Article(id=1324050679366558422, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508086, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1754582400000, receivedDateStr=2025-08-08, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607881633, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607881633, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607881633, creator=13701087609, updateTime=1793607881633, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1574, endPage=1578, ext={EN=ArticleExt(id=1324050680729707223, articleId=1324050679366558422, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Application effect of machine learning models in predicting intensive care unit length of stay in adult patients: a systematic review and Meta-analysis, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To systematically evaluate the application effects of different types of machine learning (ML) models in predicting intensive care unit length of stay (ICULOS) in adult patients.

Methods

By searching China National Knowledge Infrastructure (CNKI), Wanfang Database, and English databases PubMed and Web of Science, we collected studies on machine learning to predict ICULOS in adult patients published from the establishment of the database to October 2025, screened the included literature, and performed Meta-analysis using RStudio.

Results

A total of 40 articles were included, among which the three most frequently used models were random forest (RF), extreme gradient boosting (XGBoost), and gradient boosting machine (GBM) models. The overall prediction performance was good, with a combined area under curve (AUC) of 0.82 (95% CI: 0.79-0.85). Among the prediction models for ICULOS in adult patients with cardiovascular-related diseases, XGBoost had the best prediction effect (AUC=0.88, 95% CI: 0.86-0.93). Among the prediction models for ICULOS in adult patients with central nervous system-related diseases, mixed models showed the best predictive performance (AUC=0.90). In the prediction models of ICULOS of adult patients with other diseases and undifferentiated disease types, RF had the best prediction effect (AUCother specific diseases=0.89, 95% CI: 0.84-0.94; AUCundifferentiated diseases=0.95).

Conclusion

ML showed good performance in predicting ICULOS of adult patients. In the prediction of ICULOS of adult patients with different diseases, the appropriate ML model should be selected in combination with the specific disease and data structure.

, authors=Yu-jia ZHU1, 2, Yue MA1, 2, Ling-gen GAO3, Hong-wei WANG4, Yan YUAN1, Qun-xia MAO1, authorsList=Yu-jia ZHU, Yue MA, Ling-gen GAO, Hong-wei WANG, Yan YUAN, Qun-xia MAO, authorCompany=null, correspAuthors=Qun-xia MAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050682654892770, articleId=1324050679366558422, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于机器学习模型预测成年患者重症监护室住院时间的应用效果——系统综述和Meta分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

系统评估机器学习在预测成年患者重症监护室住院时间(intensive care unit length of stay,ICULOS)的应用效果。

方法

通过检索中国知网、万方数据库及英文数据库Pubmed和Web of Science,收集建库至2025年10月发表的有关机器学习预测成年患者ICULOS的研究,采用Rstudio对纳入文献进行meta分析。

结果

共纳入40篇文献,其中采用较多的三类模型是随机森林、极端梯度提升(eXtreme gradient boosting,XGBoost)和梯度提升机模型。整体预测性能良好,整体报告受试者工作特征曲线下面积(area under curve,AUC)为0.82(95%CI:0.79~0.85),其中在心血管相关疾病成年患者ICULOS的预测中,XGBoost预测效果相对最优(AUC=0.88;95%CI:0.86~0.93);中枢神经相关疾病成年患者ICULOS的预测中,混合模型效果相对最好(AUC=0.9);其他单种疾病和未区分疾病类型的成年患者ICULOS的预测中,随机森林预测效果相对最优(AUC其他单种疾病=0.89,95%CI:0.84~0.94;AUC未区分疾病类型=0.95)。

结论

机器学习在成年患者ICULOS预测中效果良好。但对不同疾病ICULOS的预测应结合具体疾病和数据结构选择合适的模型。

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朱昱嘉(2000—),女,硕士在读,研究方向:重症监护资源利用研究

