-Sánchez M, Chamorro K, Fors M, Mora FX, Ramírez H, Fernandez-Moreira E, Ballaz SJ. Biomarkers of severe COVID-19 pneumonia on admission using data-mining powered by common laboratory blood tests-datasets. Comput Biol Med 2021; 136:104738. [PMID: 34391001 PMCID: PMC8349478 DOI: 10.1016/j.compbiomed.2021.104738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022]
Abstract
In the epidemiological COVID-19 research, artificial intelligence is a unique approach to make predictions about disease severity to manage COVID-19 patients. A limitation of artificial intelligence is, however, the high risk of bias. We investigated the skill of data mining and machine learning, two advanced forms of artificial intelligence, to predict severe COVID-19 pneumonia based on routine laboratory tests. A sample of 4009 COVID-19 patients was divided into Severe (PaO2< 60 mmHg, 489 cases) and Non-Severe (PaO2 ≥ 60 mmHg, 3520 cases) groups according to blood hypoxemia on admission and their laboratory datasets analyzed by the R software and WEKA workbench. After curation, data were processed for the selection of the most influential features including hemogram, pCO2, blood acid-base balance, prothrombin time, inflammation biomarkers, and glucose. The best fit of variables was successfully confirmed by either the Multilayer Perceptron, a feedforward neural network algorithm that performed machine recognition of severe COVID-19 with 96.5% precision, or by the C4.5 software, a supervised learning algorithm based on an objective-predefined variable (severity) that generated a decision tree with 89.4% precision. Finally, a complex bivariate Pearson's correlation matrix combined with advanced hierarchical clustering (dendrograms) were conducted for knowledge discovery. The hidden structure of the datasets revealed shift patterns related to the development of COVID-19-induced pneumonia that involved the lymphocyte-to-C-reactive protein and leukocyte-to-C-protein ratios, neutrophil %, pH and pCO2. The data mining approaches to the hematological fluctuations associated with severe COVID-19 pneumonia could not only anticipate adverse clinical outcomes, but also reveal putative therapeutic targets.
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Affiliation(s)
- Mary Pulgar-Sánchez
- Escuela de Ciencias Biológicas e Ingeniería. Universidad Yachay Tech, Urcuquí, Ecuador
| | - Kevin Chamorro
- Escuela de Matemáticas y Ciencias Computacionales. Universidad Yachay Tech, Urcuquí, Ecuador; Universidad Técnica Del Norte, Ibarra, Ecuador
| | - Martha Fors
- Escuela de Medicina; Universidad de las Américas, Quito, Ecuador
| | | | - Hégira Ramírez
- Escuela de Medicina; Universidad de las Américas, Quito, Ecuador
| | | | - Santiago J Ballaz
- Escuela de Ciencias Biológicas e Ingeniería. Universidad Yachay Tech, Urcuquí, Ecuador; Escuela de Medicina, Universidad Espíritu Santo, Samborondón, Ecuador.
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36
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Lin B, Wu S. Digital Transformation in Personalized Medicine with Artificial Intelligence and the Internet of Medical Things. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 26:77-81. [PMID: 33887155 DOI: 10.1089/omi.2021.0037] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Digital transformation is impacting every facet of science and society, not least because there is a growing need for digital services and products with the COVID-19 pandemic. But the need for digital transformation in diagnostics and personalized medicine field cuts deeper. In the past, personalized/precision medicine initiatives have been unable to capture the patients' experiences and clinical outcomes in real-time and in real-world settings. The availability of wearable smart sensors, wireless connectivity, artificial intelligence, and the Internet of Medical Things is changing the personalized/precision medicine research and implementation landscape. Digital transformation in poised to accelerate personalized/precision medicine and systems science in multiple fronts such as deep real-time phenotyping with patient-reported outcomes, high-throughput association studies between omics and highly granular phenotypic variation, digital clinical trials, among others. The present expert review offers an analysis of these systems science frontiers with a view to future applications at the intersection of digital health and personalized medicine, or put in other words, signaling the rise of "digital personalized medicine."
