Incorporating High-Frequency Physiologic Data Using Computational Dictionary Learning Improves Prediction of Delayed Cerebral Ischemia Compared to Existing Methods

Frontiers in Neurology

Noemie Elhadad¹  Angela G. Velazquez²  David Jinou Roh²  Murad Megjhani²  Kalijah Terilli²  Kevin William Doyle²  Hans-Peter Frey²  Sachin Agarwal²  Jan Claassen²  Soojin Park²  Edward Sander Connolly³ 

[1] Department of Biomedical Informatics, Columbia University, New York, NY, United States;Department of Neurology, Columbia University, New York, NY, United States;Department of Neurosurgery, Columbia University, New York, NY, United States;

关键词: subarachnoid hemorrhage;    convolutional dictionary learning;    time series;    machine learning;    critical care;   

DOI  :  10.3389/fneur.2018.00122

来源: DOAJ

【 摘 要 】

PurposeAccurate prediction of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone.Methods488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included. Models were trained on 80%, while 20% were set aside for validation testing. Modified Fisher Scale was considered the standard grading scale in clinical use; baseline features also analyzed included age, sex, Hunt–Hess, and Glasgow Coma Scales. An unsupervised approach using convolution dictionary learning was used to extract features from physiological time series (systolic blood pressure and diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation). Classifiers (partial least squares and linear and kernel support vector machines) were trained on feature subsets of the derivation dataset. Models were applied to the validation dataset.ResultsThe performances of the best classifiers on the validation dataset are reported by feature subset. Standard grading scale (mFS): AUC 0.54. Combined demographics and grading scales (baseline features): AUC 0.63. Kernel derived physiologic features: AUC 0.66. Combined baseline and physiologic features with redundant feature reduction: AUC 0.71 on derivation dataset and 0.78 on validation dataset.ConclusionCurrent DCI prediction tools rely on admission imaging and are advantageously simple to employ. However, using an agnostic and computationally inexpensive learning approach for high-frequency physiologic time series data, we demonstrated that we could incorporate individual physiologic data to achieve higher classification accuracy.

【 授权许可】

Unknown