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Artificial intelligence-based prediction of transfusion in the intensive care unit in patients with gastrointestinal bleeding.
Levi, Riccardo; Carli, Francesco; Arévalo, Aldo Robles; Altinel, Yuksel; Stein, Daniel J; Naldini, Matteo Maria; Grassi, Federica; Zanoni, Andrea; Finkelstein, Stan; Vieira, Susana M; Sousa, João; Barbieri, Riccardo; Celi, Leo Anthony.
Afiliación
  • Levi R; Department of Electronic, Information and Bioengineering, Politecnico di Milano, Milano, Italy riccardo.levi@mail.polimi.it.
  • Carli F; Department of Informatics, Università degli Studi di Torino, Torino, Piemonte, Italy.
  • Arévalo AR; IDMEC, Instituto Superior Tecnico, Universidade de Lisboa, Lisbon, Portugal.
  • Altinel Y; General Surgery Department, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
  • Stein DJ; Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
  • Naldini MM; San Raffaele Telethon Institute for Gene Therapy, Milano, Lombardia, Italy.
  • Grassi F; School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Milano, Lombardia, Italy.
  • Zanoni A; Institute of Mathematics, Ecole Polytechnique Federale de Lausanne, Lausanne, VD, Switzerland.
  • Finkelstein S; Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
  • Vieira SM; Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Boston, MA, USA.
  • Sousa J; IDMEC, Instituto Superior Tecnico, Universidade de Lisboa, Lisbon, Portugal.
  • Barbieri R; IDMEC, Instituto Superior Tecnico, Universidade de Lisboa, Lisbon, Portugal.
  • Celi LA; Department of Electronic, Information and Bioengineering, Politecnico di Milano, Milano, Italy.
BMJ Health Care Inform ; 28(1)2021 Jan.
Article en En | MEDLINE | ID: mdl-33455913
OBJECTIVE: Gastrointestinal (GI) bleeding commonly requires intensive care unit (ICU) in cases of potentialhaemodynamiccompromise or likely urgent intervention. However, manypatientsadmitted to the ICU stop bleeding and do not require further intervention, including blood transfusion. The present work proposes an artificial intelligence (AI) solution for the prediction of rebleeding in patients with GI bleeding admitted to ICU. METHODS: A machine learning algorithm was trained and tested using two publicly available ICU databases, the Medical Information Mart for Intensive Care V.1.4 database and eICU Collaborative Research Database using freedom from transfusion as a proxy for patients who potentially did not require ICU-level care. Multiple initial observation time frames were explored using readily available data including labs, demographics and clinical parameters for a total of 20 covariates. RESULTS: The optimal model used a 5-hour observation period to achieve an area under the curve of the receiving operating curve (ROC-AUC) of greater than 0.80. The model was robust when tested against both ICU databases with a similar ROC-AUC for all. CONCLUSIONS: The potential disruptive impact of AI in healthcare innovation is acknowledge, but awareness of AI-related risk on healthcare applications and current limitations should be considered before implementation and deployment. The proposed algorithm is not meant to replace but to inform clinical decision making. Prospective clinical trial validation as a triage tool is warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Transfusión Sanguínea / Inteligencia Artificial / Hemorragia Gastrointestinal / Unidades de Cuidados Intensivos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: BMJ Health Care Inform Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Transfusión Sanguínea / Inteligencia Artificial / Hemorragia Gastrointestinal / Unidades de Cuidados Intensivos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: BMJ Health Care Inform Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido