• Sungjun Hong, Sungjoo Lee, Jeonghoon Lee, Won Chul Cha, and Kyunga Kim.
• Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea.
• JMIR Med Inform. 2020 Aug 4; 8 (8): e15932.

BackgroundThe development and application of clinical prediction models using machine learning in clinical decision support systems is attracting increasing attention.ObjectiveThe aims of this study were to develop a prediction model for cardiac arrest in the emergency department (ED) using machine learning and sequential characteristics and to validate its clinical usefulness.MethodsThis retrospective study was conducted with ED patients at a tertiary academic hospital who suffered cardiac arrest. To resolve the class imbalance problem, sampling was performed using propensity score matching. The data set was chronologically allocated to a development cohort (years 2013 to 2016) and a validation cohort (year 2017). We trained three machine learning algorithms with repeated 10-fold cross-validation.ResultsThe main performance parameters were the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). The random forest algorithm (AUROC 0.97; AUPRC 0.86) outperformed the recurrent neural network (AUROC 0.95; AUPRC 0.82) and the logistic regression algorithm (AUROC 0.92; AUPRC=0.72). The performance of the model was maintained over time, with the AUROC remaining at least 80% across the monitored time points during the 24 hours before event occurrence.ConclusionsWe developed a prediction model of cardiac arrest in the ED using machine learning and sequential characteristics. The model was validated for clinical usefulness by chronological visualization focused on clinical usability.©Sungjun Hong, Sungjoo Lee, Jeonghoon Lee, Won Chul Cha, Kyunga Kim. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 04.08.2020.

3 keywords...

hide…