Huiying Zhao

Tongyue Shi, Zhilong Zhang, Wentie Liu et al.

This study employed the MIMIC-IV database as data source to investigate the use of dynamic, high-frequency, multivariate time-series vital signs data, including temperature, heart rate, mean blood pressure, respiratory rate, and SpO2, monitored first 8 hours data in the ICU stay. Various clustering algorithms were compared, and an end-to-end multivariate time series clustering system called Time2Feat, combined with K-Means, was chosen as the most effective method to cluster patients in the ICU. In clustering analysis, data of 8,080 patients admitted between 2008 and 2016 was used for model development and 2,038 patients admitted between 2017 and 2019 for model validation. By analyzing the differences in clinical mortality prognosis among different categories, varying risks of ICU mortality and hospital mortality were found between different subgroups. Furthermore, the study visualized the trajectory of vital signs changes. The findings of this study provide valuable insights into the potential use of multivariate time-series clustering systems in patient management and monitoring in the ICU setting.

Zeyu Wang, Huiying Zhao, Peng Ren et al.

Sepsis is a leading cause of death in the ICU. It is a disease requiring complex interventions in a short period of time, but its optimal treatment strategy remains uncertain. Evidence suggests that the practices of currently used treatment strategies are problematic and may cause harm to patients. To address this decision problem, we propose a new medical decision model based on historical data to help clinicians recommend the best reference option for real-time treatment. Our model combines offline reinforcement learning and deep reinforcement learning to solve the problem of traditional reinforcement learning in the medical field due to the inability to interact with the environment, while enabling our model to make decisions in a continuous state-action space. We demonstrate that, on average, the treatments recommended by the model are more valuable and reliable than those recommended by clinicians. In a large validation dataset, we find out that the patients whose actual doses from clinicians matched the decisions made by AI has the lowest mortality rates. Our model provides personalized and clinically interpretable treatment decisions for sepsis to improve patient care.