Comparison of deep learning with regression analysis in creating predictive models for SARS-CoV-2 outcomes
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RESEARCH ARTICLE
Open Access
Comparison of deep learning with regression analysis in creating predictive models for SARS‑CoV‑2 outcomes Ahmed Abdulaal1†, Aatish Patel1†, Esmita Charani2, Sarah Denny1, Saleh A. Alqahtani3,4, Gary W. Davies1, Nabeela Mughal1,2,5 and Luke S. P. Moore1,2,5*
Abstract Background: Accurately predicting patient outcomes in Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) could aid patient management and allocation of healthcare resources. There are a variety of methods which can be used to develop prognostic models, ranging from logistic regression and survival analysis to more complex machine learning algorithms and deep learning. Despite several models having been created for SARS-CoV-2, most of these have been found to be highly susceptible to bias. We aimed to develop and compare two separate predictive models for death during admission with SARS-CoV-2. Method: Between March 1 and April 24, 2020, 398 patients were identified with laboratory confirmed SARS-CoV-2 in a London teaching hospital. Data from electronic health records were extracted and used to create two predictive models using: (1) a Cox regression model and (2) an artificial neural network (ANN). Model performance profiles were assessed by validation, discrimination, and calibration. Results: Both the Cox regression and ANN models achieved high accuracy (83.8%, 95% confidence interval (CI) 73.8–91.1 and 90.0%, 95% CI 81.2–95.6, respectively). The area under the receiver operator curve (AUROC) for the ANN (92.6%, 95% CI 91.1–94.1) was significantly greater than that of the Cox regression model (86.9%, 95% CI 85.7–88.2), p = 0.0136. Both models achieved acceptable calibration with Brier scores of 0.13 and 0.11 for the Cox model and ANN, respectively. Conclusion: We demonstrate an ANN which is non-inferior to a Cox regression model but with potential for further development such that it can learn as new data becomes available. Deep learning techniques are particularly suited to complex datasets with non-linear solutions, which make them appropriate for use in conditions with a paucity of prior knowledge. Accurate prognostic models for SARS-CoV-2 can provide benefits at the patient, departmental and organisational level. Keywords: COVID-19, Coronavirus, Machine learning, Artificial intelligence, Prognostication
*Correspondence: [email protected] † Ahmed Abdulaal and Aatish Patel contributed equally to this work 1 Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK Full list of author information is available at the end of the article
Background Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) has led to healthcare crises in several countries and remains disruptive in several others [1]. Accurately predicting patient outcomes would aid clinical staff in allocating limited healthcare resources and establishing appropriate ceilings of care, thereby mitigating the
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 I
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