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2024 (English)In: Neurocritical Care, ISSN 1541-6933, E-ISSN 1556-0961Article in journal (Refereed) Epub ahead of print
Abstract [en]
Background
In neurointensive care, increased intracranial pressure (ICP) is a feared secondary brain insult in traumatic brain injury (TBI). A system that predicts ICP insults before they emerge may facilitate early optimization of the physiology, which may in turn lead to stopping the predicted ICP insult from occurring. The aim of this study was to evaluate the performance of different artificial intelligence models in predicting the risk of ICP insults.
Methods
The models were trained to predict risk of ICP insults starting within 30 min, using the Uppsala high frequency TBI dataset. A restricted dataset consisting of only monitoring data were used, and an unrestricted dataset using monitoring data as well as clinical data, demographic data, and radiological evaluations was used. Four different model classes were compared: Gaussian process regression, logistic regression, random forest classifier, and Extreme Gradient Boosted decision trees (XGBoost).
Results
Six hundred and two patients with TBI were included (total monitoring 138,411 h). On the task of predicting upcoming ICP insults, the Gaussian process regression model performed similarly on the Uppsala high frequency TBI dataset (sensitivity 93.2%, specificity 93.9%, area under the receiver operating characteristic curve [AUROC] 98.3%), as in earlier smaller studies. Using a more flexible model (XGBoost) resulted in a comparable performance (sensitivity 93.8%, specificity 94.6%, AUROC 98.7%). Adding more clinical variables and features further improved the performance of the models slightly (XGBoost: sensitivity 94.1%, specificity of 94.6%, AUROC 98.8%).
Conclusions
Artificial intelligence models have potential to become valuable tools for predicting ICP insults in advance during neurointensive care. The fact that common off-the-shelf models, such as XGBoost, performed well in predicting ICP insults opens new possibilities that can lead to faster advances in the field and earlier clinical implementations.
Place, publisher, year, edition, pages
Springer, 2024
Keywords
TBI, AI, Machine learning, Intracranial hypertension, Critical care
National Category
Signal Processing Neurology
Identifiers
urn:nbn:se:uu:diva-533622 (URN)10.1007/s12028-024-02119-7 (DOI)
Funder
Swedish Research Council, 2022-06725Swedish Research Council, 2018-05973Kjell and Marta Beijer FoundationSwedish National Infrastructure for Computing (SNIC)National Academic Infrastructure for Supercomputing in Sweden (NAISS)Uppsala UniversityRegion Uppsala
Note
De två första författarna delar förstaförfattarskapet
2024-06-272024-06-272024-09-27Bibliographically approved