Predicting In-Hospital Mortality After Acute Myeloid Leukemia Therapy: Through Supervised Machine Learning Algorithms

Background To assess the feasibility of a machine learning (ML) approach using radiomics features of perfusion defects on rest myocardial perfusion imaging (MPI) to detect the presence of hibernating myocardium. Methodology Data of patients who underwent 99mTc-sestamibi MPI and 18F-FDG PET/CT for myocardial viability assessment were retrieved. Rest MPI data were processed on ECToolbox, and polar maps were saved using theNFile PMap tool. The reference standard for defining hibernating myocardium was the presence of mismatched perfusion-metabolism defect with impaired myocardial contractility at rest. Perfusion defects on the polar maps were delineated with regions of interest (ROIs) after spatial resampling and intensity discretization. Replicable random sampling allocated 80% (257) of the perfusion defects of the patients from January 2017 to September 2022 to the training set and the remaining 20% (64) to the validation set. An independent dataset of perfusion defects from 29 consecutive patients from October 2022 to January 2023 was used as the testing set for model evaluation. One hundred ten first and second-order texture features were extracted for each ROI. After feature normalization and imputation, 14 best-ranked features were selected using a multistep feature selection process including the Logistic Regression and Fast Correlation-Based Filter. Thirteen supervised ML algorithms were trained with stratified five-fold cross-validation on the training set and validated on the validation set. The ML algorithms with a Log Loss of <0.688 and <0.672 in the cross-validation and validation steps were evaluated on the testing set. Performance matrices of the algorithms assessed included area under the curve (AUC), classification accuracy (CA), F1 score, precision, recall, and specificity. To provide transparency and interpretability, SHapley Additive exPlanations (SHAP) values were assessed and depicted as beeswarm plots. Results Two hundred thirty-nine patients (214 males; mean age 56 ± 11 years) were enrolled in the study. There were 371 perfusion defects (321 in the training and validation sets; 50 in the testing set). Based on the reference standard, 168 perfusion defects had hibernating myocardium (139 in the training and validation sets; 29 in the testing set). On cross-validation, six ML algorithms with Log Loss <0.688 had AUC >0.800. On validation, 10 ML algorithms had a Log Loss value <0.672, among which six had AUC >0.800. On model evaluation of the selected models on the unseen testing set, nine ML models had AUC >0.800 with Gradient Boosting Random Forest (xgboost) [GB RF (xgboost)] achieving the highest AUC of 0.860 and could detect the presence of hibernating myocardium in 21/29 (72.4%) perfusion defects with a precision of 87.5% (21/24), specificity 85.7% (18/21), CA 78.0% (39/50) and F1 Score 0.792. Four models depicted a clear pattern of model interpretability based on the beeswarm SHAP plots. These were GB RF (xgboost), GB (scikit-learn), GB (xgboost), and Random Forest. Conclusion Our study demonstrates the potential of ML in detecting hibernating myocardium using radiomics features extracted from perfusion defects on rest MPI images. This proof-of-concept underscores the notion that radiomics features capture nuanced information beyond what is perceptible to the human eye, offering promising avenues for improved myocardial viability assessment.

Racial and Ethnic Disparities in Predictive Accuracy of Machine Learning Algorithms Developed Using a National Database for 30-Day Complications Following Total Joint Arthroplasty

The purpose of this analysis is to assess the use of machine learning (ML) algorithms in the prediction of postoperative outcomes, including complications, recurrence, and death in transsphenoidal surgery. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed all papers that used at least one ML algorithm to predict outcomes after transsphenoidal surgery. We searched Scopus, PubMed, and Web of Science databases for studies published prior to May 12, 2021. We identified 13 studies enrolling 5,048 patients. We extracted the general characteristics of each study; the sensitivity, specificity, area under the curve (AUC) of the ML models developed as well as the features identified as important by the ML models. We identified 12 studies with 5,048 patients that included ML algorithms for adenomas, three with 1807 patients specifically for acromegaly, and five with 2105 patients specifically for Cushing's disease. Nearly all were single-institution studies. The studies used a heterogeneous mix of ML algorithms and features to build predictive models. All papers reported an AUC greater than 0.7, which indicates clinical utility. ML algorithms have the potential to predict postoperative outcomes of transsphenoidal surgery and can improve patient care. Ensemble algorithms and neural networks were often top performers when compared with other ML algorithms. Biochemical and preoperative features were most likely to be selected as important by ML models. Inexplicability remains a challenge, but algorithms such as local interpretable model–agnostic explanation or Shapley value can increase explainability of ML algorithms. Our analysis shows that ML algorithms have the potential to greatly assist surgeons in clinical decision making.

