1. Predicting defibrillation success in out-of-hospital cardiac arrested patients: Moving beyond feature design
- Author
-
Ljupčo Hadžievski, Bjoern M. Eskofier, Marija D. Ivanović, Fabio Baronio, Julius Hannink, Matthias Ring, and Vladan Vukcevic
- Subjects
Ventricular fibrillation (VF) ,Computer science ,Defibrillation ,medicine.medical_treatment ,Feature extraction ,Medicine (miscellaneous) ,Shock outcome ,Machine learning ,computer.software_genre ,Machine Learning ,03 medical and health sciences ,0302 clinical medicine ,Artificial Intelligence ,medicine ,Humans ,Prospective Studies ,Sensitivity (control systems) ,Convolutional neural networks (CNN) ,Dropout (neural networks) ,030304 developmental biology ,0303 health sciences ,business.industry ,Deep learning ,Perceptron ,Hospitals ,Feature (computer vision) ,Neural Networks, Computer ,Artificial intelligence ,business ,computer ,030217 neurology & neurosurgery ,Optimal decision - Abstract
Objective Optimizing timing of defibrillation by evaluating the likelihood of a successful outcome could significantly enhance resuscitation. Previous studies employed conventional machine learning approaches and hand-crafted features to address this issue, but none have achieved superior performance to be widely accepted. This study proposes a novel approach in which predictive features are automatically learned. Methods A raw 4s VF episode immediately prior to first defibrillation shock was feed to a 3-stage CNN feature extractor. Each stage was composed of 4 components: convolution, rectified linear unit activation, dropout and max-pooling. At the end of feature extractor, the feature map was flattened and connected to a fully connected multi-layer perceptron for classification. For model evaluation, a 10 fold cross-validation was employed. To balance classes, SMOTE oversampling method has been applied to minority class. Results The obtained results show that the proposed model is highly accurate in predicting defibrillation outcome (Acc = 93.6 %). Since recommendations on classifiers suggest at least 50 % specificity and 95 % sensitivity as safe and useful predictors for defibrillation decision, the reported sensitivity of 98.8 % and specificity of 88.2 %, with the analysis speed of 3 ms/input signal, indicate that the proposed model possesses a good prospective to be implemented in automated external defibrillators. Conclusions The learned features demonstrate superiority over hand-crafted ones when performed on the same dataset. This approach benefits from being fully automatic by fusing feature extraction, selection and classification into a single learning model. It provides a superior strategy that can be used as a tool to guide treatment of OHCA patients in bringing optimal decision of precedence treatment. Furthermore, for encouraging replicability, the dataset has been made publicly available to the research community.
- Published
- 2020