| Autor: |
Maria D'Amato, Pasquale Ambrosino, Francesca Simioli, Sarah Adamo, Anna Agnese Stanziola, Giovanni D'Addio, Antonio Molino, Mauro Maniscalco |
| Přispěvatelé: |
D'Amato, Maria, Ambrosino, Pasquale, Simioli, Francesca, Adamo, Sarah, Stanziola, Anna Agnese, D'Addio, Giovanni, Molino, Antonio, Maniscalco, Mauro |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
European journal of internal medicine. 104 |
| ISSN: |
1879-0828 |
| Popis: |
One of the main problems in poorly controlled asthma is the access to the Emergency Department (ED). Using a machine learning (ML) approach, the aim of our study was to identify the main predictors of severe asthma exacerbations requiring hospital admission.Consecutive patients with asthma exacerbation were screened for inclusion within 48 hours of ED discharge. A k-means clustering algorithm was implemented to evaluate a potential distinction of different phenotypes. K-Nearest Neighbor (KNN) as instance-based algorithm and Random Forest (RF) as tree-based algorithm were implemented in order to classify patients, based on the presence of at least one additional access to the ED in the previous 12 months.To train our model, we included 260 patients (31.5% males, mean age 47.6 years). Unsupervised ML identified two groups, based on eosinophil count. A total of 86 patients with eosinophiles ≥370 cells/µL were significantly older, had a longer disease duration, more restrictions to daily activities, and lower rate of treatment compared to 174 patients with eosinophileslt;370 cells/μL. In addition, they reported lower values of predicted FEVsub1/sub(64.8±12.3% vs. 83.9±17.3%) and FEVsub1/sub/FVC (71.3±9.3 vs. 78.5±6.8), with a higher amount of exacerbations/year. In supervised ML, KNN achieved the best performance in identifying frequent exacerbators (AUROC: 96.7%), confirming the importance of spirometry parameters and eosinophil count, along with the number of prior exacerbations and other clinical and demographic variables.This study confirms the key prognostic value of eosinophiles in asthma, suggesting the usefulness of ML in defining biological pathways that can help plan personalized pharmacological and rehabilitation strategies. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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