Machine learning (ML) models have been constructed to predict the risk of in-hospital mortality in patients with myocardial infarction (MI). Due to diverse ML models and modeling variables, along with the significant imbalance in data, the predictive accuracy of these models remains controversial.

This study aimed to review the accuracy of ML in predicting in-hospital mortality risk in MI patients and to provide evidence-based advices for the development or updating of clinical tools.

PubMed, Embase, Cochrane, and Web of Science databases were searched, up to June 4, 2024. PROBAST and ChAMAI checklist are utilized to assess the risk of bias in the included studies. Since the included studies constructed models based on severely unbalanced datasets, subgroup analyses were conducted by the type of dataset (balanced data, unbalanced data, model type).

This meta-analysis included 32 studies. In the validation set, the pooled C-index, sensitivity, and specificity of prediction models based on balanced data were 0.83 (95 % CI: 0.795-0.866), 0.81 (95 % CI: 0.79-0.84), and 0.82 (95 % CI: 0.78-0.86), respectively. In the validation set, the pooled C-index, sensitivity, and specificity of ML models based on imbalanced data were 0.815 (95 % CI: 0.789-0.842), 0.66 (95 % CI: 0.60-0.72), and 0.84 (95 % CI: 0.83-0.85), respectively.

ML models such as LR, SVM, and RF exhibit high sensitivity and specificity in predicting in-hospital mortality in MI patients. However, their sensitivity is not superior to well-established scoring tools. Mitigating the impact of imbalanced data on ML models remains challenging.

In recent years, the fusion of the medical and computer science domains has gained significant traction in the scientific research landscape. Progress in both fields has enabled the generation of a vast amount of data used for making predictions and identifying interesting clusters and pathways. The Machine Learning (ML) model's application in the medical domain is one of the most compelling and challenging topics to explore, bridging the gap between Artificial Intelligence (AI) and healthcare. The combination of AI and medical information offers the possibility to create tools that can benefit both healthcare providers and physicians. This enables the enhancement of rehabilitation therapy and patient care. In the rehabilitation context, this work provides an alternative perspective: prediction of patients' home discharge upon completing the rehabilitation protocol. Demographic and clinical data were collected on 7282 inpatients from electronic Medical Record, each record was categorized into Neurological Patients (NP, N = 3222) or Orthopedic Patients (OP, N = 4060). To identify the most suitable machine learning model, an extensive data preprocessing phase was conducted. This process involved variables recoding, scaling, and the evaluation of different dataset balancing methods to optimize model performance. Following a thorough review and comparison of algorithms commonly employed in the clinical-rehabilitative field, the Random Over Sampling (ROS) technique, in combination with the Random Forest (RF) machine learning model, was selected. Subsequently, a comprehensive hyperparameter tuning phase was performed using a grid search approach. The optimized model achieved an average accuracy of 98% for OP and 96% for NP, based on 10-fold cross-validation applied to the balanced training set (unrealistic scenario). When tested on the unbalanced dataset (real-world condition), the RF model maintained strong generalization performance, achieving 90% accuracy for OP and 83% for NP. This work points out the increasing importance of AI in medicine, especially in the realm of personalized rehabilitation. The use of such approaches could signify a transformative shift in healthcare. The integration of machine learning not only enhances the precision of treatment but also opens new possibilities for patient-centered care, improving outcomes and quality of care for individuals undergoing rehabilitation.

Metabolic-bariatric surgery (MBS) is the last effective way to lose weight whom around half of the patients are women of reproductive age. It is recommended an interval of 12 months between surgery and pregnancy to optimize weight loss and nutritional status. Predicting pregnancy up to 12 months after MBS is important for evaluating reproductive health services in bariatric centers; therefore, this study aimed to present a prediction model for pregnancy at the first year following MBS using machine learning (ML) algorithms.

