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Machine learning to predict the likelihood of acute myocardial infarction
- Source :
- Than, M P, Pickering, J W, Sandoval, Y, Shah, A S V, Tsanas, A, Apple, F S, Blankenberg, S, Cullen, L, Mueller, C, Neumann, J T, Twerenbold, R, Westermann, D & Beshiri, A & Mills, N L 2019, ' Machine learning to predict the likelihood of acute myocardial infarction ', Circulation, vol. 140, no. 11, pp. 899-909 . https://doi.org/10.1161/CIRCULATIONAHA.119.041980, Circulation
- Publication Year :
- 2019
-
Abstract
- Supplemental Digital Content is available in the text.<br />Background: Variations in cardiac troponin concentrations by age, sex, and time between samples in patients with suspected myocardial infarction are not currently accounted for in diagnostic approaches. We aimed to combine these variables through machine learning to improve the assessment of risk for individual patients. Methods: A machine learning algorithm (myocardial-ischemic-injury-index [MI3]) incorporating age, sex, and paired high-sensitivity cardiac troponin I concentrations, was trained on 3013 patients and tested on 7998 patients with suspected myocardial infarction. MI3 uses gradient boosting to compute a value (0–100) reflecting an individual’s likelihood of a diagnosis of type 1 myocardial infarction and estimates the sensitivity, negative predictive value, specificity and positive predictive value for that individual. Assessment was by calibration and area under the receiver operating characteristic curve. Secondary analysis evaluated example MI3 thresholds from the training set that identified patients as low risk (99% sensitivity) and high risk (75% positive predictive value), and performance at these thresholds was compared in the test set to the 99th percentile and European Society of Cardiology rule-out pathways. Results: Myocardial infarction occurred in 404 (13.4%) patients in the training set and 849 (10.6%) patients in the test set. MI3 was well calibrated with a very high area under the receiver operating characteristic curve of 0.963 [0.956–0.971] in the test set and similar performance in early and late presenters. Example MI3 thresholds identifying low- and high-risk patients in the training set were 1.6 and 49.7, respectively. In the test set, MI3 values were
- Subjects :
- medicine.medical_specialty
Acute coronary syndrome
Cardiac troponin
030204 cardiovascular system & hematology
acute coronary syndrome
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
Internal medicine
Original Research Articles
Medicine
In patient
030212 general & internal medicine
Myocardial infarction
biology
business.industry
troponin
medicine.disease
Troponin
machine learning
myocardial infarction
biology.protein
Cardiology
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 12616001
- Database :
- OpenAIRE
- Journal :
- Than, M P, Pickering, J W, Sandoval, Y, Shah, A S V, Tsanas, A, Apple, F S, Blankenberg, S, Cullen, L, Mueller, C, Neumann, J T, Twerenbold, R, Westermann, D & Beshiri, A & Mills, N L 2019, ' Machine learning to predict the likelihood of acute myocardial infarction ', Circulation, vol. 140, no. 11, pp. 899-909 . https://doi.org/10.1161/CIRCULATIONAHA.119.041980, Circulation
- Accession number :
- edsair.doi.dedup.....7fb349b4c4f7c41c1f410fba9ac05ad6