临床新进展

人工智能在肝性脑病风险预测模型中的应用进展

  • 黄良江 ,
  • 毛德文 ,
  • 郑景辉 ,
  • 王明刚 ,
  • 姚春
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  • 1.广西中医药大学 (南宁 530200 )
    2.广西中医药大学第一附属医院 肝病科 (南宁 530023 )
    3.广西中医药大学第一附属医院 科研部 (南宁 530023 )
    4.广西中医药大学附属瑞康医院 (南宁 530023 )
姚春,二级教授,博士研究生导师,第二届广西壮族自治区桂派中医大师,全国“三八”红旗手。现任广西中医药大学校长。擅长治疗各类神经系统疾病、消化系统疾病以及内科疑难杂病。作为项目负责人承担了广西科技重大专项、广西首个中药民族药产业专项揭榜挂帅项目、2023年度国家自然科学基金区域创新发展联合基金重点支持项目等省部级以上科研项目10余项。荣获广西科学技术进步奖一等奖1 项、二等奖1项、三等奖3项,广西社会科学优秀成果奖二等奖1项。主编或参编专著(教材)3部。在专业期刊上发表论文90余篇,其中SCI收录14篇,拥有发明及实用新型专利3项,获得授权计算机软件著作权2项。

收稿日期: 2023-09-26

  网络出版日期: 2024-02-22

基金资助

广西重点研发计划项目(编号:桂科AB22035076);国家自然科学基金地区基金(82260899);广西研究生教育创新计划项目(YCSW2022343)

Application of artificial intelligence in HE risk prediction modelling and research advances

  • Liangjiang HUANG ,
  • Dewen MAO ,
  • Jinghui ZHENG ,
  • Minggang WANG ,
  • Chun YAO
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  • Guangxi University of Traditional Chinese Medicine,Nanning 530200,China

Received date: 2023-09-26

  Online published: 2024-02-22

摘要

肝性脑病是由肝功能不全引起的中枢神经系统功能紊乱的临床综合征。它严重影响患者的生活质量,并可能导致死亡。准确预测肝性脑病的发生风险对于早期干预和治疗至关重要。为了提前识别患者的肝性脑病风险,许多研究都在致力于努力开发工具及方法,以尽早识别肝性脑病的风险,从而制定预防和早期管理策略。目前大多数传统的肝性脑病风险预测模型通过分析临床数据和生化指标等因素,来评估患者发生肝性脑病的概率,然而其准确性、灵敏性和阳性预测值都不高。人工智能在临床预测模型的应用是一个非常热门和有前景的领域,它可以利用大量的数据和复杂的算法来提高诊断和预后的准确性和效率。到目前为止,利用人工智能技术预测肝性脑病的研究还很少。因此,本文综述了肝性脑病风险预测模型的研究进展,探讨人工智能在肝性脑病风险预测模型中的应用前景,并指出人工智能在肝性脑病风险预测模型研究中的挑战及未来研究方向,以促进肝性脑病风险预测模型的发展和临床应用。

本文引用格式

黄良江 , 毛德文 , 郑景辉 , 王明刚 , 姚春 . 人工智能在肝性脑病风险预测模型中的应用进展[J]. 实用医学杂志, 2024 , 40(3) : 289 -294 . DOI: 10.3969/j.issn.1006-5725.2024.03.002

Abstract

Hepatic encephalopathy is a clinical syndrome of central nervous system dysfunction caused by liver insufficiency. It severely affects the quality of life of patients and may lead to death. Accurate prediction of the risk of developing hepatic encephalopathy is crucial for early intervention and treatment. In order to identify the risk of hepatic encephalopathy in patients in advance, many studies have been devoted to efforts to develop tools and methods to identify the risk of hepatic encephalopathy as early as possible, so as to develop preventive and early management strategies. Most conventional hepatic encephalopathy risk prediction models currently assess the probability of a patient developing hepatic encephalopathy by analysing factors such as clinical data and biochemical indicators, however, their accuracy, sensitivity and positive predictive value are not high. The application of artificial intelligence to clinical predictive modelling is a very hot and promising area, which can use large amounts of data and complex algorithms to improve the accuracy and efficiency of diagnosis and prognosis. To date, there have been few studies using AI techniques to predict hepatic encephalopathy. Therefore, this paper reviews the research progress of hepatic encephalopathy risk prediction models, and also discusses the prospect of AI application in hepatic encephalopathy risk prediction models. It also points out the challenges and future research directions of AI in HE risk prediction model research in order to promote the development and clinical application of hepatic encephalopathy risk prediction models.

