Machine Learning Methods for Neonatal Mortality and Morbidity Classification

Preterm birth is the leading cause of mortality in children under the age of five. In particular, low birth weight and low gestational age are associated with an increased risk of mortality. Preterm birth also increases the risks of several complications, which can increase the risk of death, or cause long-term morbidities with both individual and societal impacts. In this work, we use machine learning for prediction of neonatal mortality as well as neonatal morbidities of bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity, among very low birth weight infants. Our predictors include time series data and clinical variables collected at the neonatal intensive care unit of Children's Hospital, Helsinki University Hospital. We examine 9 different classifiers and present our main results in AUROC, similar to our previous studies, and in F1-score, which we propose for classifier selection in this study. We also investigate how the predictive performance of the classifiers evolves as the length of time series is increased, and examine the relative importance of different features using the random forest classifier, which we found to generally perform the best in all tasks. Our systematic study also involves different data preprocessing methods which can be used to improve classifier sensitivities. Our best classifier AUROC is 0.922 in the prediction of mortality, 0.899 in the prediction of bronchopulmonary dysplasia, 0.806 in the prediction of necrotizing enterocolitis, and 0.846 in the prediction of retinopathy of prematurity. Our best classifier F1-score is 0.493 in the prediction of mortality, 0.704 in the prediction of bronchopulmonary dysplasia, 0.215 in the prediction of necrotizing enterocolitis, and 0.368 in the prediction of retinopathy of prematurity.Peer reviewe

Detection of atrial fibrillation in ECG hand-held devices using a random forest classifier

Atrial Fibrillation (AF) is characterized by chaotic electrical impulses in the atria, which leads to irregular heartbeats and can develop blood clots and stroke. Therefore, early detection of AF is crucial for increasing the success rate of the treatment. This study is focused on detection of AF rhythm using hand-held ECG monitoring devices, in addition to three other classes: normal or sinus rhythm, other rhythms, and too noisy to analyze. The pipeline of the proposed method consists of three major components: preprocessing and feature extraction, feature selection, and classification. In total, 491 hand-crafted features are extracted. Then, 150 features are selected in a feature ranking procedure. The selected features are from time, frequency, time-frequency domains, and phase space reconstruction of the ECG signals. In the final stage, a random forest classifier is used to classify the selected features into one of the four aforementioned ECG classes. Using the scoring mechanism provided by PhysioNet/Computing in Cardiology (CinC) Challenge 2017, the overall score (mean±std) of 81.9±2.6% is achieved over the training dataset in 10-fold cross-validation. The proposed algorithm tied for the first place in the PhysioNet/CinC Challenge 2017 with an overall score of 82.6% (rounded to 83%) on the unseen test dataset.Scopu

A probabilistic function to model the relationship between quality of chest compressions and the physiological response for patients in cardiac arrest

Cardiopulmonary resuscitation quality (CPRQ) parameters can be derived from electric signals obtained during resuscitation. We propose to model a probabilistic relationship between CPRQ parameters and the physiological response as judged by ECG-features, to guide therapy in a clinical context. A total of 821 compression sequences were extracted from 394 out-of-hospital resuscitation episodes. Sequences were categorized as effective if the post sequence cardiac rhythm had better prognosis than the pre-sequence rhythm by a positive difference, otherwise as non effective if the difference was negative. CPRQ parameters related to depth and rate were calculated. Three alternative approaches were designed for the binary classifier based on the CPRQ parameters: quadratic discriminant analysis (QDA), logistic regression (LR) and artificial neural networks (ANN). The positive class discriminant function defined the probability of effective compressions (Pec). The classification accuracies were around 0.6 for all three models. The highest probability estimates of effective chest compressions corresponded to the depth (5–6 cm) and rate (100–120 min −1 ) currently recommended in the CPR guidelines. We have proposed a novel method to relate the quality of chest compressions to the physiologic response to CPR.acceptedVersio

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)