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茅群霞,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=6nHifIlzi3yAzHfhxQaQhw==, magXml=KMpi4mrRejIgBr2OhZOJOw==, pdfUrl=null, pdf=tkHEhy4hzesGs3Be8WSdXg==, pdfFileSize=1082238, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=wSfo/Vho/vTPU3Rkpn4UtQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=7FvyMkWThJKehzA/RtEX/g==, mapNumber=null, fund=null)}, authors=[Author(id=1324050683363730157, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050679366558422, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324050685062423280, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050679366558422, authorId=1324050683363730157, language=EN, stringName=Yu-jia ZHU, firstName=Yu-jia, middleName=null, lastName=ZHU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=National Research Institute for Family Planning, Social Medicine Center, Beijing, 100081, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324050685146309361, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050679366558422, authorId=1324050683363730157, language=CN, stringName=朱昱嘉, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.国家卫生健康委科学技术研究所 社会医学中心,北京 100081
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基于机器学习模型预测成年患者重症监护室住院时间的应用效果——系统综述和Meta分析
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朱昱嘉 1, 2 , 马跃 1, 2 , 高凌根 3 , 王宏伟 4 , 袁艳 1 , 茅群霞 1
现代预防医学 | 流行病与统计方法 2026,53(9): 1574-1578
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现代预防医学 |流行病与统计方法 2026 , 53 (9) : 1574 -1578
基于机器学习模型预测成年患者重症监护室住院时间的应用效果——系统综述和Meta分析
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朱昱嘉1, 2, 马跃1, 2, 高凌根3, 王宏伟4, 袁艳1, 茅群霞1
作者信息
  • 1.国家卫生健康委科学技术研究所 社会医学中心,北京 100081
  • 2.中国医学科学院北京协和医学院,北京 100730
  • 3.中国人民解放军总医院 第二医学中心
  • 4.中国劳动关系学院安全工程学院
通讯作者:
茅群霞,E-mail:
作者简介:

朱昱嘉(2000—),女,硕士在读,研究方向:重症监护资源利用研究

Application effect of machine learning models in predicting intensive care unit length of stay in adult patients: a systematic review and Meta-analysis
Yu-jia ZHU1, 2, Yue MA1, 2, Ling-gen GAO3, Hong-wei WANG4, Yan YUAN1, Qun-xia MAO1
Affiliations
  • National Research Institute for Family Planning, Social Medicine Center, Beijing, 100081, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202508086
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目的

系统评估机器学习在预测成年患者重症监护室住院时间(intensive care unit length of stay,ICULOS)的应用效果。

方法

通过检索中国知网、万方数据库及英文数据库Pubmed和Web of Science,收集建库至2025年10月发表的有关机器学习预测成年患者ICULOS的研究,采用Rstudio对纳入文献进行meta分析。

结果

共纳入40篇文献,其中采用较多的三类模型是随机森林、极端梯度提升(eXtreme gradient boosting,XGBoost)和梯度提升机模型。整体预测性能良好,整体报告受试者工作特征曲线下面积(area under curve,AUC)为0.82(95%CI:0.79~0.85),其中在心血管相关疾病成年患者ICULOS的预测中,XGBoost预测效果相对最优(AUC=0.88;95%CI:0.86~0.93);中枢神经相关疾病成年患者ICULOS的预测中,混合模型效果相对最好(AUC=0.9);其他单种疾病和未区分疾病类型的成年患者ICULOS的预测中,随机森林预测效果相对最优(AUC其他单种疾病=0.89,95%CI:0.84~0.94;AUC未区分疾病类型=0.95)。

结论

机器学习在成年患者ICULOS预测中效果良好。但对不同疾病ICULOS的预测应结合具体疾病和数据结构选择合适的模型。

重症监护  /  住院时间  /  机器学习  /  预测模型  /  Meta分析
Objective

To systematically evaluate the application effects of different types of machine learning (ML) models in predicting intensive care unit length of stay (ICULOS) in adult patients.

Methods

By searching China National Knowledge Infrastructure (CNKI), Wanfang Database, and English databases PubMed and Web of Science, we collected studies on machine learning to predict ICULOS in adult patients published from the establishment of the database to October 2025, screened the included literature, and performed Meta-analysis using RStudio.

Results

A total of 40 articles were included, among which the three most frequently used models were random forest (RF), extreme gradient boosting (XGBoost), and gradient boosting machine (GBM) models. The overall prediction performance was good, with a combined area under curve (AUC) of 0.82 (95% CI: 0.79-0.85). Among the prediction models for ICULOS in adult patients with cardiovascular-related diseases, XGBoost had the best prediction effect (AUC=0.88, 95% CI: 0.86-0.93). Among the prediction models for ICULOS in adult patients with central nervous system-related diseases, mixed models showed the best predictive performance (AUC=0.90). In the prediction models of ICULOS of adult patients with other diseases and undifferentiated disease types, RF had the best prediction effect (AUCother specific diseases=0.89, 95% CI: 0.84-0.94; AUCundifferentiated diseases=0.95).

Conclusion

ML showed good performance in predicting ICULOS of adult patients. In the prediction of ICULOS of adult patients with different diseases, the appropriate ML model should be selected in combination with the specific disease and data structure.

