An Unsupervised Machine Learning Clustering and Prediction of Differential Clinical Phenotypes of COVID-19 Patients Based on Blood Tests—A Hong Kong Population Study

Clinical Characteristics and Outcomes of the Phenotypes of COPD-Bronchiectasis Association

INTRODUCTION

Although COPD may frequently co-exist with bronchiectasis [COPD-bronchiectasis associated (CBA)], little is known regarding the clinical heterogeneity. We aimed to identify the phenotypes and compare the clinical characteristics and prognosis of CBA.

METHODS

We conducted a retrospective cohort study involving 2928 bronchiectasis patients, 5158 COPD patients, and 1219 patients with CBA hospitalized between July 2017 and December 2020. We phenotyped CBA with a two-step clustering approach and validated in an independent retrospective cohort with decision-tree algorithms.

RESULTS

Compared with patients with COPD or bronchiectasis alone, patients with CBA had significantly longer disease duration, greater lung function impairment, and increased use of intravenous antibiotics during hospitalization. We identified five clusters of CBA. Cluster 1 (N=120, CBA-MS) had predominantly moderate-severe bronchiectasis, Cluster 2 (N=108, CBA-FH) was characterized by frequent hospitalization within the previous year, Cluster 3 (N=163, CBA-BI) had bacterial infection, Cluster 4 (N=143, CBA-NB) had infrequent hospitalization but no bacterial infection, and Cluster 5 (N=113, CBA-NHB) had no hospitalization or bacterial infection in the past year. The decision-tree model predicted the cluster assignment in the validation cohort with 91.8% accuracy. CBA-MS, CBA-BI, and CBA-FH exhibited higher risks of hospital re-admission and intensive care unit admission compared with CBA-NHB during follow-up (all P<0.05). Of the five clusters, CBA-FH conferred the worst clinical prognosis.

CONCLUSION

Bronchiectasis severity, recent hospitalizations and sputum culture findings are three defining variables accounting for most heterogeneity of CBA, the characterization of which will help refine personalized clinical management.

An interpretable clustering approach to safety climate analysis: Examining driver group distinctions

The transportation industry, particularly the trucking sector, is prone to workplace accidents and fatalities. Accidents involving large trucks accounted for a considerable percentage of overall traffic fatalities. Recognizing the crucial role of safety climate in accident prevention, researchers have sought to understand its factors and measure its impact within organizations. While existing data-driven safety climate studies have made remarkable progress, clustering employees based on their safety climate perception is innovative and has not been extensively utilized in research. Identifying clusters of drivers based on their safety climate perception allows the organization to profile its workforce and devise more impactful interventions. The lack of utilizing the clustering approach could be due to difficulties interpreting or explaining the factors influencing employees' cluster membership. Moreover, existing safety-related studies did not compare multiple clustering algorithms, resulting in potential bias. To address these problems, this study introduces an interpretable clustering approach for safety climate analysis. This study compares five algorithms for clustering truck drivers based on their safety climate perceptions. It also proposes a novel method for quantitatively evaluating partial dependence plots (QPDP). Then, to better interpret the clustering results, this study introduces different interpretable machine learning measures (Shapley additive explanations, permutation feature importance, and QPDP). The Python code used in this study is available at https://github.com/NUS-DBE/truck-driver-safety-climate. This study explains the clusters based on the importance of different safety climate factors. Drawing on data collected from more than 7,000 American truck drivers, this study significantly contributes to the scientific literature. It highlights the critical role of supervisory care promotion in distinguishing various driver groups. Moreover, it showcases the advantages of employing machine learning techniques, such as cluster analysis, to enrich the scientific knowledge in this field. Future studies could involve experimental methods to assess strategies for enhancing supervisory care promotion, as well as integrating deep learning clustering techniques with safety climate evaluation.

Applications of Artificial Intelligence in Temporal Bone Imaging: Advances and Future Challenges

The applications of artificial intelligence (AI) in temporal bone (TB) imaging have gained significant attention in recent years, revolutionizing the field of otolaryngology and radiology. Accurate interpretation of imaging features of TB conditions plays a crucial role in diagnosing and treating a range of ear-related pathologies, including middle and inner ear diseases, otosclerosis, and vestibular schwannomas. According to multiple clinical studies published in the literature, AI-powered algorithms have demonstrated exceptional proficiency in interpreting imaging findings, not only saving time for physicians but also enhancing diagnostic accuracy by reducing human error. Although several challenges remain in routinely relying on AI applications, the collaboration between AI and healthcare professionals holds the key to better patient outcomes and significantly improved patient care. This overview delivers a comprehensive update on the advances of AI in the field of TB imaging, summarizes recent evidence provided by clinical studies, and discusses future insights and challenges in the widespread integration of AI in clinical practice.