Aim: We attempted to determine whether machine learning (ML) models outperform logistic regression (LR), a traditional prediction method, in distinguishing type 1 diabetes (T1D) from type 2 diabetes (T2D). Materials and Methods: Utilizing data from individuals of Indian origin diagnosed with diabetes between the ages of 10 and 30 years (n = 3531), we evaluated the ability of seven supervised ML algorithms (LR, gradient boosting [GB], decision tree, k-nearest neighbors, random forest [RF], support vector machine [SVM], and Naïve Bayes) to distinguish between T1D and T2D based on eight predictor variables: age at diagnosis, body mass index, total cholesterol, triglycerides, high-density lipoprotein, glycated hemoglobin, parental history, and glutamic acid decarboxylase antibody status. The dataset was split into training (70%) and testing (30%) subsets, and a grid search approach was employed for hyperparameter tuning to optimize model performance. Results: All fine-tuned ML algorithms demonstrated excellent discriminative ability, with high receiver operating characteristic (ROC) area under the curve (AUC) values (&gt;0.95). GBM (AUC = 0.9700), LR (AUC = 0.9691), and SVM (AUC = 0.9686) emerged as the top-performing models, showing similar and superior performance in distinguishing between T1D and T2D. These algorithms also exhibited strong correlations in their predictions (LR-SVM: 1.000; LR-GB: 0.979; SVM-GB: 0.980). Additionally, LR, SVM, GB, and RF provided the highest net benefit across a wide range of threshold probabilities, highlighting their clinical utility for decision-making. Conclusion: In diabetes classification, the classic LR model proved comparable performance to advanced ML algorithms.

BackgroundDespite the interest in machine learning (ML) algorithms for analyzing real-world data (RWD) in healthcare, the use of ML in predicting time-to-event data, a common scenario in clinical practice, is less explored. ML models are capable of algorithmically learning from large, complex datasets and can offer advantages in predicting time-to-event data. We reviewed the recent applications of ML for survival analysis using RWD in healthcare.MethodsPUBMED and EMBASE were searched from database inception through March 2023 to identify peer-reviewed English-language studies of ML models for predicting time-to-event outcomes using the RWD. Two reviewers extracted information on the data source, patient population, survival outcome, ML algorithms, and the Area Under the Curve (AUC).ResultsOf 257 citations, 28 publications were included. Random survival forests (N = 16, 57%) and neural networks (N = 11, 39%) were the most popular ML algorithms. There was variability across AUC for these ML models (median 0.789, range 0.6–0.950). ML algorithms were predominately considered for predicting overall survival in oncology (N = 12, 43%). ML survival models were often used to predict disease prognosis or clinical events (N = 27, 96%) in the oncology, while less were used for treatment outcomes (N = 1, 4%).ConclusionsThe ML algorithms, random survival forests and neural networks, are mainly used for RWD to predict survival outcomes such as disease prognosis or clinical events in the oncology. This review shows that more opportunities remain to apply these ML algorithms to inform treatment decision-making in clinical practice. More methodological work is also needed to ensure the utility and applicability of ML models in survival outcomes.

Background and objectiveThreatened abortion, a common pregnancy complication that often leading to abortion, is hard to predict due to its non-specific symptoms and difficulty in differentiating from other early pregnancy bleeding causes. Current diagnostic methods like serial ultrasounds and clinical monitoring are time-consuming and lack timeliness. To fill the gap in using advanced analytics for early detection and risk stratification, this study develops a machine learning (ML) model based on routine blood data to better predict threatened abortion, providing a reference for early detection and intervention.MethodsIn this study, we collected medical records from January 2022 to March 2024. We analyzed data from 1764 patients with threatened abortion and 1489 healthy controls. Blood test data of all participants were gathered. The Z-score normalization technique was applied to standardize blood routine indicators. This reduced the influence of outliers and noise. During hyperparameter optimization, ‘class_weight="balanced"’ was set to handle sample imbalance. The screening data was partitioned into a training set of 2928 cases (including the validation set) and a test set of 325 cases at an 8:1:1 ratio. Python was used to facilitate data transformation. Eight different ML algorithms—Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), Gradient Boosting (GBM), Extreme Gradient Boosting (XGB), Deep Neural Network (DNN), Decision Tree (DT) and Naive Bayes (NB)—were used to construct a threatened abortion prediction model. The prediction performances of the ML models were evaluated by calculating the area under the curve (AUC) values. We used the SHapley Additive exPlanation (SHAP) method to explain the models.ResultsComparatively, the DNN model showed the highest predictive performance among the eight models, with the highest AUC value of 96.76% and top metrics for accuracy (91.88%), specificity (91.62%), sensitivity (92.11%), and F1 score (92.48%). SHAP analysis identified Red Cell Distribution Width - Standard Deviation (RDW-SD), Platelet Distribution Width (PDW), Mean Platelet Volume (MPV), Red Cell Distribution Width - Coefficient of Variation (RDW-CV), Absolute Basophil Count (BAS#), Platelet Count (PLT), Mean Corpuscular Hemoglobin Concentration (MCHC) and Lymphocyte Percentage (LYM) as the most influential features in predicting threatened abortion, with PDW, RDW-CV, BAS#, PLT, MCHC and LYM positively contributing to the prediction, whereas RDW-SD and MPV had negative contributions.ConclusionsOur research on constructing a prediction model for threatened abortion through routine blood tests has revealed the great potential of ML algorithms in detecting threatened abortion. This algorithm is expected to analyse routine blood data to identify at-risk pregnancies at an early stage, significantly improving the early detection of this common pregnancy complication. It will assist healthcare providers in intervening earlier and reducing the incidence of abortion. However, before the model can be translated into routine clinical applications, more extensive validation studies are still needed.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12884-025-08030-z.

