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Machine learning prediction of posttraumatic stress disorder trajectories following traumatic injury: Identification and validation in two independent samples.
Tomas, Carissa W; Fitzgerald, Jacklynn M; Bergner, Carisa; Hillard, Cecilia J; Larson, Christine L; deRoon-Cassini, Terri A.
Afiliação
  • Tomas CW; Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Fitzgerald JM; Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Bergner C; Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA.
  • Hillard CJ; Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Larson CL; Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • deRoon-Cassini TA; Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
J Trauma Stress ; 35(6): 1656-1671, 2022 12.
Article em En | MEDLINE | ID: mdl-36006041
Due to its heterogeneity, the prediction of posttraumatic stress disorder (PTSD) development after traumtic injury is difficult. Recent machine learning approaches have yielded insight into predicting PTSD symptom trajectories. Using data collected within 1 month of traumatic injury, we applied eXtreme Gradient Boosting (XGB) to classify admitted and discharged patients (hospitalized, n = 192; nonhospitalized, n = 214), recruited from a Level 1 trauma center, according to PTSD symptom trajectories. Trajectories were identified using latent class mixed models on PCL-5 scores collected at baseline, 1-3 months posttrauma, and 6 months posttrauma. In both samples, nonremitting, remitting, and resilient PTSD symptom trajectories were identified. In the admitted patient sample, a unique delayed trajectory emerged. Machine learning classifiers (i.e., XGB) were developed and tested on the admitted patient sample and externally validated on the discharged sample with biological and clinical self-report baseline variables as predictors. For external validation sets, prediction was fair for nonremitting versus other trajectories, areas under the curve (AUC = .70); good for nonremitting versus resilient trajectories, AUCs = .73-.76; and prediction failed for nonremitting versus remitting trajectories, AUCs = .46-.48. However, poor precision (< .57) across all models suggests limited generalizability of nonremitting symptom trajectory prediction from admitted to discharged patient samples. Consistency in symptom trajectory identification across samples supports prior studies on the stability of PTSD symptom trajectories following trauma exposure; however, continued work and replication with larger samples are warranted to understand overlapping and unique predictive features of PTSD in different traumatic injury populations.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transtornos de Estresse Pós-Traumáticos Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transtornos de Estresse Pós-Traumáticos Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article