参考文献

1 ROSE C F, AMODIO P, BAJAJ J S, et al. Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy [J]. J Hepatol, 2020, 73(6): 1526-1547. doi:10.1016/j.jhep.2020.07.013
2 WIJDICKS E F. Hepatic Encephalopathy [J]. N Engl J Med, 2016, 375(17): 1660-1670. doi:10.1056/nejmra1600561
3 ELSAID M I, JOHN T, LI Y, et al. The Health Care Burden of Hepatic Encephalopathy [J]. Clin Liver Dis, 2020, 24(2): 263-275. doi:10.1016/j.cld.2020.01.006
4 DEBRAY T P A, COLLINS G S, RILEY R D, et al. Transparent reporting of multivariable prediction models developed or validated using clustered data (TRIPOD-Cluster): explanation and elaboration [J]. BMJ, 2023, 380: e071058. doi:10.1136/bmj-2022-071058
5 YANG H, LI X, CAO H, et al. Using machine learning methods to predict hepatic encephalopathy in cirrhotic patients with unbalanced data [J]. Comput Methods Programs Biomed, 2021, 211: 106420. doi:10.1016/j.cmpb.2021.106420
6 贾学友,晋晓丽,戴进前. 基于Cox风险回归预测模型判断HBV-ACLF短期预后的价值[J]. 中西医结合肝病杂志, 2022(4): 32.
7 LE BERRE C, SANDBORN W J, ARIDHI S, et al. Application of Artificial Intelligence to Gastroenterology and Hepatology [J]. Gastroenterology, 2020, 158(1): 76-94.e2. doi:10.1053/j.gastro.2019.08.058
8 林建辉,陈丽霞,蓝丽琴,等. 乙型肝炎相关慢加急性肝衰竭患者住院新发显性肝性脑病风险的预测模型构建[J]. 解放军医学杂志, 2022,47(12):1232-1240.
9 HU C, JIANG N, ZHENG J, et al. Liver volume based prediction model for patients with hepatitis B virus-related acute-on-chronic liver failure [J]. J Hepatobiliary Pancreat Sci, 2022, 29(12): 1253-1263. doi:10.1002/jhbp.1112
10 ACHARYA C, SHAW J, DUONG N, et al. QuickStroop, a Shortened Version of EncephalApp, Detects Covert Hepatic Encephalopathy With Similar Accuracy Within One Minute [J]. Clin Gastroenterol Hepatol, 2023, 21(1): 136-142. doi:10.1016/j.cgh.2021.12.047
11 YU X, LU Y, SUN S, et al. Clinical Prediction Models for Hepatitis B Virus-related Acute-on-chronic Liver Failure: A Technical Report [J]. J Clin Transl Hepatol, 2021, 9(6): 838-849.
12 GUO L W, LYU Z Y, MENG Q C, et al. A risk prediction model for selecting high-risk population for computed tomography lung cancer screening in China [J]. Lung Cancer, 2022, 163: 27-34. doi:10.1016/j.lungcan.2021.11.015
13 李应龙,庞桦进,何晓峰. 经颈静脉肝内门腔静脉分流术后早期肝性脑病列线图的建立和验证[J]. 实用医学杂志,2020,36(7):963-968. doi:10.3969/j.issn.1006-5725.2020.07.026
14 American Association for the study of Liver Diseases, European Association for the study of the Liver. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases [J]. J Hepatol, 2014, 61(3): 642-659. doi:10.1016/j.jhep.2014.05.042
15 ROMERO-GóMEZ M, CóRDOBA J, JOVER R, et al. Value of the critical flicker frequency in patients with minimal hepatic encephalopathy [J]. Hepatology, 2007, 45(4): 879-885. doi:10.1002/hep.21586
16 胡小鹏,高建. 国际标准化比值和终末期肝病模型评分对并发肝性脑病的肝硬化患者短期预后的预测价值[J]. 第三军医大学学报, 2019, 41(14):7.
17 TAKIKAWA Y, ENDO R, SUZUKI K, et al. Prediction of hepatic encephalopathy development in patients with severe acute hepatitis [J]. Dig Dis Sci, 2006, 51(2): 359-364. doi:10.1007/s10620-006-3138-7
