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Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model

INTRODUCTION: The mortality risk in children admitted to Pediatric Intensive Care Units (PICU) is usually estimated by means of validated scales, which only include objective data among their items. Human perceptions may also add relevant information to prognosticate the risk of death, and the tool...

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Autores principales: Rey, Corsino, Mayordomo-Colunga, Juan, Gobergs, Roberts, Balmaks, Reinis, Vivanco-Allende, Ana, Concha, Andrés, Medina, Alberto, Colubi, Ana, González-Rodríguez, Gil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913138/
https://www.ncbi.nlm.nih.gov/pubmed/35281613
http://dx.doi.org/10.1155/2022/7740785
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author Rey, Corsino
Mayordomo-Colunga, Juan
Gobergs, Roberts
Balmaks, Reinis
Vivanco-Allende, Ana
Concha, Andrés
Medina, Alberto
Colubi, Ana
González-Rodríguez, Gil
author_facet Rey, Corsino
Mayordomo-Colunga, Juan
Gobergs, Roberts
Balmaks, Reinis
Vivanco-Allende, Ana
Concha, Andrés
Medina, Alberto
Colubi, Ana
González-Rodríguez, Gil
author_sort Rey, Corsino
collection PubMed
description INTRODUCTION: The mortality risk in children admitted to Pediatric Intensive Care Units (PICU) is usually estimated by means of validated scales, which only include objective data among their items. Human perceptions may also add relevant information to prognosticate the risk of death, and the tool to use this subjective data is fuzzy logic. The objective of our study was to develop a mathematical model to predict mortality risk based on the subjective perception of PICU staff and to evaluate its accuracy compared to validated scales. METHODS: A prospective observational study in two PICUs (one in Spain and another in Latvia) was performed. Children were consecutively included regardless of the cause of admission along a two-year period. A fuzzy set program was developed for the PICU staff to record the subjective assessment of the patients' mortality risk expressed through a short range and a long range, both between 0% and 100%. Pediatric Index of Mortality 2 (PIM2) and Therapeutic Intervention Scoring System 28 (TISS28) were also prospectively calculated for each patient. Subjective and objective predictions were compared using the logistic regression analysis. To assess the prognostication ability of the models a stratified B-random K-fold cross-validation was performed. RESULTS: Five hundred ninety-nine patients were included, 308 in Spain (293 survivors, 15 nonsurvivors) and 291 in Latvia (282 survivors, 9 nonsurvivors). The best logistic classification model for subjective information was the one based on MID (midpoint of the short range), whereas objective information was the one based on PIM2. Mortality estimation performance was 86.3% for PIM2, 92.6% for MID, and the combination of MID and PIM2 reached 96.4%. CONCLUSIONS: Subjective assessment was as useful as validated scales to estimate the risk of mortality. A hybrid model including fuzzy information and probabilistic scales (PIM2) seems to increase the accuracy of prognosticating mortality in PICU.
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spelling pubmed-89131382022-03-11 Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model Rey, Corsino Mayordomo-Colunga, Juan Gobergs, Roberts Balmaks, Reinis Vivanco-Allende, Ana Concha, Andrés Medina, Alberto Colubi, Ana González-Rodríguez, Gil Biomed Res Int Research Article INTRODUCTION: The mortality risk in children admitted to Pediatric Intensive Care Units (PICU) is usually estimated by means of validated scales, which only include objective data among their items. Human perceptions may also add relevant information to prognosticate the risk of death, and the tool to use this subjective data is fuzzy logic. The objective of our study was to develop a mathematical model to predict mortality risk based on the subjective perception of PICU staff and to evaluate its accuracy compared to validated scales. METHODS: A prospective observational study in two PICUs (one in Spain and another in Latvia) was performed. Children were consecutively included regardless of the cause of admission along a two-year period. A fuzzy set program was developed for the PICU staff to record the subjective assessment of the patients' mortality risk expressed through a short range and a long range, both between 0% and 100%. Pediatric Index of Mortality 2 (PIM2) and Therapeutic Intervention Scoring System 28 (TISS28) were also prospectively calculated for each patient. Subjective and objective predictions were compared using the logistic regression analysis. To assess the prognostication ability of the models a stratified B-random K-fold cross-validation was performed. RESULTS: Five hundred ninety-nine patients were included, 308 in Spain (293 survivors, 15 nonsurvivors) and 291 in Latvia (282 survivors, 9 nonsurvivors). The best logistic classification model for subjective information was the one based on MID (midpoint of the short range), whereas objective information was the one based on PIM2. Mortality estimation performance was 86.3% for PIM2, 92.6% for MID, and the combination of MID and PIM2 reached 96.4%. CONCLUSIONS: Subjective assessment was as useful as validated scales to estimate the risk of mortality. A hybrid model including fuzzy information and probabilistic scales (PIM2) seems to increase the accuracy of prognosticating mortality in PICU. Hindawi 2022-03-03 /pmc/articles/PMC8913138/ /pubmed/35281613 http://dx.doi.org/10.1155/2022/7740785 Text en Copyright © 2022 Corsino Rey et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Rey, Corsino
Mayordomo-Colunga, Juan
Gobergs, Roberts
Balmaks, Reinis
Vivanco-Allende, Ana
Concha, Andrés
Medina, Alberto
Colubi, Ana
González-Rodríguez, Gil
Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model
title Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model
title_full Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model
title_fullStr Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model
title_full_unstemmed Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model
title_short Predicting the Risk of Mortality in Children using a Fuzzy-Probabilistic Hybrid Model
title_sort predicting the risk of mortality in children using a fuzzy-probabilistic hybrid model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913138/
https://www.ncbi.nlm.nih.gov/pubmed/35281613
http://dx.doi.org/10.1155/2022/7740785
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