Development, validation, and feature extraction of a deep learning model predicting in-hospital mortality using Japan’s largest national ICU database: a validation framework for transparent clinical Artificial Intelligence (cAI) development - 22/03/23
Highlights |
• | Evaluated a novel deep neural network to promote transparent clinical AI development. |
• | Data within 24 hours of ICU admission from Japan’s largest ICU database was used. |
• | Our novel deep neural network performed higher than traditional mortality models. |
• | The DNN-based feature extraction method is robust for developing interpretable clinical AI tools. |
Abstract |
Objective |
While clinical Artificial Intelligence (cAI) mortality prediction models and relevant studies have increased, limitations including the lack of external validation studies and inadequate model calibration leading to decreased overall accuracy have been observed. To combat this, we developed and evaluated a novel deep neural network (DNN) and a validation framework to promote transparent cAI development.
Methods |
Data from Japan’s largest ICU database was used to develop the DNN model, predicting in-hospital mortality including ICU and post-ICU mortality by days since ICU discharge. The most important variables to the model were extracted with SHapley Additive exPlanations (SHAP) to examine the DNN’s efficacy as well as develop models that were also externally validated.
Main results |
The area under the receiver operating characteristic curve (AUC) for predicting ICU mortality was 0.94 [0.93-0.95], and 0.91 [0.90-0.92] for in-hospital mortality, ranging between 0.91–0.95 throughout one year since ICU discharge. An external validation using only the top 20 variables resulted with higher AUCs than traditional severity scores.
Conclusions |
Our DNN model consistently generated AUCs between 0.91–0.95 regardless of days since ICU discharge. The 20 most important variables to our DNN, also generated higher AUCs than traditional severity scores regardless of days since ICU discharge. To our knowledge, this is the first study that predicts ICU and in-hospital mortality using cAI by post-ICU discharge days up to over a year. This finding could contribute to increased transparency on cAI applications.
Le texte complet de cet article est disponible en PDF.Keywords : Clinical decision support, Machine learning, Artificial Intelligence, Mortality prediction, Ethical artificial intelligence
Plan
Vol 42 - N° 2
Article 101167- avril 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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