Evidence map›Paper›PMID 32152583›Full record

ArticleNature medicine2020

Early prediction of circulatory failure in the intensive care unit using machine learning.

Stephanie L Hyland, Martin Faltys, Matthias Hüser, Xinrui Lyu, Thomas Gumbsch, Cristóbal Esteban, Christian Bock, Max Horn, Michael Moor, Bastian Rieck and 5 more

Abstract read
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In one paragraph

Article in Nature medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 227 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
227citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

227 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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167 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Stephanie L Hyland *Department of Computer Science, ETH Zürich, Zürich, Switzerland.
Martin Faltys *Department of Intensive Care Medicine, University Hospital, University of Bern, Bern, Switzerland.
Matthias Hüser *Department of Computer Science, ETH Zürich, Zürich, Switzerland.ORCID http://orcid.org/0000-0001-6397-1689
Xinrui Lyu *Department of Computer Science, ETH Zürich, Zürich, Switzerland.
Thomas Gumbsch *Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.
Cristóbal EstebanDepartment of Computer Science, ETH Zürich, Zürich, Switzerland.
Christian BockDepartment of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.ORCID http://orcid.org/0000-0002-0701-5868
Max HornDepartment of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.
Michael MoorDepartment of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.
Bastian RieckDepartment of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.
Marc ZimmermannDepartment of Computer Science, ETH Zürich, Zürich, Switzerland.
Dean BodenhamDepartment of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland.
Karsten BorgwardtDepartment of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland. karsten.borgwardt@bsse.ethz.ch.ORCID http://orcid.org/0000-0001-7221-2393
Gunnar RätschDepartment of Computer Science, ETH Zürich, Zürich, Switzerland. gunnar.raetsch@inf.ethz.ch.ORCID http://orcid.org/0000-0001-5486-8532
Tobias M MerzDepartment of Intensive Care Medicine, University Hospital, University of Bern, Bern, Switzerland. tobiasm@adhb.govt.nz.ORCID http://orcid.org/0000-0002-3149-5873

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Intensive-care clinicians are presented with large quantities of measurements from multiple monitoring systems. The limited ability of humans to process complex information hinders early recognition of patient deterioration, and high numbers of monitoring alarms lead to alarm fatigue. We used machine learning to develop an early-warning system that integrates measurements from multiple organ systems using a high-resolution database with 240 patient-years of data. It predicts 90% of circulatory-failure events in the test set, with 82% identified more than 2 h in advance, resulting in an area under the receiver operating characteristic curve of 0.94 and an area under the precision-recall curve of 0.63. On average, the system raises 0.05 alarms per patient and hour. The model was externally validated in an independent patient cohort. Our model provides early identification of patients at risk for circulatory failure with a much lower false-alarm rate than conventional threshold-based systems.

Indexed as

Intensive Care UnitsMachine LearningCohort StudiesDatabases as TopicHumansModels, TheoreticalPrognosisReproducibility of ResultsRisk FactorsROC CurveShockTime Factors

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.