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We propose a quantum machine learning algorithm for efficiently solving a class of problems encoded in quantum controlled unitary operations. The central physical mechanism of the protocol is the iteration of a quantum time-delayed equation that introduces feedback in the dynamics and eliminates the necessity of intermediate measurements. The performance of the quantum algorithm is analyzed by comparing the results obtained in numerical simulations with the outcome of classical machine learning methods for the same problem. The use of time-delayed equations enhances the toolbox of the field of quantum machine learning, which may enable unprecedented applications in quantum technologies.
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Chronic Kidney Disease (CKD) anemia is one of the main common comorbidities in patients undergoing End Stage Renal Disease (ESRD). Iron supplement and especially Erythropoiesis Stimulating Agents (ESA) have become the treatment of choice for that anemia. However, it is very complicated to find an adequate treatment for every patient in each particular situation since dosage guidelines are based on average behaviors, and thus, they do not take into account the particular response to those drugs by different patients, although that response may vary enormously from one patient to another and even for the same patient in different stages of the anemia. This work proposes an advance with respect to previous works that have faced this problem using different methodologies (Machine Learning (ML), among others), since the diversity of the CKD population has been explicitly taken into account in order to produce a general and reliable model for the prediction of ESA/Iron therapy response. Furthermore, the ML model makes use of both human physiology and drug pharmacology to produce a model that outperforms previous approaches, yielding Mean Absolute Errors (MAE) of the Hemoglobin (Hb) prediction around or lower than 0.6 g/dl in the three countries analyzed in the study, namely, Spain, Italy and Portugal.
Assuntos
Anemia , Falência Renal Crônica/terapia , Aprendizado de Máquina , Modelos Biológicos , Diálise Renal , Anemia/sangue , Anemia/tratamento farmacológico , Anemia/etiologia , Estudos de Coortes , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: Anemia is a frequent comorbidity in hemodialysis patients that can be successfully treated by administering erythropoiesis-stimulating agents (ESAs). ESAs dosing is currently based on clinical protocols that often do not account for the high inter- and intra-individual variability in the patient's response. As a result, the hemoglobin level of some patients oscillates around the target range, which is associated with multiple risks and side-effects. This work proposes a methodology based on reinforcement learning (RL) to optimize ESA therapy. METHODS: RL is a data-driven approach for solving sequential decision-making problems that are formulated as Markov decision processes (MDPs). Computing optimal drug administration strategies for chronic diseases is a sequential decision-making problem in which the goal is to find the best sequence of drug doses. MDPs are particularly suitable for modeling these problems due to their ability to capture the uncertainty associated with the outcome of the treatment and the stochastic nature of the underlying process. The RL algorithm employed in the proposed methodology is fitted Q iteration, which stands out for its ability to make an efficient use of data. RESULTS: The experiments reported here are based on a computational model that describes the effect of ESAs on the hemoglobin level. The performance of the proposed method is evaluated and compared with the well-known Q-learning algorithm and with a standard protocol. Simulation results show that the performance of Q-learning is substantially lower than FQI and the protocol. When comparing FQI and the protocol, FQI achieves an increment of 27.6% in the proportion of patients that are within the targeted range of hemoglobin during the period of treatment. In addition, the quantity of drug needed is reduced by 5.13%, which indicates a more efficient use of ESAs. CONCLUSION: Although prospective validation is required, promising results demonstrate the potential of RL to become an alternative to current protocols.
