Multimodal deep learning for COVID-19 prognosis prediction in the emergency department: a bi-centric study.

Journal: Scientific reports
Published Date:

Abstract

Predicting clinical deterioration in COVID-19 patients remains a challenging task in the Emergency Department (ED). To address this aim, we developed an artificial neural network using textual (e.g. patient history) and tabular (e.g. laboratory values) data from ED electronic medical reports. The predicted outcomes were 30-day mortality and ICU admission. We included consecutive patients from Humanitas Research Hospital and San Raffaele Hospital in the Milan area between February 20 and May 5, 2020. We included 1296 COVID-19 patients. Textual predictors consisted of patient history, physical exam, and radiological reports. Tabular predictors included age, creatinine, C-reactive protein, hemoglobin, and platelet count. TensorFlow tabular-textual model performance indices were compared to those of models implementing only tabular data. For 30-day mortality, the combined model yielded slightly better performances than the tabular fastai and XGBoost models, with AUC 0.87 ± 0.02, F1 score 0.62 ± 0.10 and an MCC 0.52 ± 0.04 (p < 0.32). As for ICU admission, the combined model MCC was superior (p < 0.024) to the tabular models. Our results suggest that a combined textual and tabular model can effectively predict COVID-19 prognosis which may assist ED physicians in their decision-making process.

Authors

  • Franca Dipaola
    Internal Medicine, Syncope Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy.
  • Mauro Gatti
    IBM, 20100 Milan, Italy.
  • Alessandro Giaj Levra
    Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy.
  • Roberto Menè
    Department of Medicine and Surgery, University of Milano-Bicocca, 20100 Milan, Italy.
  • Dana Shiffer
    Emergency Department, IRCCS Humanitas Research Hospital, 20089 Milan, Italy.
  • Roberto Faccincani
    Emergency Department, Humanitas Mater Domini, Castellanza, Varese, Italy.
  • Zainab Raouf
    IRCCS-Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
  • Antonio Secchi
    IRCCS-Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
  • Patrizia Rovere Querini
    IRCCS-Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
  • Antonio Voza
    Emergency Department, IRCCS Humanitas Research Hospital, 20089 Milan, Italy.
  • Salvatore Badalamenti
    Internal Medicine, Humanitas Clinical and Research Center, IRCCS, Humanitas Research Hospital, Humanitas University, Via A. Manzoni, 56, 20089, Rozzano, Milan, Italy.
  • Monica Solbiati
    Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università Degli Studi Di Milano, 20100 Milan, Italy.
  • Giorgio Costantino
    Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università Degli Studi Di Milano, 20100 Milan, Italy.
  • Victor Savevski
    Artificial Intelligence Center IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
  • Raffaello Furlan
    Internal Medicine, Syncope Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy.