论文标题

Autoscore-Ordinal:一个可解释的机器学习框架,用于生成序数结果的评分模型

AutoScore-Ordinal: An interpretable machine learning framework for generating scoring models for ordinal outcomes

论文作者

Saffari, Seyed Ehsan, Ning, Yilin, Feng, Xie, Chakraborty, Bibhas, Volovici, Victor, Vaughan, Roger, Ong, Marcus Eng Hock, Liu, Nan

论文摘要

背景:风险预测模型是临床决策中有用的工具,有助于进行风险分层和资源分配,并可能为患者提供更好的医疗保健。 Autoscore是一种基于机器学习的自动临床评分生成器,用于二进制结果。这项研究旨在扩大自动赛框架,为序数结果提供可解释的风险预测工具。方法:使用原始Autoscore算法的6个模块(包括可变排名,可变转换,得分派生(来自比例的赔率模型),模型选择,得分微调和模型评估)生成自动式框架。为了说明自动界绩效,该方法是在2008年至2017年的新加坡综合医院急诊科的电子健康记录数据上进行的。该模型接受了70%的数据培训,对10%进行了验证,并对剩余20%进行了测试。结果:这项研究包括445,989例住院病例,其中序数结局的分布在没有30天的再入院的情况下还活着80.7%,在30天的再入院中活着12.5%,而6.8%的住院死亡或出院后第30天死亡。使用灵活变量选择过程确定的两组8组预测变量开发了两个基于点的风险预测模型。这两个模型表明,在接收器操作特征曲线(0.785和0.793)和广义C索引(0.737和0.760)下,通过平均面积进行了相当好的性能,它们与替代模型相当。结论:Autoscore-Ordinal提供了一个自动化且易于使用的框架,用于开发和验证序数结果的风险预测模型,该模型可以系统地从高维数据中系统地识别潜在的预测指标。

Background: Risk prediction models are useful tools in clinical decision-making which help with risk stratification and resource allocations and may lead to a better health care for patients. AutoScore is a machine learning-based automatic clinical score generator for binary outcomes. This study aims to expand the AutoScore framework to provide a tool for interpretable risk prediction for ordinal outcomes. Methods: The AutoScore-Ordinal framework is generated using the same 6 modules of the original AutoScore algorithm including variable ranking, variable transformation, score derivation (from proportional odds models), model selection, score fine-tuning, and model evaluation. To illustrate the AutoScore-Ordinal performance, the method was conducted on electronic health records data from the emergency department at Singapore General Hospital over 2008 to 2017. The model was trained on 70% of the data, validated on 10% and tested on the remaining 20%. Results: This study included 445,989 inpatient cases, where the distribution of the ordinal outcome was 80.7% alive without 30-day readmission, 12.5% alive with 30-day readmission, and 6.8% died inpatient or by day 30 post discharge. Two point-based risk prediction models were developed using two sets of 8 predictor variables identified by the flexible variable selection procedure. The two models indicated reasonably good performance measured by mean area under the receiver operating characteristic curve (0.785 and 0.793) and generalized c-index (0.737 and 0.760), which were comparable to alternative models. Conclusion: AutoScore-Ordinal provides an automated and easy-to-use framework for development and validation of risk prediction models for ordinal outcomes, which can systematically identify potential predictors from high-dimensional data.

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