ANALYSIS OF THE CLINICAL-VARIABLES DRIVING DECISION IN AN ARTIFICIAL NEURAL NETWORK TRAINED TO IDENTIFY THE PRESENCE OF MYOCARDIAL-INFARCTION

被引:55
作者
BAXT, WG
机构
[1] Departments of Emergency Medicine and Medicine, University of California, San Diego Medical Center
关键词
D O I
10.1016/S0196-0644(05)80056-3
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objective: To determine which clinical variables drive the output of an artificial neural network trained to identify the presence of myocardial infarction. Design: Partial output analysis. Setting: Tertiary university teaching center. Participants: Seven hundred six patients more than 1 8 years old presenting with anterior chest pain. Measurements: Differential network output analysis. Main results: A methodology was developed as the first step in measuring the impact input clinical variables have on the output (diagnosis) of an artificial neural network trained to identify the presence of acute myocardial infarction. The methodology revealed that the network used the presence of ECG findings, as well as the presence of rales, syncope, jugular venous distension, response to trinitroglycerin, and nausea and vomiting, as major predictive sources. Although this first-step analysis studied individual variables, it must be stated that the network comes to clinical closure based on the settings of all variables in a pattern and that the impact of a single variable cannot be taken out of the context of a pattern. Conclusion: An artificial neural network trained to recognize the presence of myocardial infarction appears to place diagnostic importance on clinical variables that have not been shown previously to be highly predictive for infarction.
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收藏
页码:1439 / 1444
页数:6
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共 21 条
  • [11] Eberhart, Dobbins, Hutton, Neural network paradigm comparisons for appendicitis diagnosis, Proceedings of the Fourth Annual IEEE Symposium on Computer-Based Medical Systems, pp. 298-304, (1991)
  • [12] Mulsant, Servan-Schreiber, A connectionist approach to the diagnosis of dementia, Symposium on Computer Applications in Medical Care 1988 Proceedings: 12th Annual Symposium, Washington, DC, 12, pp. 245-250, (1988)
  • [13] Bounds, Lloyd, Mathew, A comparison of neural network and other pattern recognition approaches to the diagnosis of low back disorders, Neural Networks, 3, pp. 583-591, (1990)
  • [14] Yoon, Brobst, Bergstresser, Et al., A desktop neural network for dermatology diagnosis, J Neural Network Computation, pp. 43-52, (1989)
  • [15] Baxt, Use of an artificial neural network for data analysis in clinical decision-making The diagnosis of acute coronary occlusion, Neural Computation, 2, pp. 480-489, (1991)
  • [16] Baxt, Use of an artificial neural network for the diagnosis of myocardial infarction, Ann Intern Med, 115, pp. 843-848, (1991)
  • [17] Baxt, Improving the accuracy of an artificial neural network using multiple differently trained networks, Neural Computation, 4, pp. 772-780, (1992)
  • [18] Harrison, Marshall, Kennedy, The early diagnosis of heart attacks A neurocomputational approach, Proceedings of the International Joint Conference on Neural Networks, Seattle, 1, pp. 1-5, (1991)
  • [19] Pozen, D'Agostino, Mitchell, Et al., The usefulness of a predictive instrument to reduce inappropriate admissions to the coronary care unit, Ann Intern Med, 92, pp. 238-242, (1980)
  • [20] Goldman, Weinberg, Weisberg, Et al., A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain, N Engl J Med, 307, pp. 588-596, (1982)