Clinical application of the Innovance D-dimer assay in the diagnosis of acute pulmonary thromboembolism

Predicting 7-day unplanned readmission in elderly patients with coronary heart disease using machine learning

Background

Short-term unplanned readmission is always neglected, especially for elderly patients with coronary heart disease (CHD). However, tools to predict unplanned readmission are lacking. This study aimed to establish the most effective predictive model for the unplanned 7-day readmission in elderly CHD patients using machine learning (ML) algorithms.

Methods

The detailed clinical data of elderly CHD patients were collected retrospectively. Five ML algorithms, including extreme gradient boosting (XGB), random forest, multilayer perceptron, categorical boosting, and logistic regression, were used to establish predictive models. We used the area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, the F1 value, the Brier score, the area under the precision-recall curve (AUPRC), and the calibration curve to evaluate the performance of ML models. The SHapley Additive exPlanations (SHAP) value was used to interpret the best model.

Results

The final study included 834 elderly CHD patients, whose average age was 73.5 ± 8.4 years, among whom 426 (51.08%) were men and 139 had 7-day unplanned readmissions. The XGB model had the best performance, exhibiting the highest AUC (0.9729), accuracy (0.9173), F1 value (0.9134), and AUPRC (0.9766). The Brier score of the XGB model was 0.08. The calibration curve of the XGB model showed good performance. The SHAP method showed that fracture, hypertension, length of stay, aspirin, and D-dimer were the most important indicators for the risk of 7-day unplanned readmissions. The top 10 variables were used to build a compact XGB, which also showed good predictive performance.

Conclusions

In this study, five ML algorithms were used to predict 7-day unplanned readmissions in elderly patients with CHD. The XGB model had the best predictive performance and potential clinical application perspective.

Analysis of COVID-19 severity from the perspective of coagulation index using evolutionary machine learning with enhanced brain storm optimization

Coronavirus 2019 (COVID-19) is an extreme acute respiratory syndrome. Early diagnosis and accurate assessment of COVID-19 are not available, resulting in ineffective therapeutic therapy. This study designs an effective intelligence framework to early recognition and discrimination of COVID-19 severity from the perspective of coagulation indexes. The framework is proposed by integrating an enhanced new stochastic optimizer, a brain storm optimizing algorithm (EBSO), with an evolutionary machine learning algorithm called EBSO-SVM. Fast convergence and low risk of the local stagnant can be guaranteed for EBSO with added by Harris hawks optimization (HHO), and its property is verified on 23 benchmarks. Then, the EBSO is utilized to perform parameter optimization and feature selection simultaneously for support vector machine (SVM), and the presented EBSO-SVM early recognition and discrimination of COVID-19 severity in terms of coagulation indexes using COVID-19 clinical data. The classification performance of the EBSO-SVM is very promising, reaching 91.9195% accuracy, 90.529% Matthews correlation coefficient, 90.9912% Sensitivity and 88.5705% Specificity on COVID-19. Compared with other existing state-of-the-art methods, the EBSO-SVM in this paper still shows obvious advantages in multiple metrics. The statistical results demonstrate that the proposed EBSO-SVM shows predictive properties for all metrics and higher stability, which can be treated as a computer-aided technique for analysis of COVID-19 severity from the perspective of coagulation.