In a nested case-control study of 473 women with a history of pregnancy after MBS during 2009-2023, predisposing factors in pregnancy within 12 months after MBS were identified and subsequently, several ML models, including the classification algorithms and decision trees, as well as regression analyses, were applied to predict pregnancy up to 12 months after MBS.

The highest area under the curve (AUC) was 0.920 ± 0.014 (95%CI 0.906, 0.927) for the C5.0 decision tree with sensitivity and specificity of 0.762 ± 0.044 (95%CI 0.739, 0.801) and 0.916 ± 0.028 (95%CI 0.883, 0.922), respectively. This model considered thirteen important factors to predict pregnancy at the first 12 months following MB, including menstrual irregularity, marital status, a history of abnormal fetal development, age, infertility type, parity, gravidity, fertility treatment, presurgery body mass index (BMI), infertility, infertility duration, polycystic ovary syndrome (PCOS), and type 2 diabetes (T2DM).

Developing the ML models, which predict pregnancy within 12 months after MBS, can help bariatric surgeons and obstetricians to prevent and manage suboptimal surgical response and adverse pregnancy outcomes.

In the health monitoring of electromechanical transmission systems, the collected state data typically consist of only a minimal amount of labeled data, with a vast majority remaining unlabeled. Consequently, deep learning-based diagnostic models encounter the challenge of scarcity in labeled data and abundance in unlabeled data. Traditional semi-supervised deep learning methods based on pseudo-label self-training, while alleviating the issue of labeled data scarcity to some extent, neglect the reliability of pseudo-label information, the accuracy of feature extraction from unlabeled data, and the imbalance in sample selection. To address these issues, this paper proposes a novel semi-supervised fault diagnosis method under imbalanced unlabeled sample class information screening. Firstly, an information screening mechanism for unlabeled data based on active learning is established. This mechanism discriminates based on the variability of intrinsic feature information in fault samples, accurately screening out unlabeled samples located near decision boundaries that are difficult to separate clearly. Then, combining the maximum membership degree of these unlabeled data in the classification space of the supervised model and interacting with the active learning expert system, label information is assigned to the screened unlabeled data. Secondly, a cost-sensitive function driven by data imbalance is constructed to address the class imbalance problem in unlabeled sample screening, adaptively adjusting the weights of different class samples during model training to guide the training of the supervised model. Ultimately, through dynamic optimization of the supervised model and the feature extraction capability of unlabeled samples, the recognition ability of the diagnostic model for unlabeled samples is significantly enhanced. Validation through two datasets, encompassing a total of 12 experimental scenarios, demonstrates that in scenarios with only a small amount of labeled data, the proposed method achieves a diagnostic accuracy increment exceeding 10% compared to existing typical methods, fully validating the effectiveness and superiority of the proposed method in practical applications.

A smart city is deemed smart enough because it has the capability to make decisions on its own. Artificial intelligence needs a lot of data from the physical world to make correct decisions. IoT sensor devices collect data from the surroundings, which is further used for predictive analytics. Collected data may be balanced or imbalanced. Unbalanced data used for decision-making without any pre-processing may lead to ravaging results. This paper proposes a novel predictive analytical technique to manage unbalanced data. A pipeline is designed using Principal Component Analysis (PCA), a hybrid sampling method, and a Machine Learning (ML) prediction method. SMOTE + ENN, a hybrid data balancing method, is used to specify imbalanced data to a balanced state. ML method is applied to form clusters and make predictions over the dataset. A large Smart City IoT dataset having 4,05,184 records has been used in this study. The proposed technique is used to predict the presence of a person in the vicinity of IoT devices. Evaluation parameters such as accuracy, precision, recall, F1-score, and Area Under Curve (AUC)/Receiver Operating Characteristic (ROC) curve are used to evaluate the proposed approach. Accuracy, Precision, Recall, F1-score, and AUC obtained using the proposed technique for cluster 0 are 0.79, 1.0, 0.79, 0.87, and 0.88 and for cluster 1 are 0.86 0.99, 0.86, 0.92, and 0.92, respectively. In view of the encouraging results, the proposed technique may prove to be a good choice to help in decision-making in different application domains in real life.

