A Patient Similarity Network (CHDmap) to Predict Outcomes After Congenital Heart Surgery: Development and Validation Study

作者：Haomin Li, Ming-Cheng Zhou, Yuhan Sun, Jinshen Yang, Xian Xian Zeng, Y. H. Qiu, Yuanyuan Xia, Zhijie Zheng, Yu Jin, Yuqing Feng, Z. Shi, Ting Huang, Linhua Tan, Ru Lin, Jianhua Li, Xiangming Fan, Jingjing Ye, Huilong Duan, Shanshan Shi, Qiang Shu · 发表于：JMIR Medical Informatics · 年份：2024 · DOI：10.2196/49138 · 被引用次数：13 · 研究领域：Machine Learning in Healthcare、Artificial Intelligence in Healthcare and Education、Congenital Heart Disease Studies

Background: Although evidence-based medicine proposes personalized care that considers the best evidence, it still fails to address personal treatment in many real clinical scenarios where the complexity of the situation makes none of the available evidence applicable. "Medicine-based evidence" (MBE), in which big data and machine learning techniques are embraced to derive treatment responses from appropriately matched patients in real-world clinical practice, was proposed. However, many challenges remain in translating this conceptual framework into practice. Objective: This study aimed to technically translate the MBE conceptual framework into practice and evaluate its performance in providing general decision support services for outcomes after congenital heart disease (CHD) surgery. Methods: Data from 4774 CHD surgeries were collected. A total of 66 indicators and all diagnoses were extracted from each echocardiographic report using natural language processing technology. Combined with some basic clinical and surgical information, the distances between each patient were measured by a series of calculation formulas. Inspired by structure-mapping theory, the fusion of distances between different dimensions can be modulated by clinical experts. In addition to supporting direct analogical reasoning, a machine learning model can be constructed based on similar patients to provide personalized prediction. A user-operable patient similarity network (PSN) of CHD called CHDmap was...