Using machine learning to predict blood culture outcomes in the emergency department: A single-centre, retrospective, observational study

Autor: Boerman, Anneroos W, Schinkel, Michiel, Meijerink, Lotta, van den Ende, Eva S, Pladet, Lara CA, Scholtemeijer, Martijn G, Zeeuw, Joost, van der Zaag, Anuschka Y, Minderhoud, Tanca C, Elbers, Paul W G, Wiersinga, W Joost, de Jonge, Robert, Kramer, Mark HH, Nanayakkara, Prabath W B
Přispěvatelé: Center of Experimental and Molecular Medicine, Graduate School, Infectious diseases, AII - Cancer immunology, AII - Infectious diseases, Clinical chemistry, Internal medicine, Intensive care medicine, ACS - Diabetes & metabolism, Amsterdam Gastroenterology Endocrinology Metabolism, VU University medical center, APH - Quality of Care, APH - Digital Health
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMJ open, 12(1):e053332. BMJ Publishing Group
BMJ Open, 12(1):e053332. BMJ Publishing Group
Boerman, A W, Schinkel, M, Meijerink, L, van den Ende, E S, Pladet, L C, Scholtemeijer, M G, Zeeuw, J, van der Zaag, A Y, Minderhoud, T C, Elbers, P W G, Wiersinga, W J, de Jonge, R, Kramer, M H & Nanayakkara, P W B 2022, ' Using machine learning to predict blood culture outcomes in the emergency department : A single-centre, retrospective, observational study ', BMJ Open, vol. 12, no. 1, e053332 . https://doi.org/10.1136/bmjopen-2021-053332
BMJ Open
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2021-053332
Popis: ObjectivesTo develop predictive models for blood culture (BC) outcomes in an emergency department (ED) setting.DesignRetrospective observational study.SettingED of a large teaching hospital in the Netherlands between 1 September 2018 and 24 June 2020.ParticipantsAdult patients from whom BCs were collected in the ED. Data of demographic information, vital signs, administered medications in the ED and laboratory and radiology results were extracted from the electronic health record, if available at the end of the ED visits.Main outcome measuresThe primary outcome was the performance of two models (logistic regression and gradient boosted trees) to predict bacteraemia in ED patients, defined as at least one true positive BC collected at the ED.ResultsIn 4885 out of 51 399 ED visits (9.5%), BCs were collected. In 598/4885 (12.2%) visits, at least one of the BCs was true positive. Both a gradient boosted tree model and a logistic regression model showed good performance in predicting BC results with area under curve of the receiver operating characteristics of 0.77 (95% CI 0.73 to 0.82) and 0.78 (95% CI 0.73 to 0.82) in the test sets, respectively. In the gradient boosted tree model, the optimal threshold would predict 69% of BCs in the test set to be negative, with a negative predictive value of over 94%.ConclusionsBoth models can accurately identify patients with low risk of bacteraemia at the ED in this single-centre setting and may be useful to reduce unnecessary BCs and associated healthcare costs. Further studies are necessary for validation and to investigate the potential clinical benefits and possible risks after implementation.
Databáze: OpenAIRE
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