The role of NLRP3 inflammasome in innate immunity is newly recognized. The NLRP3 protein is a family of nucleotide-binding and oligomerization domain-like receptors as well as a pyrin domain-containing protein. It has been shown that NLRP3 may contribute to the development and progression of a variety of diseases, such as multiple sclerosis, metabolic disorders, inflammatory bowel disease, and other auto-immune and auto-inflammatory conditions. The use of machine learning methods in pharmaceutical research has been widespread for several decades. An important objective of this study is to apply machine learning approaches for the multinomial classification of NLRP3 inhibitors. However, data imbalances can affect machine learning. Therefore, a synthetic minority oversampling technique (SMOTE) has been developed to increase the sensitivity of classifiers to minority groups. The QSAR modelling was performed using 154 molecules retrieved from the ChEMBL database (version 29). The accuracy of the multiclass classification top six models was found to fall within ranges of 0.99 to 0.86, and log loss ranges of 0.2 to 2.3, respectively. The results showed that the receiver operating characteristic curve (ROC) plot values significantly improved when tuning parameters were adjusted and imbalanced data was handled. Moreover, the results demonstrated that SMOTE offers a significant advantage in handling imbalanced datasets as well as substantial improvements in overall accuracy of machine learning models. The top models were then used to predict data from unseen datasets. In summary, these QSAR classification models exhibited robust statistical results and were interpretable, which strongly supported their use for rapid screening of NLRP3 inhibitors.

Tuberculosis spondylitis (TS), commonly known as Pott's disease, is a severe type of skeletal tuberculosis that typically requires surgical treatment. However, this treatment option has led to an increase in healthcare costs due to prolonged hospital stays (PLOS). Therefore, identifying risk factors associated with extended PLOS is necessary. In this research, we intended to develop an interpretable machine learning model that could predict extended PLOS, which can provide valuable insights for treatments and a web-based application was implemented.

We obtained patient data from the spine surgery department at our hospital. Extended postoperative length of stay (PLOS) refers to a hospitalization duration equal to or exceeding the 75th percentile following spine surgery. To identify relevant variables, we employed several approaches, such as the least absolute shrinkage and selection operator (LASSO), recursive feature elimination (RFE) based on support vector machine classification (SVC), correlation analysis, and permutation importance value. Several models using implemented and some of them are ensembled using soft voting techniques. Models were constructed using grid search with nested cross-validation. The performance of each algorithm was assessed through various metrics, including the AUC value (area under the curve of receiver operating characteristics) and the Brier Score. Model interpretation involved utilizing methods such as Shapley additive explanations (SHAP), the Gini Impurity Index, permutation importance, and local interpretable model-agnostic explanations (LIME). Furthermore, to facilitate the practical application of the model, a web-based interface was developed and deployed.

The study included a cohort of 580 patients and 11 features include (CRP, transfusions, infusion volume, blood loss, X-ray bone bridge, X-ray osteophyte, CT-vertebral destruction, CT-paravertebral abscess, MRI-paravertebral abscess, MRI-epidural abscess, postoperative drainage) were selected. Most of the classifiers showed better performance, where the XGBoost model has a higher AUC value (0.86) and lower Brier Score (0.126). The XGBoost model was chosen as the optimal model. The results obtained from the calibration and decision curve analysis (DCA) plots demonstrate that XGBoost has achieved promising performance. After conducting tenfold cross-validation, the XGBoost model demonstrated a mean AUC of 0.85 ± 0.09. SHAP and LIME were used to display the variables' contributions to the predicted value. The stacked bar plots indicated that infusion volume was the primary contributor, as determined by Gini, permutation importance (PFI), and the LIME algorithm.

Our methods not only effectively predicted extended PLOS but also identified risk factors that can be utilized for future treatments. The XGBoost model developed in this study is easily accessible through the deployed web application and can aid in clinical research.

