The COVID-19 pandemic continues to have a devastating global impact, and has placed a tremendous burden on struggling healthcare systems around the world. Given the limited resources, accurate patient triaging and care planning is critical in the fight against COVID-19, and one crucial task within care planning is determining if a patient should be admitted to a hospital's intensive care unit (ICU). Motivated by the need for transparent and trustworthy ICU admission clinical decision support, we introduce COVID-Net Clinical ICU, a neural network for ICU admission prediction based on patient clinical data. Driven by a transparent, trust-centric methodology, the proposed COVID-Net Clinical ICU was built using a clinical dataset from Hospital Sirio-Libanes comprising of 1,925 COVID-19 patients, and is able to predict when a COVID-19 positive patient would require ICU admission with an accuracy of 96.9% to facilitate better care planning for hospitals amidst the on-going pandemic. We conducted system-level insight discovery using a quantitative explainability strategy to study the decision-making impact of different clinical features and gain actionable insights for enhancing predictive performance. We further leveraged a suite of trust quantification metrics to gain deeper insights into the trustworthiness of COVID-Net Clinical ICU. By digging deeper into when and why clinical predictive models makes certain decisions, we can uncover key factors in decision making for critical clinical decision support tasks such as ICU admission prediction and identify the situations under which clinical predictive models can be trusted for greater accountability.
翻译:COVID-19大流行继续给全球带来毁灭性影响,给世界各地挣扎的医疗保健系统带来巨大负担。鉴于资源有限,准确的病人三角和护理规划对于抗击COVID-19至关重要,护理规划中的一项关键任务是确定病人是否应当被医院的重症监护单位(ICU)接纳。出于对透明和可信赖的ICU入院临床决策支持的需求,我们引入了COVID-Net临床ICU神经网络,这是根据病人临床数据对ICU入院情况进行预测的神经网络。在透明、以信任为中心的临床方法驱使下,拟议的COVID-Net临床ICU是使用Sirio-Libarnes医院的临床数据集,由1 925 COVID-19病人组成,在护理规划中的一项关键任务就是确定病人是否应该被医院收住院,准确度为96.9%,以便在不断流行的流行病中更好地进行医院护理规划。我们使用定量解释战略来研究不同临床特征的决策影响,并获得可操作的深入的诊断性见解。我们通过更深入的临床诊断性判断,可以进一步利用CUILU的判断性决定,从而获得更深入的判断性判断性判断性决定。