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Predicting mortality risk for preterm infants using random forest.

ABSTRACT: Mortality is an unfortunately common outcome of extremely and very preterm birth. Existing clinical prediction models capture mortality risk at birth but fail to account for the remainder of the hospital course. Infants born < 32 weeks gestation with complete physiologic and clinical data were included in this retrospective study. Mortality risk was quantified by conventional means (clinical factors) using the CRIB-II score and the optimal logistic regression model. A random forest (RF) model was trained using a subset of the cohort, labeling data within 6 h of death as "worry." The model was then tested using the remaining infants. A total of 275 infants were included in the study with a mean gestational age of 27 weeks, mean birth weight of 929 g, 49% female, and a mortality rate of 21%. The CRIB-II and logistic regression models had acceptable performance with sensitivities of 71% and 80% AUC scores of 0.78 and 0.84, respectively. The RF model had superior performance with a sensitivity of 88% and an AUC of 0.93. A random forest model which incorporates fixed clinical factors with the influence of aberrancies in subsequent physiology has superior performance for mortality prediction compared to conventional models.

SUBMITTER: Lee J

PROVIDER: S-EPMC8012581 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Predicting mortality risk for preterm infants using random forest.

Lee Jennifer J Cai Jinjin J Li Fuhai F Vesoulis Zachary A ZA

Scientific reports 20210331 1

Mortality is an unfortunately common outcome of extremely and very preterm birth. Existing clinical prediction models capture mortality risk at birth but fail to account for the remainder of the hospital course. Infants born < 32 weeks gestation with complete physiologic and clinical data were included in this retrospective study. Mortality risk was quantified by conventional means (clinical factors) using the CRIB-II score and the optimal logistic regression model. A random forest (RF) model wa ...[more]

PMID: 33790395

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Project description:BackgroundMajority of influenza A viruses reside and circulate among animal populations, seldom infecting humans due to host range restriction. Yet when some avian strains do acquire the ability to overcome species barrier, they might become adapted to humans, replicating efficiently and causing diseases, leading to potential pandemic. With the huge influenza A virus reservoir in wild birds, it is a cause for concern when a new influenza strain emerges with the ability to cross host species barrier, as shown in light of the recent H7N9 outbreak in China. Several influenza proteins have been shown to be major determinants in host tropism. Further understanding and determining host tropism would be important in identifying zoonotic influenza virus strains capable of crossing species barrier and infecting humans.ResultsIn this study, computational models for 11 influenza proteins have been constructed using the machine learning algorithm random forest for prediction of host tropism. The prediction models were trained on influenza protein sequences isolated from both avian and human samples, which were transformed into amino acid physicochemical properties feature vectors. The results were highly accurate prediction models (ACC>96.57; AUC>0.980; MCC>0.916) capable of determining host tropism of individual influenza proteins. In addition, features from all 11 proteins were used to construct a combined model to predict host tropism of influenza virus strains. This would help assess a novel influenza strain's host range capability.ConclusionsFrom the prediction models constructed, all achieved high prediction performance, indicating clear distinctions in both avian and human proteins. When used together as a host tropism prediction system, zoonotic strains could potentially be identified based on different protein prediction results. Understanding and predicting host tropism of influenza proteins lay an important foundation for future work in constructing computation models capable of directly predicting interspecies transmission of influenza viruses. The models are available for prediction at http://fluleap.bic.nus.edu.sg.

Project description:BackgroundThe long-term prognosis of the cardio-metabolic and renal complications, in addition to mortality in patients with newly diagnosed pulmonary hypertension, are unclear. This study aims to develop a scalable predictive model in the form of an electronic frailty index (eFI) to predict different adverse outcomes.MethodsThis was a population-based cohort study of patients diagnosed with pulmonary hypertension between January 1st, 2000 and December 31st, 2017, in Hong Kong public hospitals. The primary outcomes were mortality, cardiovascular complications, renal diseases, and diabetes mellitus. The univariable and multivariable Cox regression analyses were applied to identify the significant risk factors, which were fed into the non-parametric random survival forest (RSF) model to develop an eFI.ResultsA total of 2,560 patients with a mean age of 63.4 years old (interquartile range: 38.0-79.0) were included. Over a follow-up, 1,347 died and 1,878, 437, and 684 patients developed cardiovascular complications, diabetes mellitus, and renal disease, respectively. The RSF-model-identified age, average readmission, anti-hypertensive drugs, cumulative length of stay, and total bilirubin were among the most important risk factors for predicting mortality. Pair-wise interactions of factors including diagnosis age, average readmission interval, and cumulative hospital stay were also crucial for the mortality prediction. Patients who developed all-cause mortality had higher values of the eFI compared to those who survived (P < 0.0001). An eFI ≥ 9.5 was associated with increased risks of mortality [hazard ratio (HR): 1.90; 95% confidence interval [CI]: 1.70-2.12; P < 0.0001]. The cumulative hazards were higher among patients who were 65 years old or above with eFI ≥ 9.5. Using the same cut-off point, the eFI predicted a long-term mortality over 10 years (HR: 1.71; 95% CI: 1.53-1.90; P < 0.0001). Compared to the multivariable Cox regression, the precision, recall, area under the curve (AUC), and C-index were significantly higher for RSF in the prediction of outcomes.ConclusionThe RSF models identified the novel risk factors and interactions for the development of complications and mortality. The eFI constructed by RSF accurately predicts the complications and mortality of patients with pulmonary hypertension, especially among the elderly.

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Predicting mortality risk for preterm infants using random forest.

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Predicting mortality risk for preterm infants using random forest.

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