Intensive care unit  /  Length of stay  /  Machine learning  /  Prediction model  /  Meta-analysis
朱昱嘉, 马跃, 高凌根, 王宏伟, 袁艳, 茅群霞. 基于机器学习模型预测成年患者重症监护室住院时间的应用效果——系统综述和Meta分析. 现代预防医学, 2026 , 53 (9) : 1574 -1578 . DOI: 10.20043/j.cnki.MPM.202508086
Yu-jia ZHU, Yue MA, Ling-gen GAO, Hong-wei WANG, Yan YUAN, Qun-xia MAO. Application effect of machine learning models in predicting intensive care unit length of stay in adult patients: a systematic review and Meta-analysis[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1574 -1578 . DOI: 10.20043/j.cnki.MPM.202508086
全球重症监护负担沉重,患者死亡率居高不下,在发达国家(如北美、欧洲国家)死亡率为8%~18%,而低收入国家死亡率达40%[1-2]。世界卫生组织发布的《全球感染预防与控制报告》指出,全球重症监护室(intensive care unit,ICU)床位和专业人员配置严重不足,中低收入国家尤为突出[3]。因此,有必要通过精准评估患者临床需求,以提升重症医疗资源配置效率[4]。ICU住院时间(ICU length of stay,ICULOS)与医疗成本密切相关,准确预测ICULOS对控制医疗支出和提升服务质量具有重要意义[5-6]。
传统logistic回归方法多适用于变量较少的预测任务,而在处理具有复杂的ICU数据时预测能力有限[7]。机器学习(machine learning)是一类从数据中自动学习并构建预测模型的方法[8]。既往研究显示,机器学习在预测胃肠道手术结局时较logistic回归模型具有更优性能[曲线下面积(area under the curve,AUC)提升0.07,P<0.001][9],提示其在整合复杂临床数据方面具有优势。
目前,机器学习模型在ICULOS预测中的应用逐渐增多,但既往研究多为单中心、特定人群研究,尚缺乏系统评价。本研究旨在通过meta分析,综合评估不同机器学习模型在预测成年患者ICULOS的准确性、稳健性及应用效果,为相关临床研究提供循证依据。
系统检索中国知网、万方数据库、PubMed和Web of Science数据库中公开发表的相关文献。检索时间为建库起至2025年10月,语言限定为中英文。中文检索词包括:“重症监护”“预测模型”“机器学习”“住院时间” 等及其同义表达;英文检索词包括:“length of stay”“Intensive Care Units”“Machine Learning” 等及其同义表达。同时排除与新生儿或儿童ICU相关的关键词,如“Pediatric Intensive Care Unit”等。
(1)纳入标准:①研究对象为成年ICU患者;②以ICULOS为结局;③采用机器学习进行预测;④报告受试者工作特征AUC等模型性能指标。
(2)排除标准:①研究主题不符;②无法获取全文;③指标无法提取或读数;④同一作者基于相同数据的多篇研究中,仅保留信息最完整者。
由二名研究者独立进行文献筛选和数据提取,结果进行交叉核对,如有分歧由第三人加入讨论直至确定。提取信息包括第一作者、发表年份、研究国家、预测模型、数据来源、样本量、患者年龄、ICULOS分组依据、预测变量、模型性能评估指标及疾病类型。
按疾病类型将研究分为心血管、中枢神经和感染相关疾病、其他单种疾病以及未区分疾病类型。常用模型评价指标包括准确率、精确率、AUC和布里尔分数等[10]。其中,AUC值能直观反映模型预测性能[11]。通常作为判断模型拟合效果的标准:<0.70较差、0.70~0.80中等、>0.80良好[12]。由于所有纳入研究均报告了AUC值,本研究将其作为主要评价指标,提取各研究中性能最优模型的AUC及其95%CI,并按疾病分类进行合并分析。其他指标在所纳入研究中较少见,故未进行分析。
本研究采用Q检验与I2统计量(P<0.05提示异质性有统计学意义,I2>50%则选择随机效应模型)评估异质性,并通过meta回归分析探究异质性来源。使用PROBAST工具从参与者、预测因子、结局和分析四个方面(共20个条目)评估模型偏倚风险。具体判定标准为:若任一条目评为高风险,则总体风险为“高(High)”;如无高风险条目且有一个或多个领域存在不明确条目,则为“不明确(Unclear)”;其余情况则为“低(Low)”[13]。采用逐一剔除法进行敏感性分析,采用Egger回归检验和漏斗图评估发表偏倚。所有统计分析均在RStudio(R version 4.3.2)中完成,主要使用meta与metafor 包。
