Prediction of pulmonary embolism by an explainable machine learning approach in the real world

Abstract In recent years, large amounts of researches showed that pulmonary embolism (PE) has become a common disease, and PE remains a clinical challenge because of its high mortality, high disability, high missed and high misdiagnosed rates. To address this, we employed an artificial intelligence–...

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Main Authors: Qiao Zhou, Ruichen Huang, Xingyu Xiong, Zongan Liang, Wei Zhang
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-75435-9
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author Qiao Zhou
Ruichen Huang
Xingyu Xiong
Zongan Liang
Wei Zhang
author_facet Qiao Zhou
Ruichen Huang
Xingyu Xiong
Zongan Liang
Wei Zhang
author_sort Qiao Zhou
collection DOAJ
description Abstract In recent years, large amounts of researches showed that pulmonary embolism (PE) has become a common disease, and PE remains a clinical challenge because of its high mortality, high disability, high missed and high misdiagnosed rates. To address this, we employed an artificial intelligence–based machine learning algorithm (MLA) to construct a robust predictive model for PE. We retrospectively analyzed 1480 suspected PE patients hospitalized in West China Hospital of Sichuan University between May 2015 and April 2020. 126 features were screened and diverse MLAs were utilized to craft predictive models for PE. Area under the receiver operating characteristic curves (AUC) were used to evaluate their performance and SHapley Additive exPlanation (SHAP) values were utilized to elucidate the prediction model. Regarding the efficacy of the single model that most accurately predicted the outcome, RF demonstrated the highest efficacy in predicting outcomes, with an AUC of 0.776 (95% CI 0.774–0.778). The SHAP summary plot delineated the positive and negative effects of features attributed to the RF prediction model, including D-dimer, activated partial thromboplastin time (APTT), fibrin and fibrinogen degradation products (FFDP), platelet count, albumin, cholesterol, and sodium. Furthermore, the SHAP dependence plot illustrated the impact of individual features on the RF prediction model. Finally, the MLA based PE predicting model was designed as a web page that can be applied to the platform of clinical management. In this study, PE prediction model was successfully established and designed as a web page, facilitating the optimization of early diagnosis and timely treatment strategies to enhance PE patient outcomes.
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spelling doaj-art-3f691fc27af2413b967098cafc4e2be42025-08-20T02:46:13ZengNature PortfolioScientific Reports2045-23222025-01-011511810.1038/s41598-024-75435-9Prediction of pulmonary embolism by an explainable machine learning approach in the real worldQiao Zhou0Ruichen Huang1Xingyu Xiong2Zongan Liang3Wei Zhang4Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical UniversityDepartment of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital of Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital of Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical UniversityAbstract In recent years, large amounts of researches showed that pulmonary embolism (PE) has become a common disease, and PE remains a clinical challenge because of its high mortality, high disability, high missed and high misdiagnosed rates. To address this, we employed an artificial intelligence–based machine learning algorithm (MLA) to construct a robust predictive model for PE. We retrospectively analyzed 1480 suspected PE patients hospitalized in West China Hospital of Sichuan University between May 2015 and April 2020. 126 features were screened and diverse MLAs were utilized to craft predictive models for PE. Area under the receiver operating characteristic curves (AUC) were used to evaluate their performance and SHapley Additive exPlanation (SHAP) values were utilized to elucidate the prediction model. Regarding the efficacy of the single model that most accurately predicted the outcome, RF demonstrated the highest efficacy in predicting outcomes, with an AUC of 0.776 (95% CI 0.774–0.778). The SHAP summary plot delineated the positive and negative effects of features attributed to the RF prediction model, including D-dimer, activated partial thromboplastin time (APTT), fibrin and fibrinogen degradation products (FFDP), platelet count, albumin, cholesterol, and sodium. Furthermore, the SHAP dependence plot illustrated the impact of individual features on the RF prediction model. Finally, the MLA based PE predicting model was designed as a web page that can be applied to the platform of clinical management. In this study, PE prediction model was successfully established and designed as a web page, facilitating the optimization of early diagnosis and timely treatment strategies to enhance PE patient outcomes.https://doi.org/10.1038/s41598-024-75435-9Pulmonary embolismMachine learning algorithmsPrediction modelSHAP value
spellingShingle Qiao Zhou
Ruichen Huang
Xingyu Xiong
Zongan Liang
Wei Zhang
Prediction of pulmonary embolism by an explainable machine learning approach in the real world
Scientific Reports
Pulmonary embolism
Machine learning algorithms
Prediction model
SHAP value
title Prediction of pulmonary embolism by an explainable machine learning approach in the real world
title_full Prediction of pulmonary embolism by an explainable machine learning approach in the real world
title_fullStr Prediction of pulmonary embolism by an explainable machine learning approach in the real world
title_full_unstemmed Prediction of pulmonary embolism by an explainable machine learning approach in the real world
title_short Prediction of pulmonary embolism by an explainable machine learning approach in the real world
title_sort prediction of pulmonary embolism by an explainable machine learning approach in the real world
topic Pulmonary embolism
Machine learning algorithms
Prediction model
SHAP value
url https://doi.org/10.1038/s41598-024-75435-9
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AT xingyuxiong predictionofpulmonaryembolismbyanexplainablemachinelearningapproachintherealworld
AT zonganliang predictionofpulmonaryembolismbyanexplainablemachinelearningapproachintherealworld
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