Tailoring a physical activity intervention to older adults receiving intensive chemotherapy for acute myeloid leukemia (AML): One size does not fit all

­Selective Inhibitor of Nuclear Export (SINE), Selinexor (KPT-330), Shows Remarkable Activity Against AML Leukemia-Initiating Cells

Pegylated Recombinant G-CSF after Sequential High Dose Cytarabine Based Induction Chemotherapy in AML - Analysis of Pharmakokinetics and Effect on Neutrophil Recovery of Pegfilgrastim.

In Mild Cognitive Impairment (MCI), identifying a high risk of conversion to Alzheimer’s Disease Dementia (AD) is a primary goal for patient management. Machine Learning (ML) algorithms are widely employed to pursue data-driven diagnostic and prognostic goals. An agreement on the stability of these algorithms –when applied to different biomarkers and other conditions– is far from being reached. In this study, we compared the different prognostic performances of three supervised ML algorithms fed with multimodal biomarkers of MCI subjects obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Random Forest, Gradient Boosting, and eXtreme Gradient Boosting algorithms predict MCI conversion to AD. They can also be simultaneously employed –with the voting procedure– to improve predictivity. AD prediction accuracy is influenced by the nature of the data (i.e., neuropsychological test scores, cerebrospinal fluid AD-related proteins and APOE ε4, cerebral structural MRI (sMRI) data). In our study, independent of the applied ML algorithms, sMRI data showed the lowest accuracy (0.79) compared to other classes. Multimodal data were helpful in the algorithms’ performances by combining clinical and biological measures. Accordingly, using the three ML algorithms, the highest accuracy (0.90) was reached by employing neuropsychological and AD-related biomarkers. Finally, the feature selection procedure indicated that the most critical variables in the respective classes were the ADAS-Cog-13 scale, the medial temporal lobe and hippocampus atrophy, and the ratio between phosphorylated Tau and Aβ42 proteins. In conclusion, our data support the notion that using multiple ML algorithms and multimodal biomarkers helps make more accurate and solid predictions.

Surgical site infection (SSI) following a neurosurgical operation is a complication that impacts morbidity, mortality, and economics. Currently, machine learning (ML) algorithms are used for outcome prediction in various neurosurgical aspects. The implementation of ML algorithms to learn from medical data may help in obtaining prognostic information on diseases, especially SSIs. The purpose of this study was to compare the performance of various ML models for predicting surgical infection after neurosurgical operations. A retrospective cohort study was conducted on patients who had undergone neurosurgical operations at tertiary care hospitals between 2010 and 2017. Supervised ML algorithms, which included decision tree, naive Bayes with Laplace correction, k-nearest neighbors, and artificial neural networks, were trained and tested as binary classifiers (infection or no infection). To evaluate the ML models from the testing data set, their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), as well as their accuracy, receiver operating characteristic curve, and area under the receiver operating characteristic curve (AUC) were analyzed. Data were available for 1471 patients in the study period. The SSI rate was 4.6%, and the type of SSI was superficial, deep, and organ/space in 1.2%, 0.8%, and 2.6% of cases, respectively. Using the backward stepwise method, the authors determined that the significant predictors of SSI in the multivariable Cox regression analysis were postoperative CSF leakage/subgaleal collection (HR 4.24, p < 0.001) and postoperative fever (HR 1.67, p = 0.04). Compared with other ML algorithms, the naive Bayes had the highest performance with sensitivity at 63%, specificity at 87%, PPV at 29%, NPV at 96%, and AUC at 76%. The naive Bayes algorithm is highlighted as an accurate ML method for predicting SSI after neurosurgical operations because of its reasonable accuracy. Thus, it can be used to effectively predict SSI in individual neurosurgical patients. Therefore, close monitoring and allocation of treatment strategies can be informed by ML predictions in general practice.

