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Abstract The purpose of this study is to identify additional clinical features for sepsis detection through the use of a novel mechanism for interpreting black-box machine learning models trained and to provide a suitable evaluation for the mechanism. We use the publicly available dataset from the 2019 PhysioNet Challenge. It has around 40,000 Intensive Care Unit (ICU) patients with 40 physiological variables. Using Long Short-Term Memory (LSTM) as the representative black-box machine learning model, we adapted the Multi-set Classifier to globally interpret the black-box model for concepts it learned about sepsis. To identify relevant features, the result is compared against: (i) features used by a computational sepsis expert, (ii) clinical features from clinical collaborators, (iii) academic features from literature, and (iv) significant features from statistical hypothesis testing. Random Forest was found to be the computational sepsis expert because it had high accuracies for solving both the detection and early detection, and a high degree of overlap with clinical and literature features. Using the proposed interpretation mechanism and the dataset, we identified 17 features that the LSTM used for sepsis classification, 11 of which overlaps with the top 20 features from the Random Forest model, 10 with academic features and 5 with clinical features. Clinical opinion suggests, 3 LSTM features have strong correlation with some clinical features that were not identified by the mechanism. We also found that age, chloride ion concentration, pH and oxygen saturation should be investigated further for connection with developing sepsis. Interpretation mechanisms can bolster the incorporation of state-of-the-art machine learning models into clinical decision support systems, and might help clinicians to address the issue of early sepsis detection. The promising results from this study warrants further investigation into creation of new and improvement of existing interpretation mechanisms for black-box models, and into clinical features that are currently not used in clinical assessment of sepsis.
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A perspective on sepsis pathogenesis, biomarkers and diagnosis: A concise survey
Abstract Sepsis is a potentially fatal physiological state caused by an imbalance in the body's immune response to an infection and is one of the most common causes for deaths in the non‐coronary intensive care unit worldwide. In this article, the state of art on sepsis is presented in a manner that facilitates easy comprehension also for the non‐medical researchers by introducing sepsis, its causes, extent and comparison of diagnostic techniques (conventional labeled as well as label‐free detection). The article also provides a comprehensive discussion on sepsis biomarkers, to help researchers from multi‐disciplinary domain in developing devices and ideas to complement the existing sepsis diagnosis systems for quick and premature detection of the physiological condition and reduce mortality by means of early treatments.
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- PAR ID:
- 10161973
- Publisher / Repository:
- Wiley Blackwell (John Wiley & Sons)
- Date Published:
- Journal Name:
- MEDICAL DEVICES & SENSORS
- Volume:
- 3
- Issue:
- 4
- ISSN:
- 2573-802X
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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