Early prediction of hypothermia in pediatric intensive care units using machine learning
Hypothermia is a life-threatening condition where the temperature of the body drops below 35°C and is a key source of concern in Intensive Care Units (ICUs). Early identification can help to nudge clinical management to initiate early interventions. Despite its importance, very few studies have focu...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.921884/full |
| _version_ | 1811209675784323072 |
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| author | Pradeep Singh Aditya Nagori Aditya Nagori Aditya Nagori Rakesh Lodha Tavpritesh Sethi Tavpritesh Sethi |
| author_facet | Pradeep Singh Aditya Nagori Aditya Nagori Aditya Nagori Rakesh Lodha Tavpritesh Sethi Tavpritesh Sethi |
| author_sort | Pradeep Singh |
| collection | DOAJ |
| description | Hypothermia is a life-threatening condition where the temperature of the body drops below 35°C and is a key source of concern in Intensive Care Units (ICUs). Early identification can help to nudge clinical management to initiate early interventions. Despite its importance, very few studies have focused on the early prediction of hypothermia. In this study, we aim to monitor and predict Hypothermia (30 min-4 h) ahead of its onset using machine learning (ML) models developed on physiological vitals and to prospectively validate the best performing model in the pediatric ICU. We developed and evaluated ML algorithms for the early prediction of hypothermia in a pediatric ICU. Sepsis advanced forecasting engine ICU Database (SafeICU) data resource is an in-house ICU source of data built in the Pediatric ICU at the All-India Institute of Medical Science (AIIMS), New Delhi. Each time-stamp at 1-min resolution was labeled for the presence of hypothermia to construct a retrospective cohort of pediatric patients in the SafeICU data resource. The training set consisted of windows of the length of 4.2 h with a lead time of 30 min-4 h from the onset of hypothermia. A set of 3,835 hand-engineered time-series features were calculated to capture physiological features from the time series. Features selection using the Boruta algorithm was performed to select the most important predictors of hypothermia. A battery of models such as gradient boosting machine, random forest, AdaBoost, and support vector machine (SVM) was evaluated utilizing five-fold test sets. The best-performing model was prospectively validated. A total of 148 patients with 193 ICU stays were eligible for the model development cohort. Of 3,939 features, 726 were statistically significant in the Boruta analysis for the prediction of Hypothermia. The gradient boosting model performed best with an Area Under the Receiver Operating Characteristic curve (AUROC) of 85% (SD = 1.6) and a precision of 59.2% (SD = 8.8) for a 30-min lead time before the onset of Hypothermia onset. As expected, the model showed a decline in model performance at higher lead times, such as AUROC of 77.2% (SD = 2.3) and precision of 41.34% (SD = 4.8) for 4 h ahead of Hypothermia onset. Our GBM(gradient boosting machine) model produced equal and superior results for the prospective validation, where an AUROC of 79.8% and a precision of 53% for a 30-min lead time before the onset of Hypothermia whereas an AUROC of 69.6% and a precision of 38.52% for a (30 min-4 h) lead time prospective validation of Hypothermia. Therefore, this work establishes a pipeline termed ThermoGnose for predicting hypothermia, a major complication in pediatric ICUs. |
| first_indexed | 2024-04-12T04:43:16Z |
| format | Article |
| id | doaj.art-61718a65e02c44fbb8f5d6785b516648 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-12T04:43:16Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj.art-61718a65e02c44fbb8f5d6785b5166482022-12-22T03:47:34ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-09-011310.3389/fphys.2022.921884921884Early prediction of hypothermia in pediatric intensive care units using machine learningPradeep Singh0Aditya Nagori1Aditya Nagori2Aditya Nagori3Rakesh Lodha4Tavpritesh Sethi5Tavpritesh Sethi6Indraprastha Institute of Information Technology, Delhi, IndiaIndraprastha Institute of Information Technology, Delhi, IndiaCSIR-Institute of Genomics and Integrative Biology, New Delhi, IndiaAcademy of Scientific and