Evidence map›Paper›PMID 37540703›Full record

Observational studyPloS one2023

A data-driven model for early prediction of need for invasive mechanical ventilation in pediatric intensive care unit patients.

Sanjukta N Bose, Andrew Defante, Joseph L Greenstein, Gabriel G Haddad, Julie Ryu, Raimond L Winslow

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

6 authors.

Sanjukta N BoseEnterprise Data and Analytics, University of Maryland Medical System, Linthicum Heights, MD, United States of America.
Andrew DefanteRady Children's Hospital, San Diego, CA, United States of America.
Joseph L GreensteinInstitute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States of America.
Gabriel G HaddadRady Children's Hospital, San Diego, CA, United States of America.
Julie RyuDivision of Respiratory Medicine, Department of Pediatrics, University of California San Diego, La Jolla, CA, United States of America.ORCID 0009-0009-0000-0274
Raimond L WinslowInstitute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States of America.

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
NCATS NIH HHS UL1 TR001079
6 · The paper itself

Abstract

rationaleAcute respiratory failure is a life-threatening clinical outcome in critically ill pediatric patients. In severe cases, patients can require mechanical ventilation (MV) for survival. Early recognition of these patients can potentially help clinicians alter the clinical course and lead to improved outcomes.

objectivesTo build a data-driven model for early prediction of the need for mechanical ventilation in pediatric intensive care unit (PICU) patients.

methodsThe study consists of a single-center retrospective observational study on a cohort of 13,651 PICU patients admitted between 1/01/2010 and 5/15/2018 with a prevalence of 8.06% for MV due to respiratory failure. XGBoost (extreme gradient boosting) and a convolutional neural network (CNN) using medication history were used to develop a prediction model that could yield a time-varying "risk-score"-a continuous probability of whether a patient will receive MV-and an ideal global threshold was calculated from the receiver operating characteristics (ROC) curve. The early prediction point (EPP) was the first time the risk-score surpassed the optimal threshold, and the interval between the EPP and the start of the MV was the early warning period (EWT). Spectral clustering identified patient groups based on risk-score trajectories after EPP.

resultsA clinical and medication history-based model achieved a 0.89 area under the ROC curve (AUROC), 0.6 sensitivity, 0.95 specificity, 0.55 positive predictive value (PPV), and 0.95 negative predictive value (NPV). Early warning time (EWT) median [inter-quartile range] of this model was 9.9[4.2-69.2] hours. Clustering risk-score trajectories within a six-hour window after the early prediction point (EPP) established three patient groups, with the highest risk group's PPV being 0.92.

conclusionsThis study uses a unique method to extract and apply medication history information, such as time-varying variables, to identify patients who may need mechanical ventilation for respiratory failure and provide an early warning period to avert it.

Indexed as

Respiration, ArtificialRespiratory InsufficiencyChildHumansIntensive Care UnitsIntensive Care Units, PediatricRetrospective StudiesROC Curve

Identifiers

PMID37540703
PMCPMC10403092

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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.