Hypotension Risk Prediction via Sequential Contrast Patterns of ICU Blood Pressure

© 2013 IEEE. Acute hypotension is a significant risk factor for in-hospital mortality at intensive care units. Prolonged hypotension can cause tissue hypoperfusion, leading to cellular dysfunction and severe injuries to multiple organs. Prompt medical interventions are thus extremely important for dealing with acute hypotensive episodes (AHE). Population level prognostic scoring systems for risk stratification of patients are suboptimal in such scenarios. However, the design of an efficient risk prediction system can significantly help in the identification of critical care patients, who are at risk of developing an AHE within a future time span. Toward this objective, a pattern mining algorithm is employed to extract informative sequential contrast patterns from hemodynamic data, for the prediction of hypotensive episodes. The hypotensive and normotensive patient groups are extracted from the MIMIC-II critical care research database, following an appropriate clinical inclusion criteria. The proposed method consists of a data preprocessing step to convert the blood pressure time series into symbolic sequences, using a symbolic aggregate approximation algorithm. Then, distinguishing subsequences are identified using the sequential contrast mining algorithm. These subsequences are used to predict the occurrence of an AHE in a future time window separated by a user-defined gap interval. Results indicate that the method performs well in terms of the prediction performance as well as in the generation of sequential patterns of clinical significance. Hence, the novelty of sequential patterns is in their usefulness as potential physiological biomarkers for building optimal patient risk stratification systems and for further clinical investigation of interesting patterns in critical care patients

Machine Learning for the Early Detection of Acute Episodes in Intensive Care Units

In Intensive Care Units (ICUs), mere seconds might define whether a patient lives or dies. Predictive models capable of detecting acute events in advance may allow for anticipated interventions, which could mitigate the consequences of those events and promote a greater number of lives saved. Several predictive models developed for this purpose have failed to meet the high requirements of ICUs. This might be due to the complexity of anomaly prediction tasks, and the inefficient utilization of ICU data. Moreover, some essential intensive care demands, such as continuous monitoring, are often not considered when developing these solutions, making them unfit to real contexts. This work approaches two topics within the mentioned problem: the relevance of ICU data used to predict acute episodes and the benefits of applying Layered Learning (LL) techniques to counter the complexity of these tasks. The first topic was undertaken through a study on the relevance of information retrieved from physiological signals and clinical data for the early detection of Acute Hypotensive Episodes (AHE) in ICUs. Then, the potentialities of LL were accessed through an in-depth analysis of the applicability of a recently proposed approach on the same topic. Furthermore, different optimization strategies enabled by LL configurations were proposed, including a new approach aimed at false alarm reduction. The results regarding data relevance might contribute to a shift in paradigm in terms of information retrieved for AHE prediction. It was found that most of the information commonly used in the literature might be wrongly perceived as valuable, since only three features related to blood pressure measures presented actual distinctive traits. On another note, the different LL-based strategies developed confirm the versatile possibilities offered by this paradigm. Although these methodologies did not promote significant performance improvements in this specific context, they can be further explored and adapted to other domains.Em Unidades de Cuidados Intensivos (UCIs), meros segundos podem ser o fator determinante entre a vida e a morte de um paciente. Modelos preditivos para a previsão de eventos adversos podem promover intervenções antecipadas, com vista à mitigação das consequências destes eventos, e traduzir-se num maior número de vidas salvas. Múltiplos modelos desenvolvidos para este propósito não corresponderam às exigências das UCIs. Isto pode dever-se à complexidade de tarefas de previsão de anomalias e à ineficiência no uso da informação gerada em UCIs. Além disto, algumas necessidades inerentes à provisão de cuidados intensivos, tais como a monitorização contínua, são muitas vezes ignoradas no desenvolvimento destas soluções, tornando-as desadequadas para contextos reais. Este projeto aborda dois tópicos dentro da problemática introduzida, nomeadamente a relevância da informação usada para prever episódios agudos, e os benefícios de técnicas de Aprendizagem em Camadas (AC) para contrariar a complexidade destas tarefas. Numa primeira fase, foi conduzido um estudo sobre o impacto de diversos sinais fisiológicos e dados clínicos no contexto da previsão de episódios agudos de hipotensão. As potencialidades do paradigma de AC foram avaliadas através da análise de uma abordagem proposta recentemente para o mesmo caso de estudo. Nesta segunda fase, diversas estratégias de otimização compatíveis com configurações em camadas foram desenvolvidas, incluindo um modelo para reduzir falsos alarmes. Os resultados relativos à relevância da informação podem contribuir para uma mudança de paradigma em termos da informação usada para treinar estes modelos. A maior parte da informação poderá estar a ser erroneamente considerada como importante, uma vez que apenas três variáveis, deduzidas dos valores de pressão arterial, foram identificadas como realmente impactantes. Por outro lado, as diferentes estratégias baseadas em AC confirmaram a versatilidade oferecida por este paradigma. Apesar de não terem promovido melhorias significativas neste contexto, estes métodos podem ser adaptados a outros domínios

AI Enabled Drug Design and Side Effect Prediction Powered by Multi-Objective Evolutionary Algorithms & Transformer Models

Due to the large search space and conflicting objectives, drug design and discovery is a difficult problem for which new machine learning (ML) approaches are required. Here, the problem is to invent a method by which new, therapeutically useful, compounds can be discovered; and to simultaneously avoid compounds which will fail clinical trials or pass unwanted effects onto the end patient. By extending current technologies as well as adding new ones, more design criteria can be included, and more promising novel drugs can be discovered. This work advances the field of computational drug design by (1) developing MOEA-DT, a non-deep learning application for multi-objective molecular optimization, which generates new molecules with high performance in a variety of design criteria; and (2) developing SEMTL-BERT, a side effect prediction algorithm which leverages the latest ML techniques and datasets to accomplish its task. Experiments performed show that MOEA-DT either matches or outperforms other similar methods, and that SEMTL-BERT can enhance predictive ability

Predicting hypotensive episodes in the traumatic brain injury domain

The domain with which this research is concerned is traumatic brain injury and models which attempt to predict hypotensive (low blood pressure) events occurring in a hospital intensive care unit environment. The models process anonymised, clinical, minute-byminute, physiological data from the BrainIT consortium. The research reviews three predictive modelling techniques: classic time series analysis; hidden Markov models; and classifier models, which are the main focus of this thesis. The data preparation part of this project is extensive and six applications have been developed: an event list generator, used to process a given event definition; a data set generation tool, which produces a series of base data sets that can be used to train machine learning models; a training and test set generation application, which produces randomly drawn training and test data sets; an application used to build and assess a series of logistic regression models; an application to test the statistical models on unseen data, which uses anonymised real clinical data from intensive care unit bedside monitors; and finally, an application that implements a proposed clinical warning protocol, which attempts to assess a model’s performance in terms of usefulness to a clinical team. These applications are being made available under a public domain licence to enable further research (see Appendix A for details). Six logistic regression models and two Bayesian neural network models are examined using the physiological signals heart rate and arterial blood pressure, along with the demographic variables of age and gender. Model performance is assessed using the standard ROC technique to give the AUC metric. An alternative performance metric, the H score, is also investigated. Using unseen clinical data, two of the models are assessed in a manner which mimics the ICU environment. This approach shows that models may perform better than would be suggested by standard assessment metrics. The results of the modelling experiments are compared with a recent similar project in the healthcare domain and show that logistic regression models could form the basis of a practical early warning system for use in a neuro intensive care unit