Objective: Risk prediction models are widely used to inform evidence-based clinical decision making. However, few models developed from single cohorts can perform consistently well at population level where diverse prognoses exist (such as the SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] pandemic). This study aims at tackling this challenge by synergizing prediction models from the literature using ensemble learning. Materials and Methods: In this study, we selected and reimplemented 7 prediction models for COVID-19 (coronavirus disease 2019) that were derived from diverse cohorts and used different implementation techniques. A novel ensemble learning framework was proposed to synergize them for realizing personalized predictions for individual patients. Four diverse international cohorts (2 from the United Kingdom and 2 from China; N = 5394) were used to validate all 8 models on discrimination, calibration, and clinical usefulness. Results: Results showed that individual prediction models could perform well on some cohorts while poorly on others. Conversely, the ensemble model achieved the best performances consistently on all metrics quantifying discrimination, calibration, and clinical usefulness. Performance disparities were observed in cohorts from the 2 countries: all models achieved better performances on the China cohorts. Discussion: When individual models were learned from complementary cohorts, the synergized model had the potential to achieve better performances than any individual model. Results indicate that blood parameters and physiological measurements might have better predictive powers when collected early, which remains to be confirmed by further studies. Conclusions: Combining a diverse set of individual prediction models, the ensemble method can synergize a robust and well-performing model by choosing the most competent ones for individual patients.
基金:
Medical Research Council and Health Data Research UK Grant [MR/S003991/1]; Industrial Strategy Challenge Grant [MC_PC_18029]; Wellcome Institutional Translation Partnership Award [PIII054]; National Natural Science Foundation of China [81700006]; UKRI Innovation Fellowship (Health Data Research UK) [MR/S00310X/1]; National Institute for Health Research (NIHR) covid/non-covid research grants; Queen Elizabeth Hospital Charities; LifeArc STOPCOVID award; NIHR Birmingham Experimental Cancer Medical Centre, NIHR Birmingham Surgical Reconstruction and Microbiology Research Centre, Nanocommons H2020-EU [731032]; NIHR Birmingham Biomedical Research Centre and Medical Research Council Health Data Research UK [HDRUK/CFC/01]; NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London; Health Data Research UK; BigData@Heart Consortium - Innovative Medicines Initiative-2 Joint Undertaking [116074]; National Institute for Health Research University College London Hospitals Biomedical Research Centre; UK Research and Innovation London Medical Imaging and Artificial Intelligence Centre for Value Based Healthcare; NIHR Applied Research Collaboration South London at King's College Hospital NHS Foundation Trust; MRC [MR/S003991/1, MR/S00310X/1, MC_PC_18029, MR/S004149/1] Funding Source: UKRI
第一作者单位:[1]UCL, Inst Hlth Informat, London, England[2]UCL, Hlth Data Res UK, London, England[*1]222 Euston Rd, London NW1 2DA, England
通讯作者:
通讯机构:[1]UCL, Inst Hlth Informat, London, England[2]UCL, Hlth Data Res UK, London, England[*1]222 Euston Rd, London NW1 2DA, England
推荐引用方式(GB/T 7714):
Wu Honghan,Zhang Huayu,Karwath Andreas,et al.Ensemble learning for poor prognosis predictions: A case study on SARS-CoV-2[J].JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION.2021,28(4):791-800.doi:10.1093/jamia/ocaa295.
APA:
Wu, Honghan,Zhang, Huayu,Karwath, Andreas,Ibrahim, Zina,Shi, Ting...&Guthrie, Bruce.(2021).Ensemble learning for poor prognosis predictions: A case study on SARS-CoV-2.JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION,28,(4)
MLA:
Wu, Honghan,et al."Ensemble learning for poor prognosis predictions: A case study on SARS-CoV-2".JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION 28..4(2021):791-800