论文标题
医院就诊期间使用生命体征在镰状细胞病患者中评估疼痛强度评估
Pain Intensity Assessment in Sickle Cell Disease patients using Vital Signs during Hospital Visits
论文作者
论文摘要
镰状细胞疾病(SCD)的疼痛通常与发病率,死亡率和高医疗保健成本增加有关。长期以来,预测缺乏,存在和强度的标准方法是自我报告。但是,医疗服务提供者努力根据主观疼痛的报告来管理患者,并且疼痛药物通常会导致患者沟通的进一步困难,因为它们可能导致镇静和嗜睡。最近的研究表明,客观的生理措施可以使用机器学习(ML)技术来预测住院访问的主观自我报告的疼痛评分。在这项研究中,我们评估了ML技术对从三种类型的医院就诊(即住院,门诊和门诊评估)中从50例患者那里收集的数据的普遍性。我们比较了五种分类算法在个体内(每个患者)和个体间(在患者之间)水平的各种疼痛强度水平的分类算法。尽管所有测试的分类器的表现都比机会要好得多,但决策树(DT)模型在11点严重程度量表(从0-10)上预测疼痛的表现最佳,其精度在个体间级别为0.728,并且在个体内部的疼痛级别为0.653。 DT的准确性在2分评分量表上显着提高到0.941(即无/轻度疼痛:0-5,剧烈疼痛:6-10)在个体内部水平。我们的实验结果表明,ML技术可以对所有三种医院就诊的疼痛强度水平进行客观和定量评估。
Pain in sickle cell disease (SCD) is often associated with increased morbidity, mortality, and high healthcare costs. The standard method for predicting the absence, presence, and intensity of pain has long been self-report. However, medical providers struggle to manage patients based on subjective pain reports correctly and pain medications often lead to further difficulties in patient communication as they may cause sedation and sleepiness. Recent studies have shown that objective physiological measures can predict subjective self-reported pain scores for inpatient visits using machine learning (ML) techniques. In this study, we evaluate the generalizability of ML techniques to data collected from 50 patients over an extended period across three types of hospital visits (i.e., inpatient, outpatient and outpatient evaluation). We compare five classification algorithms for various pain intensity levels at both intra-individual (within each patient) and inter-individual (between patients) level. While all the tested classifiers perform much better than chance, a Decision Tree (DT) model performs best at predicting pain on an 11-point severity scale (from 0-10) with an accuracy of 0.728 at an inter-individual level and 0.653 at an intra-individual level. The accuracy of DT significantly improves to 0.941 on a 2-point rating scale (i.e., no/mild pain: 0-5, severe pain: 6-10) at an intra-individual level. Our experimental results demonstrate that ML techniques can provide an objective and quantitative evaluation of pain intensity levels for all three types of hospital visits.