Jia Zhao1,2, Pengyu Zhao3, Chunjie Li2, Yonghong Hou3. 1. Graduate School, Tianjin Medical University, Tianjin, 300070, People's Republic of China. 2. Department of Cardiology, Tianjin Chest Hospital, Tianjin, 300222, People's Republic of China. 3. School of Electrical and Information Engineering, Tianjin University, Tianjin, 300072, People's Republic of China.
Abstract
PURPOSE: This study aimed to optimize machine learning (ML) models for predicting in-hospital mortality in patients with ST-segment elevation acute myocardial infarction (STEMI). PATIENTS AND METHODS: A total of 5708 STEMI patients were enrolled and divided into two groups according to patients' hospital outcomes. Both groups were randomly split into a training set (75%) and a testing set (25%). Four ML models were trained with data, which applied random under-sampling (RUS). The performance of optimized ML models was evaluated with respect to accuracy, sensitivity, specificity, G-mean and AUC. Two sets of features in chronological order were considered: a full set that included all variables during hospitalization and a simplified set that only included variables prior to reperfusion therapy, and the performance of the prediction models trained with these two sets of features was compared. RESULTS: For the comprehensive metric - G-mean, the models trained with RUS outperformed those without, 80.54% vs 23.31% on average in the full set and 75.72% vs 35.76% on average in the simplified set. For models trained with the full set, the SVM achieved the best performance with 85.62% accuracy, 84.21% sensitivity, 85.66% specificity, 84.93% G-mean and 0.919 AUC. For models trained with the simplified set, the SVM achieved 83.48% G-mean, which was comparable to the models trained using the full set. For the most critical metric - sensitivity, the SVM trained using the simplified set achieved 89.47%, which even exceed the SVM (84.21%), DT (81.58%) and RF (81.58%) trained using the full set. CONCLUSION: Applying RUS can improve the performance of prediction models, and the models trained with simplified set, which only included variables prior to reperfusion therapy can accurately predict high-risk patients.
PURPOSE: This study aimed to optimize machine learning (ML) models for predicting in-hospital mortality in patients with ST-segment elevation acute myocardial infarction (STEMI). PATIENTS AND METHODS: A total of 5708 STEMI patients were enrolled and divided into two groups according to patients' hospital outcomes. Both groups were randomly split into a training set (75%) and a testing set (25%). Four ML models were trained with data, which applied random under-sampling (RUS). The performance of optimized ML models was evaluated with respect to accuracy, sensitivity, specificity, G-mean and AUC. Two sets of features in chronological order were considered: a full set that included all variables during hospitalization and a simplified set that only included variables prior to reperfusion therapy, and the performance of the prediction models trained with these two sets of features was compared. RESULTS: For the comprehensive metric - G-mean, the models trained with RUS outperformed those without, 80.54% vs 23.31% on average in the full set and 75.72% vs 35.76% on average in the simplified set. For models trained with the full set, the SVM achieved the best performance with 85.62% accuracy, 84.21% sensitivity, 85.66% specificity, 84.93% G-mean and 0.919 AUC. For models trained with the simplified set, the SVM achieved 83.48% G-mean, which was comparable to the models trained using the full set. For the most critical metric - sensitivity, the SVM trained using the simplified set achieved 89.47%, which even exceed the SVM (84.21%), DT (81.58%) and RF (81.58%) trained using the full set. CONCLUSION: Applying RUS can improve the performance of prediction models, and the models trained with simplified set, which only included variables prior to reperfusion therapy can accurately predict high-risk patients.
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