Multi-modal prediction of extracorporeal support—a resource intensive therapy, utilizing a large national database
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Objective: Extracorporeal membrane oxygenation (ECMO) is among the most resource-intensive therapies in critical care. The COVID-19 pandemic highlighted the lack of ECMO resource allocation tools. We aimed to develop a continuous ECMO risk prediction model to enhance patient triage and resource allocation. Material and Methods: We leveraged multimodal data from the National COVID Cohort Collaborative (N3C) to develop a hierarchical deep learning model, labeled "PreEMPT-ECMO" (Prediction, Early Monitoring, and Proactive Triage for ECMO) which integrates static and multi-granularity time series features to generate continuous predictions of ECMO utilization. Model performance was assessed across time points ranging from 0 to 96 hours prior to ECMO initiation, using both accuracy and precision metrics. Results: Between January 2020 and May 2023, 101 400 patients were included, with 1298 (1.28%) supported on ECMO. PreEMPT-ECMO outperformed established predictive models, including Logistic Regression, Support Vector Machine, Random Forest, and Extreme Gradient Boosting Tree, in both accuracy and precision at all time points. Model interpretation analysis also highlighted variations in feature contributions through each patient's clinical course. Discussion and Conclusions: We developed a hierarchical model for continuous ECMO use prediction, utilizing a large multicenter dataset incorporating both static and time series variables of various granularities. This novel approach reflects the nuanced decision-making process inherent in ECMO initiation and has the potential to be used as an early alert tool to guide patient triage and ECMO resource allocation. Future directions include prospective validation and generalizability on non-COVID-19 refractory respiratory failure, aiming to improve patient outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 it