论文标题
实时个性化端点预测的GRU-D-WEIBULL架构的歧视,校准和点估计准确性
Discrimination, calibration, and point estimate accuracy of GRU-D-Weibull architecture for real-time individualized endpoint prediction
论文作者
论文摘要
实时个人终点预测一直是一项具有挑战性的任务,但对于患者和医疗保健提供者来说都是出色的诊所公用事业。我们以6,879次慢性肾脏病阶段4(CKD4)患者为用例,我们探索了具有衰减的封闭式复发单元的可行性和性能,以使Weibull概率密度函数(GRU-D-WEIBULL)作为实时个人端点预测的半参数纵向模型。 Gru-d-Weibull在随访4。3年时的最大C指数为0.77,而竞争模型实现了0.68。 Gru-D-Weibull的L1损失占XGB(AFT)的66%,MTLR的60%,在CKD4索引日期为AFT模型的30%。 Gru-D-Weibull的平均绝对L1损失约为一年,指数日期后至少40%的Parkes严重错误。 Gru-D-Weibull未经校准,并显着低估了真正的生存概率。特征重要性测试表明,在随访期间血压变得越来越重要,而EGFR和血白蛋白的重要性不大。大多数连续特征对预测的生存时间具有非线性/抛物线的影响,结果通常与现有知识一致。 Gru-d-Weibull作为半参数的时间模型显示了缺失的内置参数化,对异步到达测量的本机参数化,在任意预测范围内的任意时间点上的概率和点估计能力,提高了歧视的概率和点估计值,提高了歧视和点估计,并在合并了新的到达数据后准确性。需要进一步研究其具有更全面的输入功能,过程中或后过程校准的进一步研究,以使CKD4或终止患者相似。
Real-time individual endpoint prediction has always been a challenging task but of great clinic utility for both patients and healthcare providers. With 6,879 chronic kidney disease stage 4 (CKD4) patients as a use case, we explored the feasibility and performance of gated recurrent units with decay that models Weibull probability density function (GRU-D-Weibull) as a semi-parametric longitudinal model for real-time individual endpoint prediction. GRU-D-Weibull has a maximum C-index of 0.77 at 4.3 years of follow-up, compared to 0.68 achieved by competing models. The L1-loss of GRU-D-Weibull is ~66% of XGB(AFT), ~60% of MTLR, and ~30% of AFT model at CKD4 index date. The average absolute L1-loss of GRU-D-Weibull is around one year, with a minimum of 40% Parkes serious error after index date. GRU-D-Weibull is not calibrated and significantly underestimates true survival probability. Feature importance tests indicate blood pressure becomes increasingly important during follow-up, while eGFR and blood albumin are less important. Most continuous features have non-linear/parabola impact on predicted survival time, and the results are generally consistent with existing knowledge. GRU-D-Weibull as a semi-parametric temporal model shows advantages in built-in parameterization of missing, native support for asynchronously arrived measurement, capability of output both probability and point estimates at arbitrary time point for arbitrary prediction horizon, improved discrimination and point estimate accuracy after incorporating newly arrived data. Further research on its performance with more comprehensive input features, in-process or post-process calibration are warranted to benefit CKD4 or alike terminally-ill patients.