背景:机器学习(ML)在预测儿童哮喘相关结局中的整合为儿科医疗保健提供了一种新的方法。
目的:本范围审查旨在分析自2019年以来发表的研究,重点是ML算法,他们的应用,和预测性表现。
方法:我们搜索了OvidMEDLINEALL和Embase,Cochrane图书馆(Wiley)CINAHL(EBSCO),和WebofScience(核心集合)。搜索范围为2019年1月1日至2023年7月18日。包括应用ML模型预测18岁以下儿童哮喘相关结局的研究。Covidence被用于引文管理,并使用预测模型偏差风险评估工具评估偏差风险。
结果:从1231篇初始文章中,15符合我们的纳入标准。样本量为74至87,413名患者。大多数研究使用了多种ML技术,逻辑回归(n=7,47%)和随机森林(n=6,40%)是最常见的。主要结果包括预测哮喘恶化,对哮喘表型进行分类,预测哮喘诊断,并确定潜在的风险因素。为了预测恶化,递归神经网络和XGBoost显示出高性能,XGBoost实现0.76的接收器工作特征曲线下的面积(AUROC)。在对哮喘表型进行分类时,支持向量机非常有效,实现0.79的AUROC。对于诊断预测,人工神经网络优于逻辑回归,AUROC为0.63。为了确定集中在症状严重程度和肺功能的危险因素,随机森林的AUROC为0.88。基于声音的研究区分了喘息与非喘息和哮喘与正常咳嗽。偏倚风险评估显示,大多数研究(n=8,53%)表现出低至中等风险,确保对调查结果有合理的信心。研究中常见的限制包括数据质量问题,样本量约束,和可解释性问题。
结论:这篇综述强调了ML在预测小儿哮喘结局方面的不同应用。每个模型提供独特的优势和挑战。未来的研究应该解决数据质量问题,增加样本量,并增强模型的可解释性,以优化儿童哮喘管理临床环境中的ML效用。
BACKGROUND: The integration of machine learning (ML) in predicting asthma-related outcomes in children presents a novel approach in pediatric health care.
OBJECTIVE: This scoping review aims to analyze studies published since 2019, focusing on ML algorithms, their applications, and predictive performances.
METHODS: We searched Ovid MEDLINE ALL and Embase on Ovid, the Cochrane Library (Wiley), CINAHL (EBSCO), and Web of Science (core collection). The search covered the period from January 1, 2019, to July 18, 2023. Studies applying ML models in predicting asthma-related outcomes in children aged <18 years were included. Covidence was used for citation management, and the risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool.
RESULTS: From 1231 initial articles, 15 met our inclusion criteria. The sample size ranged from 74 to 87,413 patients. Most studies used multiple ML techniques, with logistic regression (n=7, 47%) and random forests (n=6, 40%) being the most common. Key outcomes included predicting asthma exacerbations, classifying asthma phenotypes, predicting asthma diagnoses, and identifying potential risk factors. For predicting exacerbations, recurrent neural networks and XGBoost showed high performance, with XGBoost achieving an area under the receiver operating characteristic curve (AUROC) of 0.76. In classifying asthma phenotypes, support vector machines were highly effective, achieving an AUROC of 0.79. For diagnosis prediction, artificial neural networks outperformed logistic regression, with an AUROC of 0.63. To identify risk factors focused on symptom severity and lung function, random forests achieved an AUROC of 0.88. Sound-based studies distinguished wheezing from nonwheezing and asthmatic from normal coughs. The risk of bias assessment revealed that most studies (n=8, 53%) exhibited low to moderate risk, ensuring a reasonable level of confidence in the findings. Common limitations across studies included data quality issues, sample size constraints, and interpretability concerns.
CONCLUSIONS: This review highlights the diverse application of ML in predicting pediatric asthma outcomes, with each model offering unique strengths and challenges. Future research should address data quality, increase sample sizes, and enhance model interpretability to optimize ML utility in clinical settings for pediatric asthma management.