Development and Comparative Analysis of Machine Learning Models for Hypoxemia Severity Triage in CBRNE Emergency Scenarios Using Physiological and Demographic Data from Medical-Grade Devices
Bibliographic record
Abstract
This paper presents the development of machine learning (ML) models to predict hypoxemia severity during emergency triage, especially in Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) events, using physiological data from medical-grade sensors. Gradient Boosting Models (XGBoost, LightGBM, CatBoost) and sequential models (LSTM, GRU) were trained on physiological and demographic data from the MIMIC-III and IV datasets. A robust preprocessing pipeline addressed missing data, class imbalances, and incorporated synthetic data flagged with masks. Gradient Boosting Models (GBMs) outperformed sequential models in terms of training speed, interpretability, and reliability, making them well-suited for real-time decision-making. While their performance was comparable to that of sequential models, the GBMs used score features from six physiological variables derived from the enhanced National Early Warning Score (NEWS) 2, which we termed NEWS2+. This approach significantly improved prediction accuracy. While sequential models handled temporal data well, their performance gains did not justify the higher computational cost. A 5-minute prediction window was chosen for timely intervention, with minute-level interpolations standardizing the data. Feature importance analysis highlighted the significant role of mask and score features in enhancing both transparency and performance. Temporal dependencies proved to be less critical, as Gradient Boosting Models were able to capture key patterns effectively without relying on them. This study highlights ML's potential to improve triage and reduce alarm fatigue. Future work will integrate data from multiple hospitals to enhance model generalizability across clinical settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".