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Cardiogenic shock and machine learning: A systematic review on prediction through clinical decision support softwares

Rene Alemán, Sinal Patel, Jose Sleiman, José Navia, Cedric Sheffield, Nicolas Brozzi

2021Journal of Cardiac Surgery18 citationsDOI

Abstract

BACKGROUND AND AIM: Cardiogenic shock (CS) withholds a significantly high mortality rate between 40% and 60% despite advances in diagnosis and medical/surgical intervention. To date, machine learning (ML) is being implemented to integrate numerous data to optimize early diagnostic predictions and suggest clinical courses. This systematic review summarizes the area under the curve (AUC) receiver operating characteristics (ROCs) accuracy for the early prediction of CS. METHODS: A systematic review was conducted within databases of PubMed, ScienceDirect, Clinical Key/MEDLINE, Embase, GoogleScholar, and Cochrane. Cohort studies that assessed the accuracy of early detection of CS using ML software were included. Data extraction was focused on AUC-ROC values directed towards the early detection of CS. RESULTS: , respectively. Collectively, 159 (22.8%) mortalities were reported following early CS detection. Altogether, the AUC-ROC value was 0.82 (α = .05), deeming it of superb sensitivity and specificity. CONCLUSIONS: From the present comprehensively gathered data, this study accounts the use of ML software for the early detection of CS in a clinical setting as a valid tool to predict patients at risk of CS. The complexity of ML and its parallel lack of clinical evidence implies that further prospective randomized control trials are needed to draw definitive conclusions before standardizing the use of these technologies. BRIEF SUMMARY: The catastrophic risk of developing CS continues to be a concern in the management of critical cardiac care. The use of ML predictive models have the potential to provide the accurate and necessary feedback for the early detection and proper management of CS. This systematic review summarizes the AUC-ROCs accuracy for the early prediction of CS.

Topics & Concepts

MedicineReceiver operating characteristicMEDLINESystematic reviewData extractionMachine learningMeta-analysisCohortProspective cohort studyClinical trialRandomized controlled trialIntensive care medicineEmergency medicineArtificial intelligenceInternal medicineLawPolitical scienceComputer scienceSepsis Diagnosis and TreatmentMechanical Circulatory Support DevicesAcute Myocardial Infarction Research
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