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1.
Comput Biol Med ; 174: 108469, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38636331

RESUMO

This research addresses the problem of detecting acute respiratory, urinary tract, and other infectious diseases in elderly nursing home residents using machine learning algorithms. The study analyzes data extracted from multiple vital signs and other contextual information for diagnostic purposes. The daily data collection process encounters sampling constraints due to weekends, holidays, shift changes, staff turnover, and equipment breakdowns, resulting in numerous nulls, repeated readings, outliers, and meaningless values. The short time series generated also pose a challenge to analysis, preventing the extraction of seasonal information or consistent trends. Blind data collection results in most of the data coming from periods when residents are healthy, resulting in excessively imbalanced data. This study proposes a data cleaning process and then builds a mechanism that reproduces the basal activity of the residents to improve the classification of the disease. The results show that the proposed basal module-assisted machine learning techniques allow anticipating diagnostics 2, 3 or 4 days before doctors decide to start treatment with antibiotics, achieving a performance measured by the area-under-the-curve metric of 0.857. The contributions of this work are: (1) a new data cleaning process; (2) the analysis of contextual information to improve data quality; (3) the generation of a baseline measure for relative comparison; and (4) the use of either binary (disease/no disease) or multiclass classification, differentiating among types of infections and showing the advantages of multiclass versus binary classification. From a medical point of view, the anticipated detection of infectious diseases in institutionalized individuals is brand new.


Assuntos
Doenças Transmissíveis , Casas de Saúde , Sinais Vitais , Humanos , Doenças Transmissíveis/diagnóstico , Idoso , Feminino , Masculino , Aprendizado de Máquina , Inteligência Artificial , Idoso de 80 Anos ou mais , Diagnóstico Precoce , Algoritmos
2.
Biomimetics (Basel) ; 9(2)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38392135

RESUMO

In this study, we introduce an innovative policy in the field of reinforcement learning, specifically designed as an action selection mechanism, and applied herein as a selector for binarization schemes. These schemes enable continuous metaheuristics to be applied to binary problems, thereby paving new paths in combinatorial optimization. To evaluate its efficacy, we implemented this policy within our BSS framework, which integrates a variety of reinforcement learning and metaheuristic techniques. Upon resolving 45 instances of the Set Covering Problem, our results demonstrate that reinforcement learning can play a crucial role in enhancing the binarization techniques employed. This policy not only significantly outperformed traditional methods in terms of precision and efficiency, but also proved to be extensible and adaptable to other techniques and similar problems. The approach proposed in this article is capable of significantly surpassing traditional methods in precision and efficiency, which could have important implications for a wide range of real-world applications. This study underscores the philosophy behind our approach: utilizing reinforcement learning not as an end in itself, but as a powerful tool for solving binary combinatorial problems, emphasizing its practical applicability and potential to transform the way we address complex challenges across various fields.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34948885

RESUMO

BACKGROUND: treating infectious diseases in elderly individuals is difficult; patient referral to emergency services often occurs, since the elderly tend to arrive at consultations with advanced, serious symptoms. AIM: it was hypothesized that anticipating an infectious disease diagnosis by a few days could significantly improve a patient's well-being and reduce the burden on emergency health system services. METHODS: vital signs from residents were taken daily and transferred to a database in the cloud. Classifiers were used to recognize patterns in the spatial domain process of the collected data. Doctors reported their diagnoses when any disease presented. A flexible microservice architecture provided access and functionality to the system. RESULTS: combining two different domains, health and technology, is not easy, but the results are encouraging. The classifiers reported good results; the system has been well accepted by medical personnel and is proving to be cost-effective and a good solution to service disadvantaged areas. In this context, this research found the importance of certain clinical variables in the identification of infectious diseases. CONCLUSIONS: this work explores how to apply mobile communications, cloud services, and machine learning technology, in order to provide efficient tools for medical staff in nursing homes. The scalable architecture can be extended to big data applications that may extract valuable knowledge patterns for medical research.


Assuntos
Pesquisa Biomédica , Doenças Transmissíveis , Idoso , Computação em Nuvem , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Humanos , Aprendizado de Máquina , Casas de Saúde
4.
Artigo em Inglês | MEDLINE | ID: mdl-33671029

RESUMO

A patient suffering from advanced chronic renal disease undergoes several dialysis sessions on different dates. Several clinical parameters are monitored during the different hours of any of these sessions. These parameters, together with the information provided by other parameters of analytical nature, can be very useful to determine the probability that a patient may suffer from hypotension during the session, which should be specially watched since it represents a proven factor of possible mortality. However, the analytical information is not always available to the healthcare personnel, or it is far in time, so the clinical parameters monitored during the session become key to the prevention of hypotension. This article presents an investigation to predict the appearance of hypotension during a dialysis session, using predictive models trained from a large dialysis database, which contains the clinical information of 98,015 sessions corresponding to 758 patients. The prediction model takes into account up to 22 clinical parameters measured five times during the session, as well as the gender and age of the patient. This model was trained by means of machine learning classifiers, providing a success in the prediction higher than 80%.


Assuntos
Hipotensão , Falência Renal Crônica , Humanos , Hipotensão/etiologia , Falência Renal Crônica/terapia , Aprendizado de Máquina , Probabilidade , Diálise Renal/efeitos adversos
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