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      Data analytics and clinical feature ranking of medical records of patients with sepsis

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          Abstract

          Background

          Sepsis is a life-threatening clinical condition that happens when the patient’s body has an excessive reaction to an infection, and should be treated in one hour. Due to the urgency of sepsis, doctors and physicians often do not have enough time to perform laboratory tests and analyses to help them forecast the consequences of the sepsis episode. In this context, machine learning can provide a fast computational prediction of sepsis severity, patient survival, and sequential organ failure by just analyzing the electronic health records of the patients. Also, machine learning can be employed to understand which features in the medical records are more predictive of sepsis severity, of patient survival, and of sequential organ failure in a fast and non-invasive way.

          Dataset and methods

          In this study, we analyzed a dataset of electronic health records of 364 patients collected between 2014 and 2016. The medical record of each patient has 29 clinical features, and includes a binary value for survival, a binary value for septic shock, and a numerical value for the sequential organ failure assessment (SOFA) score. We disjointly utilized each of these three factors as an independent target, and employed several machine learning methods to predict it (binary classifiers for survival and septic shock, and regression analysis for the SOFA score). Afterwards, we used a data mining approach to identify the most important dataset features in relation to each of the three targets separately, and compared these results with the results achieved through a standard biostatistics approach.

          Results and conclusions

          Our results showed that machine learning can be employed efficiently to predict septic shock, SOFA score, and survival of patients diagnoses with sepsis, from their electronic health records data. And regarding clinical feature ranking, our results showed that Random Forests feature selection identified several unexpected symptoms and clinical components as relevant for septic shock, SOFA score, and survival. These discoveries can help doctors and physicians in understanding and predicting septic shock. We made the analyzed dataset and our developed software code publicly available online.

          Supplementary Information

          The online version contains supplementary material available at (10.1186/s13040-021-00235-0).

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          Most cited references72

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          Deep learning.

          Deep learning allows computational models that are composed of multiple processing layers to learn representations of data with multiple levels of abstraction. These methods have dramatically improved the state-of-the-art in speech recognition, visual object recognition, object detection and many other domains such as drug discovery and genomics. Deep learning discovers intricate structure in large data sets by using the backpropagation algorithm to indicate how a machine should change its internal parameters that are used to compute the representation in each layer from the representation in the previous layer. Deep convolutional nets have brought about breakthroughs in processing images, video, speech and audio, whereas recurrent nets have shone light on sequential data such as text and speech.
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            Random Forests

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              The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

              Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.
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                Author and article information

                Contributors
                davidechicco@davidechicco.it
                luca.oneto@gmail.com
                Journal
                BioData Min
                BioData Min
                BioData Mining
                BioMed Central (London )
                1756-0381
                3 February 2021
                3 February 2021
                2021
                : 14
                : 12
                Affiliations
                [1 ]GRID grid.231844.8, ISNI 0000 0004 0474 0428, Krembil Research Institute, ; Toronto, Ontario, Canada
                [2 ]GRID grid.5606.5, ISNI 0000 0001 2151 3065, Università di Genova, ; Genoa, Italy
                [3 ]ZenaByte srl, Genoa, Italy
                Author information
                https://orcid.org/0000-0002-8445-395X
                Article
                235
                10.1186/s13040-021-00235-0
                7860202
                33536030
                d78bf9f5-e6fe-46ae-9a1d-1c771b1b0947
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 18 August 2020
                : 5 January 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Bioinformatics & Computational biology
                sepsis,septic shock,septic severity,survival,sequential organ failure assessment,sofa,machine learning,binary classification,regression analysis,feature ranking,data science,data analytics

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