Innovative Research (AcSIR), Ghaziabad, IndiaAll India Institute of Medical Sciences, Department of Pediatrics, New Delhi, IndiaIndraprastha Institute of Information Technology, Delhi, IndiaAll India Institute of Medical Sciences, Department of Pediatrics, New Delhi, IndiaHypothermia is a life-threatening condition where the temperature of the body drops below 35°C and is a key source of concern in Intensive Care Units (ICUs). Early identification can help to nudge clinical management to initiate early interventions. Despite its importance, very few studies have focused on the early prediction of hypothermia. In this study, we aim to monitor and predict Hypothermia (30 min-4 h) ahead of its onset using machine learning (ML) models developed on physiological vitals and to prospectively validate the best performing model in the pediatric ICU. We developed and evaluated ML algorithms for the early prediction of hypothermia in a pediatric ICU. Sepsis advanced forecasting engine ICU Database (SafeICU) data resource is an in-house ICU source of data built in the Pediatric ICU at the All-India Institute of Medical Science (AIIMS), New Delhi. Each time-stamp at 1-min resolution was labeled for the presence of hypothermia to construct a retrospective cohort of pediatric patients in the SafeICU data resource. The training set consisted of windows of the length of 4.2 h with a lead time of 30 min-4 h from the onset of hypothermia. A set of 3,835 hand-engineered time-series features were calculated to capture physiological features from the time series. Features selection using the Boruta algorithm was performed to select the most important predictors of hypothermia. A battery of models such as gradient boosting machine, random forest, AdaBoost, and support vector machine (SVM) was evaluated utilizing five-fold test sets. The best-performing model was prospectively validated. A total of 148 patients with 193 ICU stays were eligible for the model development cohort. Of 3,939 features, 726 were statistically significant in the Boruta analysis for the prediction of Hypothermia. The gradient boosting model performed best with an Area Under the Receiver Operating Characteristic curve (AUROC) of 85% (SD = 1.6) and a precision of 59.2% (SD = 8.8) for a 30-min lead time before the onset of Hypothermia onset. As expected, the model showed a decline in model performance at higher lead times, such as AUROC of 77.2% (SD = 2.3) and precision of 41.34% (SD = 4.8) for 4 h ahead of Hypothermia onset. Our GBM(gradient boosting machine) model produced equal and superior results for the prospective validation, where an AUROC of 79.8% and a precision of 53% for a 30-min lead time before the onset of Hypothermia whereas an AUROC of 69.6% and a precision of 38.52% for a (30 min-4 h) lead time prospective validation of Hypothermia. Therefore, this work establishes a pipeline termed ThermoGnose for predicting hypothermia, a major complication in pediatric ICUs.https://www.frontiersin.org/articles/10.3389/fphys.2022.921884/fullhypothermiaartificial intelligenceprospective validationpediatric intensive care unittime-series |
| spellingShingle | Pradeep Singh Aditya Nagori Aditya Nagori Aditya Nagori Rakesh Lodha Tavpritesh Sethi Tavpritesh Sethi Early prediction of hypothermia in pediatric intensive care units using machine learning Frontiers in Physiology hypothermia artificial intelligence prospective validation pediatric intensive care unit time-series |
| title | Early prediction of hypothermia in pediatric intensive care units using machine learning |
| title_full | Early prediction of hypothermia in pediatric intensive care units using machine learning |
| title_fullStr | Early prediction of hypothermia in pediatric intensive care units using machine learning |
| title_full_unstemmed | Early prediction of hypothermia in pediatric intensive care units using machine learning |
| title_short | Early prediction of hypothermia in pediatric intensive care units using machine learning |
| title_sort | early prediction of hypothermia in pediatric intensive care units using machine learning |
| topic | hypothermia artificial intelligence prospective validation pediatric intensive care unit time-series |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.921884/full |
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