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Gasulla Ó, Ledesma-Carbayo MJ, Borrell LN, Fortuny-Profitós J, Mazaira-Font FA, Barbero Allende JM, Alonso-Menchén D, García-Bennett J, Del Río-Carrrero B, Jofré-Grimaldo H, Seguí A, Monserrat J, Teixidó-Román M, Torrent A, Ortega MÁ, Álvarez-Mon M, Asúnsolo A. Enhancing physicians' radiology diagnostics of COVID-19's effects on lung health by leveraging artificial intelligence. Front Bioeng Biotechnol 2023; 11:1010679. [PMID: 37152658 PMCID: PMC10157246 DOI: 10.3389/fbioe.2023.1010679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/14/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction: This study aimed to develop an individualized artificial intelligence model to help radiologists assess the severity of COVID-19's effects on patients' lung health. Methods: Data was collected from medical records of 1103 patients diagnosed with COVID-19 using RT- qPCR between March and June 2020, in Hospital Madrid-Group (HM-Group, Spain). By using Convolutional Neural Networks, we determine the effects of COVID-19 in terms of lung area, opacities, and pulmonary air density. We then combine these variables with age and sex in a regression model to assess the severity of these conditions with respect to fatality risk (death or ICU). Results: Our model can predict high effect with an AUC of 0.736. Finally, we compare the performance of the model with respect to six physicians' diagnosis, and test for improvements on physicians' performance when using the prediction algorithm. Discussion: We find that the algorithm outperforms physicians (39.5% less error), and thus, physicians can significantly benefit from the information provided by the algorithm by reducing error by almost 30%.
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Affiliation(s)
- Óscar Gasulla
- Hospital Universitari de Bellvitge-Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
| | - Maria J. Ledesma-Carbayo
- Biomedical Image Technologies, Universidad Politécnica de Madrid & CIBER BBN, ISCIII, Madrid, Spain
| | - Luisa N. Borrell
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY, United States
| | | | - Ferran A. Mazaira-Font
- Departament d'Econometria, Estadística i Economia Aplicada-Universitat de Barcelona, Barcelona, Spain
| | - Jose María Barbero Allende
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - David Alonso-Menchén
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Josep García-Bennett
- Hospital Universitari de Bellvitge-Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
| | - Belen Del Río-Carrrero
- Hospital Universitari de Bellvitge-Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
| | - Hector Jofré-Grimaldo
- Hospital Universitari de Bellvitge-Universitat de Barcelona, L´Hospitalet de Llobregat, Spain
| | - Aleix Seguí
- Campus Nord, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Miguel Teixidó-Román
- Departament d'Econometria, Estadística i Economia Aplicada-Universitat de Barcelona, Barcelona, Spain
| | - Adrià Torrent
- Departament d'Econometria, Estadística i Economia Aplicada-Universitat de Barcelona, Barcelona, Spain
| | - Miguel Ángel Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- *Correspondence: Angel Asúnsolo, ; Melchor Álvarez-Mon, ; Miguel Ángel Ortega,
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Service of Internal Medicine and Immune System Diseases-Rheumatology, University Hospital Príncipe de Asturias, (CIBEREHD), Alcalá de Henares, Spain
- *Correspondence: Angel Asúnsolo, ; Melchor Álvarez-Mon, ; Miguel Ángel Ortega,
| | - Angel Asúnsolo
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcala de Henares, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY, United States
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- *Correspondence: Angel Asúnsolo, ; Melchor Álvarez-Mon, ; Miguel Ángel Ortega,
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Bel G, Gasulla Ó, Mazaira-Font FA. The Effect of Health and Economic Costs on Governments' Policy Responses to COVID-19 Crisis under Incomplete Information. Public Adm Rev 2021; 81:1131-1146. [PMID: 34226767 PMCID: PMC8242661 DOI: 10.1111/puar.13394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 05/06/2023]
Abstract
The COVID-19 pandemic has become an unprecedented health, economic, and social crisis. The present study has built a theoretical model and used it to develop an empirical strategy, analyzing the drivers of policy-response agility during the outbreak. Our empirical results show that national policy responses were delayed, both by government expectations of the healthcare system capacity and by expectations that any hard measures used to manage the crisis would entail severe economic costs. With decision-making based on incomplete information, the agility of national policy responses increased as knowledge increased and uncertainty decreased in relation to the epidemic's evolution and the policy responses of other countries.
