DeepSOFA: A Real-Time Continuous Acuity Score Framework using Deep Learning

Traditional methods for assessing illness severity and predicting in-hospital mortality among critically ill patients require manual, time-consuming, and error-prone calculations that are further hindered by the use of static variable thresholds derived from aggregate patient populations. These coarse frameworks do not capture time-sensitive individual physiological patterns and are not suitable for instantaneous assessment of patients' acuity trajectories, a critical task for the ICU where conditions often change rapidly. Furthermore, they are ill-suited to capitalize on the emerging availability of streaming electronic health record data. We propose a novel acuity score framework (DeepSOFA) that leverages temporal patient measurements in conjunction with deep learning models to make accurate assessments of a patient's illness severity at any point during their ICU stay. We compare DeepSOFA with SOFA baseline models using the same predictors and find that at any point during an ICU admission, DeepSOFA yields more accurate predictions of in-hospital mortality.

[1]  Jimeng Sun,et al.  Using recurrent neural network models for early detection of heart failure onset , 2016, J. Am. Medical Informatics Assoc..

[2]  Parisa Rashidi,et al.  Deep neural network architectures for forecasting analgesic response , 2016, 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[3]  J. Ramon,et al.  Machine learning techniques to examine large patient databases. , 2009, Best practice & research. Clinical anaesthesiology.

[4]  C. Sprung,et al.  Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. , 1998, Critical care medicine.

[5]  Thomas Higgins,et al.  SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. , 2005 .

[6]  Subhashini Venugopalan,et al.  Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs. , 2016, JAMA.

[7]  Omar Badawi,et al.  Evaluation of ICU Risk Models Adapted for Use as Continuous Markers of Severity of Illness Throughout the ICU Stay* , 2018, Critical care medicine.

[8]  Mohammad M. Ghassemi,et al.  The effects of deep network topology on mortality prediction , 2016, 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[9]  J. Vincent,et al.  The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure , 1996, Intensive Care Medicine.

[10]  Peter Bauer,et al.  SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission , 2005, Intensive Care Medicine.

[11]  A. Abu-Hanna,et al.  Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review , 2008, Critical care.

[12]  D. Teres,et al.  Assessing contemporary intensive care unit outcome: An updated Mortality Probability Admission Model (MPM0-III)* , 2007, Critical care medicine.

[13]  Bekele Afessa,et al.  Severity of illness and organ failure assessment in adult intensive care units. , 2007, Critical care clinics.

[14]  G. Clermont,et al.  Predicting hospital mortality for patients in the intensive care unit: A comparison of artificial neural networks with logistic regression models , 2001, Critical care medicine.

[15]  B. Walker I. Introduction , 2020 .

[16]  Sebastian Thrun,et al.  Dermatologist-level classification of skin cancer with deep neural networks , 2017, Nature.

[17]  Yoshua Bengio,et al.  Learning Phrase Representations using RNN Encoder–Decoder for Statistical Machine Translation , 2014, EMNLP.

[18]  J. le Gall,et al.  SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description , 2005, Intensive Care Medicine.

[19]  J. Vincent,et al.  Serial evaluation of the SOFA score to predict outcome in critically ill patients. , 2001, JAMA.

[20]  Geoffrey E. Hinton,et al.  Deep Learning , 2015, Nature.

[21]  Charles Elkan,et al.  Learning to Diagnose with LSTM Recurrent Neural Networks , 2015, ICLR.

[22]  Yoshua Bengio,et al.  Empirical Evaluation of Gated Recurrent Neural Networks on Sequence Modeling , 2014, ArXiv.

[23]  J. Zimmerman,et al.  Acute Physiology and Chronic Health Evaluation (APACHE) IV: Hospital mortality assessment for today’s critically ill patients* , 2006, Critical care medicine.

[24]  David M Maslove With Severity Scores Updated on the Hour, Data Science Inches Closer to the Bedside. , 2018, Critical care medicine.

[25]  Peter Szolovits,et al.  MIMIC-III, a freely accessible critical care database , 2016, Scientific Data.