Ensemble machine learning for predicting in-hospital mortality in Asian women with ST-elevation myocardial infarction (STEMI).

The accurate prediction of in-hospital mortality in Asian women after ST-Elevation Myocardial Infarction (STEMI) remains a crucial issue in medical research. Existing models frequently neglect this demographic's particular attributes, resulting in poor treatment outcomes. This study aims to improve the prediction of in-hospital mortality in multi-ethnic Asian women with STEMI by employing both base and ensemble machine learning (ML) models. We centred on the development of demographic-specific models using data from the Malaysian National Cardiovascular Disease Database spanning 2006 to 2016. Through a careful iterative feature selection approach that included feature importance and sequential backward elimination, significant variables such as systolic blood pressure, Killip class, fasting blood glucose, beta-blockers, angiotensin-converting enzyme inhibitors (ACE), and oral hypoglycemic medications were identified. The findings of our study revealed that ML models with selected features outperformed the conventional Thrombolysis in Myocardial Infarction (TIMI) Risk score, with area under the curve (AUC) ranging from 0.60 to 0.93 versus TIMI's AUC of 0.81. Remarkably, our best-performing ensemble ML model was surpassed by the base ML model, support vector machine (SVM) Linear with SVM selected features (AUC: 0.93, CI: 0.89-0.98 versus AUC: 0.91, CI: 0.87-0.96). Furthermore, the women-specific model outperformed a non-gender-specific STEMI model (AUC: 0.92, CI: 0.87-0.97). Our findings demonstrate the value of women-specific ML models over standard approaches, emphasizing the importance of continued testing and validation to improve clinical care for women with STEMI.

Predicting post-stroke activities of daily living through a machine learning-based approach on initiating rehabilitation.

OBJECTIVES: Prediction of activities of daily living (ADL) is crucial for optimized care of post-stroke patients. However, no suitably-validated and practical models are currently available in clinical practice. METHODS: Participants of a Post-acute Care-Cerebrovascular Diseases (PAC-CVD) program from a reference hospital in Taiwan between 2014 and 2016 were enrolled in this study. Based on 15 rehabilitation assessments, machine learning (ML) methods, namely logistic regression (LR), support vector machine (SVM), and random forest (RF), were used to predict the Barthel index (BI) status at discharge. Furthermore, SVM and linear regression were used to predict the actual BI scores at discharge. RESULTS: A total of 313 individuals (men: 208; women: 105) were enrolled in the study. All the classification models outperformed single assessments in predicting the BI statuses of the patients at discharge. The performance of the LR and RF algorithms was higher (area under ROC curve (AUC): 0.79) than that of SVM algorithm (AUC: 0.77). In addition, the mean absolute errors of both SVM and linear regression models in predicting the actual BI score at discharge were 9.86 and 9.95, respectively. CONCLUSIONS: The proposed ML-based method provides a promising and practical computer-assisted decision making tool for predicting ADL in clinical practice.