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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.
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
3.
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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