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Using machine learning to predict bacteremia in urgent care patients on the basis of triage data and laboratory results.

🔍 Innovations in Digital Health: Research Insights

Abstract

BACKGROUND: Despite advancements in antimicrobial therapies, bacteremia remains a life-threatening condition. Appropriate antimicrobials must be promptly administered to ensure patient survival. However, diagnosing bacteremia based on blood cultures is time-consuming and not something emergency department (ED) personnel are routinely trained to do.
METHODS: This retrospective cohort study developed several machine learning (ML) models to predict bacteremia in adults initially presenting with fever or hypothermia, comprising logistic regression, random forest, extreme gradient boosting, support vector machine, k-nearest neighbor, multilayer perceptron, and ensemble models. Random oversampling and synthetic minority oversampling techniques were adopted to balance the dataset. The variables included demographic characteristics, comorbidities, immunocompromised status, clinical characteristics, subjective symptoms reported during ED triage, and laboratory data. The study outcome was an episode of bacteremia.
RESULTS: Of the 5063 patients with initial fever or hypothermia from whom blood cultures were obtained, 128 (2.5 %) were diagnosed with bacteremia. We combined 36 selected variables and 10 symptoms subjectively reported by patients into features for analysis in our models. The ensemble model outperformed other models, with an area under the receiver operating characteristic curve (AUROC) of 0.930 and an F1-score of 0.735. The AUROC of all models was higher than 0.80.
CONCLUSION: The ML models developed effectively predicted bacteremia among febrile or hypothermic patients in the ED, with all models demonstrating high AUROC values and rapid processing times. The findings suggest that ED clinicians can effectively utilize ML techniques to develop predictive models for addressing clinical challenges.

Author: [‘Chiu CP’, ‘Chou HH’, ‘Lin PC’, ‘Lee CC’, ‘Hsieh SY’]

Journal: Am J Emerg Med

Citation: Chiu CP, et al. Using machine learning to predict bacteremia in urgent care patients on the basis of triage data and laboratory results. Using machine learning to predict bacteremia in urgent care patients on the basis of triage data and laboratory results. 2024; 85:80-85. doi: 10.1016/j.ajem.2024.08.045


🔑 Key Takeaways

  • 🦠 Bacteremia is a serious condition that requires prompt diagnosis and treatment.
  • 🤖 Machine learning models can effectively predict bacteremia in urgent care settings.
  • 📊 The study analyzed data from over 5,000 patients presenting with fever or hypothermia.
  • 🏆 The ensemble model achieved an impressive AUROC of 0.930, indicating high predictive accuracy.
  • 💡 A total of 36 variables and 10 subjective symptoms were utilized in the analysis.
  • 📈 All machine learning models demonstrated AUROC values above 0.80, showcasing their reliability.
  • 🏥 The findings suggest a potential for integrating machine learning into emergency department practices.
  • 🌍 Study published in the American Journal of Emergency Medicine.

📈 This study highlights the promising role of machine learning in predicting bacteremia among patients in urgent care settings. By leveraging triage data and laboratory results, healthcare professionals can enhance their diagnostic capabilities. Read the full abstract here.

📚 Background

Bacteremia, the presence of bacteria in the bloodstream, remains a critical challenge in emergency medicine. Despite advancements in antimicrobial therapies, timely diagnosis is essential for patient survival. Traditional methods, such as blood cultures, can be slow and are not always feasible in urgent care settings. This study aims to address these challenges by utilizing machine learning to predict bacteremia based on readily available triage data and laboratory results.

📊 Study Summary

This retrospective cohort study involved 5,063 adult patients who presented to the emergency department with fever or hypothermia. The objective was to develop machine learning models, including logistic regression, random forest, and support vector machines, to predict episodes of bacteremia. The researchers employed techniques to balance the dataset and analyzed a combination of demographic, clinical, and laboratory variables to enhance prediction accuracy.

📈 Key Findings

Out of the 5,063 patients, 128 (2.5%) were diagnosed with bacteremia. The ensemble model outperformed other models, achieving an area under the receiver operating characteristic curve (AUROC) of 0.930 and an F1-score of 0.735. All models demonstrated high AUROC values, indicating their effectiveness in predicting bacteremia among febrile or hypothermic patients.

🌍 Impact and Implications

The implications of this study are significant for emergency medicine. By integrating machine learning techniques into clinical practice, emergency department clinicians can enhance their diagnostic capabilities, leading to quicker and more accurate treatment decisions. This could ultimately improve patient outcomes and streamline the management of bacteremia in urgent care settings.

🔮 Conclusion

This study underscores the potential of machine learning in transforming the diagnosis of bacteremia in emergency medicine. By utilizing triage data and laboratory results, healthcare professionals can make informed decisions more rapidly. We encourage further research and exploration into the integration of machine learning technologies in clinical settings to enhance patient care. 🌟

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