PoEMS: Policy Network-Based Early Warning Monitoring System for Sepsis in Intensive Care Units

败血症 预警得分 预警系统 重症监护 适应性 计算机科学 病历 预警系统 医学 重症监护医学 人工智能 机器学习 医疗急救 内科学 电信 生物 生态学
作者
Hao Dai,Hsin‐Ginn Hwang,Vincent S. Tseng
出处
期刊:IEEE Journal of Biomedical and Health Informatics [Institute of Electrical and Electronics Engineers]
卷期号:27 (7): 3610-3621 被引量:3
标识
DOI:10.1109/jbhi.2023.3272486
摘要

Sepsis is among the leading causes of morbidity and mortality in modern intensive care units (ICU). Due to accurate and early warning, the in-time antibiotic treatment of sepsis is critical for improving sepsis outcomes, contributing to saving lives, and reducing medical costs. However, the earlier prediction of sepsis onset is made, the fewer monitoring measurements can be processed, causing a lower prediction accuracy. In contrast, a more accurate prediction can be expected by analyzing more data but leading to the delayed warning associated with life-threatening events. In this study, we propose a novel deep reinforcement learning framework for solving early prediction of sepsis, called the Policy Network-based Early Warning Monitoring System (PoEMS). The proposed PoEMS provides accurate and early prediction results for sepsis onset based on analyzing varied-length electronic medical records (EMR). Furthermore, the system serves by monitoring the patient's health status consistently and provides an early warning only when a high risk of sepsis is detected. Additionally, a controlling parameter is designed for users to adjust the trade-off between earliness and accuracy, providing the adaptability of the model to meet various medical requirements in practical scenarios. Through a series of experiments on real-world medical data, the results demonstrate that our proposed PoEMS achieves a high AUROC result of more than 91% for early prediction, and predicts sepsis onset earlier and more accurately compared to other state-of-the-art competing methods.

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