دورية أكاديمية

Detection of Bacteremia in Surgical In-Patients Using Recurrent Neural Network Based on Time Series Records: Development and Validation Study

التفاصيل البيبلوغرافية
العنوان: Detection of Bacteremia in Surgical In-Patients Using Recurrent Neural Network Based on Time Series Records: Development and Validation Study
المؤلفون: Park, Hyung Jun, Jung, Dae Yon, Ji, Wonjun, Choi, Chang-Min
المصدر: Journal of Medical Internet Research, Vol 22, Iss 8, p e19512 (2020)
بيانات النشر: JMIR Publications, 2020.
سنة النشر: 2020
المجموعة: LCC:Computer applications to medicine. Medical informatics
LCC:Public aspects of medicine
مصطلحات موضوعية: Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
الوصف: BackgroundDetecting bacteremia among surgical in-patients is more obscure than other patients due to the inflammatory condition caused by the surgery. The previous criteria such as systemic inflammatory response syndrome or Sepsis-3 are not available for use in general wards, and thus, many clinicians usually rely on practical senses to diagnose postoperative infection. ObjectiveThis study aims to evaluate the performance of continuous monitoring with a deep learning model for early detection of bacteremia for surgical in-patients in the general ward and the intensive care unit (ICU). MethodsIn this retrospective cohort study, we included 36,023 consecutive patients who underwent general surgery between October and December 2017 at a tertiary referral hospital in South Korea. The primary outcome was the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC) for detecting bacteremia by the deep learning model, and the secondary outcome was the feature explainability of the model by occlusion analysis. ResultsOut of the 36,023 patients in the data set, 720 cases of bacteremia were included. Our deep learning–based model showed an AUROC of 0.97 (95% CI 0.974-0.981) and an AUPRC of 0.17 (95% CI 0.147-0.203) for detecting bacteremia in surgical in-patients. For predicting bacteremia within the previous 24-hour period, the AUROC and AUPRC values were 0.93 and 0.15, respectively. Occlusion analysis showed that vital signs and laboratory measurements (eg, kidney function test and white blood cell group) were the most important variables for detecting bacteremia. ConclusionsA deep learning model based on time series electronic health records data had a high detective ability for bacteremia for surgical in-patients in the general ward and the ICU. The model may be able to assist clinicians in evaluating infection among in-patients, ordering blood cultures, and prescribing antibiotics with real-time monitoring.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1438-8871
العلاقة: https://www.jmir.org/2020/8/e19512Test; https://doaj.org/toc/1438-8871Test
DOI: 10.2196/19512
الوصول الحر: https://doaj.org/article/068ca4cdc3c1401496dcb3a2e92a4e09Test
رقم الانضمام: edsdoj.068ca4cdc3c1401496dcb3a2e92a4e09
قاعدة البيانات: Directory of Open Access Journals