Several machine learning (ML) algorithms have been increasingly utilized for cardiovascular disease prediction. We aim to assess and summarize the overall predictive ability of ML algorithms in cardiovascular diseases. A comprehensive search strategy was designed and executed within the MEDLINE, Embase, and Scopus databases from database inception through March 15, 2019. The primary outcome was a composite of the predictive ability of ML algorithms of coronary artery disease, heart failure, stroke, and cardiac arrhythmias. Of 344 total studies identified, 103 cohorts, with a total of 3,377,318 individuals, met our inclusion criteria. For the prediction of coronary artery disease, boosting algorithms had a pooled area under the curve (AUC) of 0.88 (95% CI 0.84–0.91), and custom-built algorithms had a pooled AUC of 0.93 (95% CI 0.85–0.97). For the prediction of stroke, support vector machine (SVM) algorithms had a pooled AUC of 0.92 (95% CI 0.81–0.97), boosting algorithms had a pooled AUC of 0.91 (95% CI 0.81–0.96), and convolutional neural network (CNN) algorithms had a pooled AUC of 0.90 (95% CI 0.83–0.95). Although inadequate studies for each algorithm for meta-analytic methodology for both heart failure and cardiac arrhythmias because the confidence intervals overlap between different methods, showing no difference, SVM may outperform other algorithms in these areas. The predictive ability of ML algorithms in cardiovascular diseases is promising, particularly SVM and boosting algorithms. However, there is heterogeneity among ML algorithms in terms of multiple parameters. This information may assist clinicians in how to interpret data and implement optimal algorithms for their dataset.

Feature extraction-reduction and machine learning for fault diagnosis in PV panels

Three-phase induction motors (IMs) are one of the most employed electric machines in industrial and household applications. Condition monitoring of these machines is essential to avoid unplanned maintenance and thereby enhance the availability. Artificial Intelligence (AI) technologies are emerging as an advanced tool for automating condition monitoring process to detect incipient faults at early stages. Machine Learning (ML) algorithms have been identified as a promising approach for condition monitoring of IMs and predicting maintenance to avoid failures. However, selecting the suitable ML algorithm for a given application is challenging because there is no predefined set of application-based algorithms. In addition, raw data processing and feature selection need careful attention to improve the accuracy of the results. This paper reviews supervised ML algorithms that can be used for condition monitoring of IMs and identifies their benefits and drawbacks. It then discusses how the dominant features from raw data can be selected through time domain and frequency domain analysis using the acoustic data collected from a three-phase induction motor. The study investigates classification accuracy of each ML algorithm and a procedure for selecting an algorithm based on the experimental results. Results of this study show that Support Vector Machines (SVM) algorithm outperforms other competing algorithms in condition monitoring of IMs when the dominant frequency components obtained through Fast Fourier Transform (FFT) are used as training data.

An intrusion detection system (IDS) is an important protection instrument for detecting complex network attacks. Various machine learning (ML) or deep learning (DL) algorithms have been proposed for implementing anomaly-based IDS (AIDS). Our review of the AIDS literature identifies some issues in related work, including the randomness of the selected algorithms, parameters, and testing criteria, the application of old datasets, or shallow analyses and validation of the results. This paper comprehensively reviews previous studies on AIDS by using a set of criteria with different datasets and types of attacks to set benchmarking outcomes that can reveal the suitable AIDS algorithms, parameters, and testing criteria. Specifically, this paper applies 10 popular supervised and unsupervised ML algorithms for identifying effective and efficient ML-AIDS of networks and computers. These supervised ML algorithms include the artificial neural network (ANN), decision tree (DT), k-nearest neighbor (k-NN), naive Bayes (NB), random forest (RF), support vector machine (SVM), and convolutional neural network (CNN) algorithms, whereas the unsupervised ML algorithms include the expectation-maximization (EM), k-means, and self-organizing maps (SOM) algorithms. Several models of these algorithms are introduced, and the turning and training parameters of each algorithm are examined to achieve an optimal classifier evaluation. Unlike previous studies, this study evaluates the performance of AIDS by measuring the true positive and negative rates, accuracy, precision, recall, and F-Score of 31 ML-AIDS models. The training and testing time for ML-AIDS models are also considered in measuring their performance efficiency given that time complexity is an important factor in AIDSs. The ML-AIDS models are tested by using a recent and highly unbalanced multiclass CICIDS2017 dataset that involves real-world network attacks. In general, the k-NN-AIDS, DT-AIDS, and NB-AIDS models obtain the best results and show a greater capability in detecting web attacks compared with other models that demonstrate irregular and inferior results.