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Affiliation(s)
- Biaoyang Lin
- Zhejiang-California International Nanosystems Institute (ZCNI) Proprium Research Center, Zhejiang University, Hangzhou, Zhejiang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, The First Affiliated Hospital, Hangzhou, China.,Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Shengjun Wu
- Department of Clinical Laboratories, School of Medicine, Zhejiang University, Sir Run Run Shaw Hospital, Hangzhou, China
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Wynants L, Van Calster B, Collins GS, Riley RD, Heinze G, Schuit E, Bonten MMJ, Dahly DL, Damen JAA, Debray TPA, de Jong VMT, De Vos M, Dhiman P, Haller MC, Harhay MO, Henckaerts L, Heus P, Kammer M, Kreuzberger N, Lohmann A, Luijken K, Ma J, Martin GP, McLernon DJ, Andaur Navarro CL, Reitsma JB, Sergeant JC, Shi C, Skoetz N, Smits LJM, Snell KIE, Sperrin M, Spijker R, Steyerberg EW, Takada T, Tzoulaki I, van Kuijk SMJ, van Bussel B, van der Horst ICC, van Royen FS, Verbakel JY, Wallisch C, Wilkinson J, Wolff R, Hooft L, Moons KGM, van Smeden M. Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ 2020; 369:m1328. [PMID: 32265220 PMCID: PMC7222643 DOI: 10.1136/bmj.m1328] [Citation(s) in RCA: 1649] [Impact Index Per Article: 412.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review and appraise the validity and usefulness of published and preprint reports of prediction models for diagnosing coronavirus disease 2019 (covid-19) in patients with suspected infection, for prognosis of patients with covid-19, and for detecting people in the general population at increased risk of covid-19 infection or being admitted to hospital with the disease. DESIGN Living systematic review and critical appraisal by the COVID-PRECISE (Precise Risk Estimation to optimise covid-19 Care for Infected or Suspected patients in diverse sEttings) group. DATA SOURCES PubMed and Embase through Ovid, up to 1 July 2020, supplemented with arXiv, medRxiv, and bioRxiv up to 5 May 2020. STUDY SELECTION Studies that developed or validated a multivariable covid-19 related prediction model. DATA EXTRACTION At least two authors independently extracted data using the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist; risk of bias was assessed using PROBAST (prediction model risk of bias assessment tool). RESULTS 37 421 titles were screened, and 169 studies describing 232 prediction models were included. The review identified seven models for identifying people at risk in the general population; 118 diagnostic models for detecting covid-19 (75 were based on medical imaging, 10 to diagnose disease severity); and 107 prognostic models for predicting mortality risk, progression to severe disease, intensive care unit admission, ventilation, intubation, or length of hospital stay. The most frequent types of predictors included in the covid-19 prediction models are vital signs, age, comorbidities, and image features. Flu-like symptoms are frequently predictive in diagnostic models, while sex, C reactive protein, and lymphocyte counts are frequent prognostic factors. Reported C index estimates from the strongest form of validation available per model ranged from 0.71 to 0.99 in prediction models for the general population, from 0.65 to more than 0.99 in diagnostic models, and from 0.54 to 0.99 in prognostic models. All models were rated at high or unclear risk of bias, mostly because of non-representative selection of control patients, exclusion of patients who had not experienced the event of interest by the end of the study, high risk of model overfitting, and unclear reporting. Many models did not include a description of the target population (n=27, 12%) or care setting (n=75, 32%), and only 11 (5%) were externally validated by a calibration plot. The Jehi diagnostic model and the 4C mortality score were identified as promising models. CONCLUSION Prediction models for covid-19 are quickly entering the academic literature to support medical decision making at a time when they are urgently needed. This review indicates that almost all pubished prediction models are poorly reported, and at high risk of bias such that their reported predictive performance is probably optimistic. However, we have identified two (one diagnostic and one prognostic) promising models that should soon be validated in multiple cohorts, preferably through collaborative efforts and data sharing to also allow an investigation of the stability and heterogeneity in their performance across populations and settings. Details on all reviewed models are publicly available at https://www.covprecise.org/. Methodological guidance as provided in this paper should be followed because unreliable predictions could cause more harm than benefit in guiding clinical decisions. Finally, prediction model authors should adhere to the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) reporting guideline. SYSTEMATIC REVIEW REGISTRATION Protocol https://osf.io/ehc47/, registration https://osf.io/wy245. READERS' NOTE This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. This version is update 3 of the original article published on 7 April 2020 (BMJ 2020;369:m1328). Previous updates can be found as data supplements (https://www.bmj.com/content/369/bmj.m1328/related#datasupp). When citing this paper please consider adding the update number and date of access for clarity.
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Affiliation(s)
- Laure Wynants
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, Netherlands
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Ben Van Calster
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Musculoskeletal Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Richard D Riley
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Georg Heinze
- Section for Clinical Biometrics, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Ewoud Schuit
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Marc M J Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Darren L Dahly
- HRB Clinical Research Facility, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Johanna A A Damen
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Thomas P A Debray
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Valentijn M T de Jong
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Maarten De Vos
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Electrical Engineering, ESAT Stadius, KU Leuven, Leuven, Belgium
| | - Paul Dhiman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Musculoskeletal Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Maria C Haller
- Section for Clinical Biometrics, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
- Ordensklinikum Linz, Hospital Elisabethinen, Department of Nephrology, Linz, Austria
| | - Michael O Harhay
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Palliative and Advanced Illness Research Center and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Liesbet Henckaerts
- Department of Microbiology, Immunology and Transplantation, KU Leuven-University of Leuven, Leuven, Belgium
- Department of General Internal Medicine, KU Leuven-University Hospitals Leuven, Leuven, Belgium
| | - Pauline Heus
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Michael Kammer
- Section for Clinical Biometrics, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
- Department of Nephrology, Medical University of Vienna, Vienna, Austria
| | - Nina Kreuzberger
- Evidence-Based Oncology, Department I of Internal Medicine and Centre for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anna Lohmann
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, Netherlands
| | - Kim Luijken
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, Netherlands
| | - Jie Ma
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Glen P Martin
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - David J McLernon
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Constanza L Andaur Navarro
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Johannes B Reitsma
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Jamie C Sergeant
- Centre for Biostatistics, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Chunhu Shi
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Nicole Skoetz
- Department of Nephrology, Medical University of Vienna, Vienna, Austria
| | - Luc J M Smits
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, Netherlands
| | - Kym I E Snell
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - Matthew Sperrin
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - René Spijker
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, Medical Library, Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
| | - Toshihiko Takada
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Bas van Bussel
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, Netherlands
- Department of Intensive Care, Maastricht University Medical Centre+, Maastricht University, Maastricht, Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care, Maastricht University Medical Centre+, Maastricht University, Maastricht, Netherlands
| | - Florien S van Royen
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Jan Y Verbakel
- EPI-Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Christine Wallisch
- Section for Clinical Biometrics, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Jack Wilkinson
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | | | - Lotty Hooft
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Karel G M Moons
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
- Cochrane Netherlands, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Maarten van Smeden
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
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