Predicting Individual Responses to Vasoactive Medications in Children with Septic Shock

arXiv.org Machine Learning

Objective: Predict individual septic children's personalized physiologic responses to vasoactive titrations by training a Recurrent Neural Network (RNN) using EMR data. Materials and Methods: This study retrospectively analyzed EMR of patients admitted to a pediatric ICU from 2009 to 2017. Data included charted time series vitals, labs, drugs, and interventions of children with septic shock treated with dopamine, epinephrine, or norepinephrine. A RNN was trained to predict responses in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) to 8,640 titrations during 652 septic episodes and evaluated on a holdout set of 3,883 titrations during 254 episodes. A linear regression model using titration data as its sole input was also developed and compared to the RNN model. Evaluation methods included the correlation coefficient between actual physiologic responses and RNN predictions, mean absolute error (MAE), and area under the receiver operating characteristic curve (AUC). Results: The actual physiologic responses displayed significant variability and were more accurately predicted by the RNN model than by titration alone (r=0.20 vs r=0.05, p<0.01). The RNN showed MAE and AUC improvements over the linear model. The RNN's MAEs associated with dopamine and epinephrine were 1-3% lower than the linear regression model MAE for HR, SBP, DBP, and MAP. Across all vitals vasoactives, the RNN achieved 1-19% AUC improvement over the linear model. Conclusion: This initial attempt in pediatric critical care to predict individual physiologic responses to vasoactive dose changes in children with septic shock demonstrated an RNN model showed some improvement over a linear model. While not yet clinically applicable, further development may assist clinical administration of vasoactive medications in children with septic shock.


Click click snap: One look at patient's face, and AI can identify rare genetic diseases

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WASHINGTON D.C. [USA]: According to a recent study, a new artificial intelligence technology can accurately identify rare genetic disorders using a photograph of a patient's face. Named DeepGestalt, the AI technology outperformed clinicians in identifying a range of syndromes in three trials and could add value in personalised care, CNN reported. The study was published in the journal Nature Medicine. According to the study, eight per cent of the population has disease with key genetic components and many may have recognisable facial features. The study further adds that the technology could identify, for example, Angelman syndrome, a disorder affecting the nervous system with characteristic features such as a wide mouth with widely spaced teeth etc. Speaking about it, Yaron Gurovich, the chief technology officer at FDNA and lead researcher of the study said, "It demonstrates how one can successfully apply state of the art algorithms, such as deep learning, to a challenging field where the available data is small, unbalanced in terms of available patients per condition, and where the need to support a large amount of conditions is great."


Artificial Intelligence Promising for Breast Cancer Metastases Detection

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A deep learning algorithm can detect metastases in sections of lymph nodes from women with breast cancer; and a deep learning system (DLS) has high sensitivity and specificity for identifying diabetic retinopathy, according to two studies published online Dec. 12 in the Journal of the American Medical Association.


Accuracy of Artificial Intelligence Assessed in CA Diagnosis

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A deep learning algorithm can detect metastases in sections of lymph nodes from women with breast cancer; and a deep learning system (DLS) has high sensitivity and specificity for identifying diabetic retinopathy, according to two studies published online December 12 in the Journal of the American Medical Association.


Artificial Intelligence Effectively Assesses Cell Therapy Functionality

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A fully automated artificial intelligence (AI)-based multispectral absorbance imaging system effectively classified function and potency of induced pluripotent stem cell derived retinal pigment epithelial cells (iPSC-RPE) from patients with age-related macular degeneration (AMD). The finding from the system could be applied to assessing future cellular therapies, according to research presented at the 2018 ARVO annual meeting. The software, which uses convolutional neural network (CNN) deep learning algorithms, effectively evaluated release criterion for the iPSC-RPE cell-based therapy in a standard, reproducible, and cost-effective fashion. The AI-based analysis was as specific and sensitive as traditional molecular and physiological assays, without the need for human intervention. "Cells can be classified with high accuracy using nothing but absorbance images," wrote lead investigator Nathan Hotaling and colleagues from the National Institutes of Health in their poster.