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1.
Am J Emerg Med ; 35(2): 260-267, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27876174

RESUMO

OBJECTIVES: To construct an artificial neural network (ANN) model that can predict the presence of acute CT findings with both high sensitivity and high specificity when applied to the population of patients≥age 65years who have incurred minor head injury after a fall. METHODS: An ANN was created in the Python programming language using a population of 514 patients ≥ age 65 years presenting to the ED with minor head injury after a fall. The patient dataset was divided into three parts: 60% for "training", 20% for "cross validation", and 20% for "testing". Sensitivity, specificity, positive and negative predictive values, and accuracy were determined by comparing the model's predictions to the actual correct answers for each patient. RESULTS: On the "cross validation" data, the model attained a sensitivity ("recall") of 100.00%, specificity of 78.95%, PPV ("precision") of 78.95%, NPV of 100.00%, and accuracy of 88.24% in detecting the presence of positive head CTs. On the "test" data, the model attained a sensitivity of 97.78%, specificity of 89.47%, PPV of 88.00%, NPV of 98.08%, and accuracy of 93.14% in detecting the presence of positive head CTs. CONCLUSIONS: ANNs show great potential for predicting CT findings in the population of patients ≥ 65 years of age presenting with minor head injury after a fall. As a good first step, the ANN showed comparable sensitivity, predictive values, and accuracy, with a much higher specificity than the existing decision rules in clinical usage for predicting head CTs with acute intracranial findings.


Assuntos
Acidentes por Quedas , Traumatismos Craniocerebrais/diagnóstico por imagem , Redes Neurais de Computação , Tomografia Computadorizada por Raios X/normas , Centros de Traumatologia/normas , Idoso , Análise Custo-Benefício , Traumatismos Craniocerebrais/economia , Traumatismos Craniocerebrais/etiologia , Sistemas de Apoio a Decisões Clínicas , Feminino , Previsões , Humanos , Masculino , Análise de Regressão , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/efeitos adversos , Tomografia Computadorizada por Raios X/economia , Centros de Traumatologia/economia , Centros de Traumatologia/estatística & dados numéricos , Estados Unidos
2.
NPJ Digit Med ; 4(1): 146, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625656

RESUMO

The COVID-19 pandemic has highlighted the global need for reliable models of disease spread. We propose an AI-augmented forecast modeling framework that provides daily predictions of the expected number of confirmed COVID-19 deaths, cases, and hospitalizations during the following 4 weeks. We present an international, prospective evaluation of our models' performance across all states and counties in the USA and prefectures in Japan. Nationally, incident mean absolute percentage error (MAPE) for predicting COVID-19 associated deaths during prospective deployment remained consistently <8% (US) and <29% (Japan), while cumulative MAPE remained <2% (US) and <10% (Japan). We show that our models perform well even during periods of considerable change in population behavior, and are robust to demographic differences across different geographic locations. We further demonstrate that our framework provides meaningful explanatory insights with the models accurately adapting to local and national policy interventions. Our framework enables counterfactual simulations, which indicate continuing Non-Pharmaceutical Interventions alongside vaccinations is essential for faster recovery from the pandemic, delaying the application of interventions has a detrimental effect, and allow exploration of the consequences of different vaccination strategies. The COVID-19 pandemic remains a global emergency. In the face of substantial challenges ahead, the approach presented here has the potential to inform critical decisions.

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