Postoperative delirium, particularly prevalent in elderly patients after abdominal cancer surgery, presents significant challenges in clinical management.

To develop a synthetic minority oversampling technique (SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.

In this retrospective cohort study, we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022. The incidence of postoperative delirium was recorded for 7 d post-surgery. Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not. A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium. The SMOTE technique was applied to enhance the model by oversampling the delirium cases. The model's predictive accuracy was then validated.

In our study involving 611 elderly patients with abdominal malignant tumors, multivariate logistic regression analysis identified significant risk factors for postoperative delirium. These included the Charlson comorbidity index, American Society of Anesthesiologists classification, history of cerebrovascular disease, surgical duration, perioperative blood transfusion, and postoperative pain score. The incidence rate of postoperative delirium in our study was 22.91%. The original predictive model (P1) exhibited an area under the receiver operating characteristic curve of 0.862. In comparison, the SMOTE-based logistic early warning model (P2), which utilized the SMOTE oversampling algorithm, showed a slightly lower but comparable area under the curve of 0.856, suggesting no significant difference in performance between the two predictive approaches.

This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods, effectively addressing data imbalance.

In order to improve the accuracy of transformer fault diagnosis and improve the influence of unbalanced samples on the low accuracy of model identification caused by insufficient model training, this paper proposes a transformer fault diagnosis method based on SMOTE and NGO-GBDT. Firstly, the Synthetic Minority Over-sampling Technique (SMOTE) was used to expand the minority samples. Secondly, the non-coding ratio method was used to construct multi-dimensional feature parameters, and the Light Gradient Boosting Machine (LightGBM) feature optimization strategy was introduced to screen the optimal feature subset. Finally, Northern Goshawk Optimization (NGO) algorithm was used to optimize the parameters of Gradient Boosting Decision Tree (GBDT), and then the transformer fault diagnosis was realized. The results show that the proposed method can reduce the misjudgment of minority samples. Compared with other integrated models, the proposed method has high fault identification accuracy, low misjudgment rate and stable performance.

The liver is the most common site of distant metastasis in rectal cancer, and liver metastasis dramatically affects the treatment strategy of patients. This study aimed to develop and validate a clinical prediction model based on machine learning algorithms to predict the risk of liver metastasis in patients with rectal cancer.

We integrated two rectal cancer cohorts from Surveillance, Epidemiology, and End Results (SEER) and Chinese multicenter hospitals from 2010-2017. We also built and validated liver metastasis prediction models for rectal cancer using six machine learning algorithms, including random forest (RF), light gradient boosting (LGBM), extreme gradient boosting (XGB), multilayer perceptron (MLP), logistic regression (LR), and K-nearest neighbor (KNN). The models were evaluated by combining several metrics, such as the area under the curve (AUC), accuracy score, sensitivity, specificity and F1 score. Finally, we created a network calculator using the best model.

The study cohort consisted of 19,958 patients from the SEER database and 924 patients from two hospitals in China. The AUC values of the six prediction models ranged from 0.70 to 0.95. The XGB model showed the best predictive power, with the following metrics assessed in the internal test set: AUC (0.918), accuracy (0.884), sensitivity (0.721), and specificity (0.787). The XGB model was assessed in the outer test set with the following metrics: AUC (0.926), accuracy (0.919), sensitivity (0.740), and specificity (0.765). The XGB algorithm also shows a good fit on the calibration decision curves for both the internal test set and the external validation set. Finally, we constructed an online web calculator using the XGB model to help generalize the model and to assist physicians in their decision-making better.

We successfully developed an XGB-based machine learning model to predict liver metastasis from rectal cancer, which was also validated with a real-world dataset. Finally, we developed a web-based predictor to guide clinical diagnosis and treatment strategies better.

Fault diagnosis and health condition monitoring have always been critical issues in the engineering research community [...].