18 LABENZ C, TOENGES G, HUBER Y, et al. Raised serum Interleukin-6 identifies patients with liver cirrhosis at high risk for overt hepatic encephalopathy [J]. Aliment Pharmacol Ther, 2019, 50(10): 1112-1119. doi:10.1111/apt.15515
19 TAPPER E B, PARIKH N D, SENGUPTA N, et al. A risk score to predict the development of hepatic encephalopathy in a population-based cohort of patients with cirrhosis [J]. Hepatology, 2018, 68(4): 1498-1507. doi:10.1002/hep.29628
20 AHN J C, CONNELL A, SIMONETTO D A, et al. Application of Artificial Intelligence for the Diagnosis and Treatment of Liver Diseases [J]. Hepatology, 2021, 73(6): 2546-2563. doi:10.1002/hep.31603
21 李欣欣. 基于代价敏感性随机森林与支持向量机的肝硬化并发肝性脑病风险预测模型研究[D]. 太原:山西医科大学,2018.
22 王旭春,翟梦梦,任浩,等. 基于重采样和Voting异质集成的分类模型在肝硬化并发肝性脑病风险预测中的探索性研究[J].中国卫生统计, 2022,39(4):039.
23 胡珉,陈新. 决策树模型联合Logistic回归法分析肝性脑病结局的影响因素[J]. 现代医学,2016,44(9):1199-1203.
24 刘宝荣,方建凯,林明华,等. 应用人工神经网络评估乙型肝炎慢加急性肝衰竭发生肝性脑病的危险因素[J]. 肝脏,2017,22(12):1085-1089,1093. doi:10.3969/j.issn.1008-1704.2017.12.006
25 程璠,曹红艳,武希润,等. 肝性脑病诱发因素的潜在类别模型与高危人群筛选[J]. 慢性病学杂志,2018,19(1):4-7+11.
26 谈军涛,许晓梅,何雨芯,等. 基于机器学习算法的肝硬化相关肝性脑病预测模型的构建[J]. 解放军医学杂志, 2021, 46(4):7. doi:10.11855/j.issn.0577-7402.2021.04.06
27 王旭春,宋伟梅,翟梦梦,等. 基于ElasticNet和贝叶斯网络模型的肝硬化并发肝性脑病相关因素分析[J]. 现代预防医学, 2021, 48(9):5.
28 VON ESCHENBACH W J. Transparency and the black box problem: Why we do not trust AI [J]. Philosophy & Technology, 2021, 34(4): 1607-1622. doi:10.1007/s13347-021-00477-0
29 NAZAR M, ALAM M M, YAFI E, et al. A systematic review of human-computer interaction and explainable artificial intelligence in healthcare with artificial intelligence techniques [J]. IEEE Access, 2021, 9: 153316-153348. doi:10.1109/access.2021.3127881
30 NAZIR S, DICKSON D M, AKRAM M U. Survey of explainable artificial intelligence techniques for biomedical imaging with deep neural networks [J]. Comput Biol Med, 2023,156: 106668. doi:10.1016/j.compbiomed.2023.106668
31 LAL A, DANG J, NABZDYK C, et al. Regulatory oversight and ethical concerns surrounding software as medical device (SaMD) and digital twin technology in healthcare [J]. Ann Transl Med, 2022, 10(18):950. doi:10.21037/atm-22-4203
32 GIL-GóMEZ A, AMPUERO J, ROJAS á, et al. Development and Validation of a Clinical-Genetic Risk Score to Predict Hepatic Encephalopathy in Patients With Liver Cirrhosis[J]. Am J Gastroenterol, 2021, 116(6): 1238-1247. doi:10.14309/ajg.0000000000001164
33 COLLINS G S, REITSMA J B, ALTMAN D G, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) the TRIPOD statement [J]. Circulation, 2015, 131(2): 211-219. doi:10.1161/circulationaha.114.014508
34 CONNELL A, BLACK G, MONTGOMERY H, et al. Implementation of a Digitally Enabled Care Pathway (Part 2): Qualitative Analysis of Experiences of Health Care Professionals [J]. J Med Internet Res, 2019, 21(7): e13143. doi:10.2196/13143
35 WOLFF R F, MOONS K G M, RILEY R D, et al. PROBAST: A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies [J]. Ann Intern Med, 2019, 170(1): 51-58. doi:10.7326/m18-1376
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