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Anemia/tratamento farmacológico , Inteligência Artificial , Técnicas de Apoio para a Decisão , Hematínicos/uso terapêutico , Reforço Psicológico , Diálise Renal/efeitos adversos , Idoso , Algoritmos , Anemia/sangue , Anemia/etiologia , Doença Crônica , Feminino , Hemoglobina A/metabolismo , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Cadeias de Markov , Pessoa de Meia-Idade , Seleção de PacientesRESUMO
Patients who suffer from chronic renal failure (CRF) tend to suffer from an associated anemia as well. Therefore, it is essential to know the hemoglobin (Hb) levels in these patients. The aim of this paper is to predict the hemoglobin (Hb) value using a database of European hemodialysis patients provided by Fresenius Medical Care (FMC) for improving the treatment of this kind of patients. For the prediction of Hb, both analytical measurements and medication dosage of patients suffering from chronic renal failure (CRF) are used. Two kinds of models were trained, global and local models. In the case of local models, clustering techniques based on hierarchical approaches and the adaptive resonance theory (ART) were used as a first step, and then, a different predictor was used for each obtained cluster. Different global models have been applied to the dataset such as Linear Models, Artificial Neural Networks (ANNs), Support Vector Machines (SVM) and Regression Trees among others. Also a relevance analysis has been carried out for each predictor model, thus finding those features that are most relevant for the given prediction.
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Anemia/sangue , Anemia/tratamento farmacológico , Inteligência Artificial , Monitoramento de Medicamentos/métodos , Eritropoetina/administração & dosagem , Hemoglobinas/análise , Diálise Renal/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Anemia/diagnóstico , Biomarcadores/sangue , Simulação por Computador , Relação Dose-Resposta a Droga , Quimioterapia Assistida por Computador/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Cardiovasculares , Diálise Renal/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resultado do Tratamento , Adulto JovemRESUMO
Detection of ventricular fibrillation (VF) at an early stage is being deeply studied in order to lower the risk of sudden death and allows the specialist to have greater reaction time to give the patient a good recovering therapy. Some works are focusing on detecting VF based on numerical analysis of time-frequency distributions, but in general the methods used do not provide insight into the problem. However, this study proposes a new methodology in order to obtain information about this problem. This work uses a supervised self-organising map (SOM) to obtain visually information among four important groups of patients: VF (ventricular fibrillation), VT (ventricular tachycardia), HP (healthy patients) and AHR (other anomalous heart rates and noise). A total number of 27 variables were obtained from continuous surface ECG recordings in standard databases (MIT and AHA), providing information in the time, frequency, and time-frequency domains. self-organising maps (SOMs), trained with 11 of the 27 variables, were used to extract knowledge about the variable values for each group of patients. Results show that the SOM technique allows to determine the profile of each group of patients, assisting in gaining a deeper understanding of this clinical problem. Additionally, information about the most relevant variables is given by the SOM analysis.
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Mineração de Dados/métodos , Taquicardia Ventricular/diagnóstico , Fibrilação Ventricular/diagnóstico , Algoritmos , Bases de Dados Factuais , Eletrocardiografia/métodos , Frequência Cardíaca , Humanos , Redes Neurais de Computação , Processamento de Sinais Assistido por Computador , Software , Taquicardia Ventricular/fisiopatologia , Fatores de Tempo , Fibrilação Ventricular/fisiopatologiaRESUMO
Sparse Manifold Clustering and Embedding (SMCE) algorithm has been recently proposed for simultaneous clustering and dimensionality reduction of data on nonlinear manifolds using sparse representation techniques. In this work, SMCE algorithm is applied to the differential discrimination of Glioblastoma and Meningioma Tumors by means of their Gene Expression Profiles. Our purpose was to evaluate the robustness of this nonlinear manifold to classify gene expression profiles, characterized by the high-dimensionality of their representations and the low discrimination power of most of the genes. For this objective, we used SMCE to reduce the dimensionality of a preprocessed dataset of 35 single-labeling cDNA microarrays with 11500 original clones. Afterwards, supervised and unsupervised methodologies were applied to obtain the classification model: the former was based on linear discriminant analysis, the later on clustering using the SMCE embedding data. The results obtained using both approaches showed that all (100%) the samples could be correctly classified and the results of all repetitions but one formed a compatible cluster of predictive labels. Finally, the embedding dimensionality of the dataset extracted by SMCE revealed large discrimination margins between both classes.