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Álvarez-Mon M, Ortega MA, Gasulla Ó, Fortuny-Profitós J, Mazaira-Font FA, Saurina P, Monserrat J, Plana MN, Troncoso D, Moreno JS, Muñoz B, Arranz A, Varona JF, Lopez-Escobar A, Barco AAD. A Predictive Model and Risk Factors for Case Fatality of COVID-19. J Pers Med 2021; 11:36. [PMID: 33430129 PMCID: PMC7827846 DOI: 10.3390/jpm11010036] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
This study aimed to create an individualized analysis model of the risk of intensive care unit (ICU) admission or death for coronavirus disease 2019 (COVID-19) patients as a tool for the rapid clinical management of hospitalized patients in order to achieve a resilience of medical resources. This is an observational, analytical, retrospective cohort study with longitudinal follow-up. Data were collected from the medical records of 3489 patients diagnosed with COVID-19 using RT-qPCR in the period of highest community transmission recorded in Europe to date: February-June 2020. The study was carried out in in two health areas of hospital care in the Madrid region: the central area of the Madrid capital (Hospitales de Madrid del Grupo HM Hospitales (CH-HM), n = 1931) and the metropolitan area of Madrid (Hospital Universitario Príncipe de Asturias (MH-HUPA) n = 1558). By using a regression model, we observed how the different patient variables had unequal importance. Among all the analyzed variables, basal oxygen saturation was found to have the highest relative importance with a value of 20.3%, followed by age (17.7%), lymphocyte/leukocyte ratio (14.4%), CRP value (12.5%), comorbidities (12.5%), and leukocyte count (8.9%). Three levels of risk of ICU/death were established: low-risk level (<5%), medium-risk level (5-20%), and high-risk level (>20%). At the high-risk level, 13% needed ICU admission, 29% died, and 37% had an ICU-death outcome. This predictive model allowed us to individualize the risk for worse outcome for hospitalized patients affected by COVID-19.
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Affiliation(s)
- Melchor Álvarez-Mon
- Service of Internal Medicine and Immune System Diseases-Rheumatology, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain; (M.N.P.); (J.S.M.); (B.M.); (A.A.)
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (M.A.O.); (J.M.); (D.T.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (M.A.O.); (J.M.); (D.T.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
| | - Óscar Gasulla
- Hospital Universitari de Bellvitge–Universitat de Barcelona, 08907 L´Hospitalet de Llobregat, Spain;
| | | | - Ferran A. Mazaira-Font
- Departament d’Econometria, Estadística I Economia Aplicada–Universitat de Barcelona, 08007 Barcelona, Spain;
| | - Pablo Saurina
- Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (M.A.O.); (J.M.); (D.T.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - María N. Plana
- Service of Internal Medicine and Immune System Diseases-Rheumatology, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain; (M.N.P.); (J.S.M.); (B.M.); (A.A.)
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (M.A.O.); (J.M.); (D.T.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - Daniel Troncoso
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (M.A.O.); (J.M.); (D.T.)
| | - José Sanz Moreno
- Service of Internal Medicine and Immune System Diseases-Rheumatology, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain; (M.N.P.); (J.S.M.); (B.M.); (A.A.)
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (M.A.O.); (J.M.); (D.T.)
| | - Benjamin Muñoz
- Service of Internal Medicine and Immune System Diseases-Rheumatology, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain; (M.N.P.); (J.S.M.); (B.M.); (A.A.)
| | - Alberto Arranz
- Service of Internal Medicine and Immune System Diseases-Rheumatology, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain; (M.N.P.); (J.S.M.); (B.M.); (A.A.)
| | - Jose F. Varona
- Service of Internal Medicine, Hospital Universitario HM Montepríncipe, HM Hospitales, 28660 Boadilla del Monte, Spain;
- Faculty of Medicine, Universidad San Pablo-CEU, CEU Universities, Fundación de Investigación HM Hospitales, 28003 Madrid, Spain;
| | - Alejandro Lopez-Escobar
- Faculty of Medicine, Universidad San Pablo-CEU, CEU Universities, Fundación de Investigación HM Hospitales, 28003 Madrid, Spain;
- Service of Pediatrics, Hospital Universitario HM Puerta del Sur, 28938 Móstoles, Spain
| | - Angel Asúnsolo-del Barco
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, University of New York, New York, NY 10027, USA
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