按检索策略共获得文献376篇,经EndNote 21去重后进行题目摘要初筛,排除245篇;再经全文复筛排除32篇后,最终纳入符合标准的文献40篇,其中中文2篇,英文38篇。其中13篇来自我国,14篇来自美国,其余13篇来自其他国家。按疾病类型划分,心血管相关疾病8篇,中枢神经相关疾病6篇,感染相关疾病2篇,其他单种疾病5篇,未区分疾病类型19篇。数据来源方面,24篇基于医院数据,15篇基于公共数据库,1篇合并两类数据。PROBAST评价显示,33篇为低偏倚风险,7篇偏倚风险不明确。
纳入研究的预测变量主要包括人口学变量、临床特征变量、实验室指标、综合评分指标及围手术期变量。Weissman等[14]的研究还纳入非结构化数据。40篇研究的AUC均值为0.80,中位数为0.81。对其中19篇报告95%CI的研究进行合并分析,合并AUC为0.82(95%CI:0.79~0.85,I2= 99.3%)。
本类共纳入8项研究,涉及心力衰竭、房颤和动脉粥样硬化等疾病,样本量为163~30 366例。研究纳入的特异性指标包括心室功能评估、体外循环使用和美国胸外科医师学会风险评分[15]等;使用的预测模型包括极端梯度提升(eXtreme gradient boosting, XGBoost)、随机森林、轻量级梯度提升机(light gradient boosting machine, LGB)、多元线性回归(multiple linear regression, MLR)和LASSO回归。8篇研究的AUC分布范围为0.72~0.88。合并5项研究报告了95%CI的研究显示,XGBoost(AUC= 0.87,95%CI:0.85~0.89,I2=9.9%)预测性能优于RF(AUC=0.77,95%CI:0.66~0.89,I2=89.3%),且异质性更低。见图1。
本类共纳入5项研究,涉及成人脊柱畸形、脊髓损伤和脑损伤,样本量为263~79 769例。研究纳入特异性变量格拉斯哥昏迷评分[16]。使用的预测模型包括梯度提升机(gradient boosting machine, GBM)、随机森林、装袋法、类别提升及混合模型。5篇研究的AUC分布范围为0.68~0.90,其中使用混合模型对脑损伤患者ICULOS预测的AUC值为0.9。合并3项报告95%CI的研究显示,合并AUC为0.80(95%CI:0.68~0.92),但异质性较高(I2=99.3%)。见图2。
本研究共纳入2项研究,均纳入机械通气及血管活性药物使用等变量。其中使用决策树模型对败血症患者预测的AUC为0.50;使用混合模型对脓毒症患者预测的AUC为0.83。由于研究数量少,未进行合并分析。
本类共纳入6项研究,涉及急性肺栓塞、出血、跌倒、躯干创伤、脑卒中、结直肠疾病等疾病;不同疾病纳入的特异性预测变量不同,如急性肺栓塞研究纳入D-二聚体,创伤研究纳入损伤严重度评分[17],脑卒中研究纳入溶栓治疗情况。样本量为758~62 501例;使用的模型包括随机森林、GBM、人工神经网络(artificial neural network, ANN)和弹性网络回归(elastic net regression, ENR)。6篇研究的AUC分布范围为0.71~0.90,其中使用随机森林预测急性肺栓塞患者ICULOS的AUC为0.9。合并4项报告95%CI的研究显示,合并AUC为0.80(95%CI:0.72~0.88),但异质性高(I2=98.7%)。见图3。
本类共纳入19项研究,样本量为896~160 238例。使用模型包括随机森林、XGBoost、GBM、梯度提升决策树(gradient boosting decision tree, GBDT)、ENR、长短期记忆网络(long short-term memory, LSTM)、支持向量回归(support vector regression, SVR)、频繁模式增长(frequent pattern growth, FP-Growth)及混合模型。19篇研究的AUC分布范围为0.7~0.95,其中使用随机森林预测消化系统相关疾病患者ICULOS的AUC为0.95。合并6项报告了95%CI的研究显示,合并AUC为0.84(95%CI:0.78~0.90),但异质性较高(I2=99.7 %)。见图4。
敏感性分析显示合并AUC稳定,变化范围为0.81(95%CI:0.78~0.85)至0.83(95%CI:0.79~0.86)。在心血管相关疾病组中,剔除Tao等[18]的研究后,合并AUC上升至0.86 (95%CI: 0.84~0.88),且研究间异质性显著降低,提示该项研究是该亚组异质性的主要来源之一。
