Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia

ObjectiveTo construct a hybrid decision-making model that integrates knowledge-driven and data-driven approaches, and to apply it to the etiological diagnosis of ventricular tachycardia (VT).MethodsClinical practice guidelines, expert consensus documents, and medical literature in the field of arrhy...

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Main Authors: WANG Min, HU Zhao, XU Xiaowei, ZHENG Si, LI Jiao, YAO Yan
Format: Article
Language:zho
Published: Editorial Office of Medical Journal of Peking Union Medical College Hospital 2024-11-01
Series:Xiehe Yixue Zazhi
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Online Access:https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0381
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author WANG Min
HU Zhao
XU Xiaowei
ZHENG Si
LI Jiao
YAO Yan
author_facet WANG Min
HU Zhao
XU Xiaowei
ZHENG Si
LI Jiao
YAO Yan
author_sort WANG Min
collection DOAJ
description ObjectiveTo construct a hybrid decision-making model that integrates knowledge-driven and data-driven approaches, and to apply it to the etiological diagnosis of ventricular tachycardia (VT).MethodsClinical practice guidelines, expert consensus documents, and medical literature in the field of arrhythmia diseases from 2018 to 2023 were retrieved as knowledge sources. Retrospective electronic medical record data of VT patients from Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, from 2013 to 2023 were collected as the dataset. A knowledge-driven model was constructed using a knowledge-rule-based approach to establish clinical pathways. A three-class machine learning model for VT etiology diagnosis was developed based on real-world data, and the best-performing model was selected as the representative of the data-driven approach. The machine learning model was embedded into the decision nodes of the clinical pathway in the form of custom operators, forming the hybrid model. The precision, recall, and F1 score of the three models were evaluated.ResultsThree clinical practice guidelines were included as knowledge sources for the knowledge-driven model. A total of 1305 patient records were collected as the dataset, and five machine learning models were constructed, with the XGBoost model performing the best. The hybrid model adopted a knowledge-driven decision-making framework, embedding the XGBoost model into the decision nodes of a two-level classification. The precision, recall, and F1 scores of the three models were as follows: the knowledge-driven model achieved 80.4%, 79.1%, and 79.7%; the data-driven model achieved 88.4%, 88.5%, and 88.4%; and the hybrid model achieved 90.4%, 90.2%, and 90.3%.ConclusionsThe hybrid model integrating knowledge-driven and data-driven approaches demonstrated higher accuracy, and all its decision outcomes were based on evidence-based practices, aligning more closely with the actual diagnostic reasoning of clinicians. Further rigorous validation is needed to assess the feasibility of widely applying the hybrid model in the medical field.
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publisher Editorial Office of Medical Journal of Peking Union Medical College Hospital
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spelling doaj-art-b68c30529fcc4a29a047181de54b68642025-08-20T02:16:05ZzhoEditorial Office of Medical Journal of Peking Union Medical College HospitalXiehe Yixue Zazhi1674-90812024-11-0116245446110.12290/xhyxzz.2024-0381Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular TachycardiaWANG Min0HU Zhao1XU Xiaowei2ZHENG Si3LI Jiao4YAO Yan5Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, ChinaArrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing 100037, ChinaInstitute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, ChinaInstitute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, ChinaInstitute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, ChinaArrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing 100037, ChinaObjectiveTo construct a hybrid decision-making model that integrates knowledge-driven and data-driven approaches, and to apply it to the etiological diagnosis of ventricular tachycardia (VT).MethodsClinical practice guidelines, expert consensus documents, and medical literature in the field of arrhythmia diseases from 2018 to 2023 were retrieved as knowledge sources. Retrospective electronic medical record data of VT patients from Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, from 2013 to 2023 were collected as the dataset. A knowledge-driven model was constructed using a knowledge-rule-based approach to establish clinical pathways. A three-class machine learning model for VT etiology diagnosis was developed based on real-world data, and the best-performing model was selected as the representative of the data-driven approach. The machine learning model was embedded into the decision nodes of the clinical pathway in the form of custom operators, forming the hybrid model. The precision, recall, and F1 score of the three models were evaluated.ResultsThree clinical practice guidelines were included as knowledge sources for the knowledge-driven model. A total of 1305 patient records were collected as the dataset, and five machine learning models were constructed, with the XGBoost model performing the best. The hybrid model adopted a knowledge-driven decision-making framework, embedding the XGBoost model into the decision nodes of a two-level classification. The precision, recall, and F1 scores of the three models were as follows: the knowledge-driven model achieved 80.4%, 79.1%, and 79.7%; the data-driven model achieved 88.4%, 88.5%, and 88.4%; and the hybrid model achieved 90.4%, 90.2%, and 90.3%.ConclusionsThe hybrid model integrating knowledge-driven and data-driven approaches demonstrated higher accuracy, and all its decision outcomes were based on evidence-based practices, aligning more closely with the actual diagnostic reasoning of clinicians. Further rigorous validation is needed to assess the feasibility of widely applying the hybrid model in the medical field.https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0381ventricular tachycardiaknowledge-drivendata-drivenhybrid modeldecision-making
spellingShingle WANG Min
HU Zhao
XU Xiaowei
ZHENG Si
LI Jiao
YAO Yan
Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia
Xiehe Yixue Zazhi
ventricular tachycardia
knowledge-driven
data-driven
hybrid model
decision-making
title Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia
title_full Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia
title_fullStr Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia
title_full_unstemmed Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia
title_short Constructing A Knowledge-driven and Data-driven Hybrid Decision Model for Etiological Diagnosis of Ventricular Tachycardia
title_sort constructing a knowledge driven and data driven hybrid decision model for etiological diagnosis of ventricular tachycardia
topic ventricular tachycardia
knowledge-driven
data-driven
hybrid model
decision-making
url https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0381
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