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Evaluating the SWIFT algorithm's efficacy in predicting hypoxemia across multiple critical care datasets

  • Background Machine learning models to predict hypoxia in patients could improve timely interventions. Due to the diversity and limited generalizability of approaches, external validation is required. Objective This study aimed to validate the generalizability of SpO2 Waveform ICU Forecasting Technique (SWIFT), an LSTM algorithm for predicting SpO2 5 and 30 min in advance, on two external datasets. Methods We trained the SWIFT model on eICU Collaborative Research Database (eICU-CRD) and validated it on Medical Information Mart for Intensive Care IV (MIMIC-IV) and Amsterdam University Medical Centers Database (UMCdb) data. We evaluated SWIFT-5 and SWIFT-30 for ventilated and non-ventilated populations. Results The sampling procedure resulted in substantial population size reduction for MIMIC-IV and UMCdb data due to differences in SpO2 measurement frequency. SWIFT performed well on eICU-CRD data but showed reduced performance on MIMIC-IV data, particularly for SWIFT-30. UMCdbBackground Machine learning models to predict hypoxia in patients could improve timely interventions. Due to the diversity and limited generalizability of approaches, external validation is required. Objective This study aimed to validate the generalizability of SpO2 Waveform ICU Forecasting Technique (SWIFT), an LSTM algorithm for predicting SpO2 5 and 30 min in advance, on two external datasets. Methods We trained the SWIFT model on eICU Collaborative Research Database (eICU-CRD) and validated it on Medical Information Mart for Intensive Care IV (MIMIC-IV) and Amsterdam University Medical Centers Database (UMCdb) data. We evaluated SWIFT-5 and SWIFT-30 for ventilated and non-ventilated populations. Results The sampling procedure resulted in substantial population size reduction for MIMIC-IV and UMCdb data due to differences in SpO2 measurement frequency. SWIFT performed well on eICU-CRD data but showed reduced performance on MIMIC-IV data, particularly for SWIFT-30. UMCdb validation demonstrated promise, with comparable performance to eICU-CRD for ventilated patients. All datasets exhibited high specificity and NPV, critical for gaining trust in alarms in clinical applications. Conclusions The study highlights challenges in generalizing prediction models across diverse ICU populations, emphasizing need for external validation. Further research should focus on improving model adaptability and interpretability, considering the practical application in clinical settings.show moreshow less

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Metadaten
Author:Leon SchmidtGND, Lena Pigat, Seyedmostafa Sheikhalishahi, Julia Sander, Mathias KasparGND, Baocheng Wang, Ludwig Christian HinskeORCiDGND
URN:urn:nbn:de:bvb:384-opus4-1224481
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/122448
ISSN:0883-9441OPAC
Parent Title (English):Journal of Critical Care
Publisher:Elsevier BV
Type:Article
Language:English
Year of first Publication:2025
Publishing Institution:Universität Augsburg
Release Date:2025/05/30
Volume:89
First Page:155123
DOI:https://doi.org/10.1016/j.jcrc.2025.155123
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Anästhesiologie und Operative Intensivmedizin
Medizinische Fakultät / Lehrstuhl für Datenmanagement und Clinical Decision Support
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCC-BY-NC-ND 4.0: Creative Commons: Namensnennung - Nicht kommerziell - Keine Bearbeitung (mit Print on Demand)