Meta回归分析显示,在7项报告了ICULOS分组依据的研究中,该因素可解释97.67% 的异质性。亚组分析显示,样本量、总变量数、临床特征变量数和人群年龄特征分别是心血管和中枢神经相关疾病、其他单种疾病以及未区分疾病类型组异质性的主要来源。Egger检验未发现发表偏倚(P=0.997)。漏斗图见图5。
本研究系统评价了国内外40篇采用机器学习模型预测成年患者ICULOS的文献,共纳入936 095名患者,涵盖感染、心血管和中枢神经系统等多种疾病类型。结果显示,机器学习模型总体预测性能良好(AUC=0.82,95%CI:0.79~0.85),提示其在ICULOS预测中具有较好的适用性。与既往研究一致,机器学习模型在复杂临床结局预测中的表现普遍优于传统logistic回归[9,19],其在处理多维临床特征及非线性关系方面具有优势。
不同疾病类型及数据特征下,机器学习模型的适用性存在差异。在心血管相关疾病中,XGBoost和随机森林预测性能较优。XGBoost具有较强的正则化能力,对多变量预测时可有效降低过拟合风险[7];而当变量数量及交互作用相对较少时,随机森林更具优势[20]。Yang等[21]发现随机森林在训练集表现较好,而XGBoost在验证集上更具优势,提示后者泛化能力可能更强。在中枢神经相关疾病中,混合模型[XGBoost+ANN+支持向量机(support vector machine,SVM)]在脑损伤患者ICULOS预测中表现最佳[22]。既往研究表明不同模型结合可优势互补,提升预测性能[23]。在其他单项疾病中,随机森林对急性肺栓塞患者ICULOS的预测效果最好(AUC=0.9)[24]。其预测变量以二分类变量为主,符合随机森林的适用条件。但在跌倒患者中,随机森林预测性能较差(AUC=0.74)[25],可能与预测变量缺失率较高有关。已有研究表明,不同缺失值处理方式会影响模型性能[26],提示模型构建过程中应重视数据质量控制。在未区分疾病类型的研究中,随机森林和GBM预测性能较优。随机森林适用于快速建模并强调稳健性,而GBM在具备调参条件时可获得更高预测精度。感染相关疾病的研究数量较少,预测性能差异明显。决策树模型在败血症患者中的预测性能较差(AUC=0.50),可能与疾病进展迅速有关。有研究表明机器学习模型在识别快速恶化事件时存在不足[27]提示模型性能与疾病特征相关。
总体而言,纳入研究间异质性较大。敏感性分析显示,心血管相关疾病组中Tao等[18]和Yang等[21] 的研究对异质性贡献较大,两项研究均基于大规模公共数据库。其中,Tao等[28-29]对房颤患者的预测性能较低(AUC=0.72),可能与疾病病因复杂及治疗策略差异有关,仍需进一步验证。其他亚组的分析中发现,异质性贡献较大的研究多基于公共数据库,提示数据来源可能是研究间异质性的重要因素。本研究进一步比较了不同数据来源的模型性能,结果显示基于医院数据与公共数据库构建的模型均具有较好预测能力,AUC分别为0.86和0.82,医院数据略优。这可能与公共数据库人群异质性较高及数据库本身的局限有关[30]。此外,ICULOS分组依据解释97.67%的异质性。但仅7项研究明确报告该信息,解释力度可能被高估,提示未来需标准化ICULOS分组。
本研究存在一定局限性。一是纳入文献多为回顾性研究;二是模型构建与超参数调优信息报告不充分;三是仅采用AUC评价模型性能;四是虽然解释了主要异质性来源,仍可能存在未测量混杂因素。尽管如此,本研究综合分析了不同疾病类型与数据特征下机器学习模型预测ICULOS的应用现状,具有一定参考价值,为ICU资源优化与患者个体化管理提供更科学的循证依据。
  • 基层卫生健康信息化服务平台研究及示范——基于云智医疗在基层的探索与服务(2020HX012)
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2026年第53卷第9期
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doi: 10.20043/j.cnki.MPM.202508086
  • 接收时间:2025-08-08
  • 首发时间:2026-11-02
  • 出版时间:2026-05-10
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  • 收稿日期:2025-08-08
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基层卫生健康信息化服务平台研究及示范——基于云智医疗在基层的探索与服务(2020HX012)
作者信息
    1.国家卫生健康委科学技术研究所 社会医学中心,北京 100081
    2.中国医学科学院北京协和医学院,北京 100730
    3.中国人民解放军总医院 第二医学中心
    4.中国劳动关系学院安全工程学院

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