论文标题

使用深度学习的压力溃疡分类:评估模型性能的临床试验

Pressure Ulcer Categorisation using Deep Learning: A Clinical Trial to Evaluate Model Performance

论文作者

Fergus, Paul, Chalmers, Carl, Henderson, William, Roberts, Danny, Waraich, Atif

论文摘要

压疮是患者和医疗保健专业人员的挑战。在英国,每年有70万人受压溃疡的影响。对他们的治疗每天花费380万英镑。他们的病因是复杂而多因素的。但是,证据表明,与疾病相关的久坐生活方式与不健康的饮食习惯之间有着密切的联系。压疮是由直接与床或椅子直接接触的,没有频繁的位置变化。泌尿和粪便尿失禁,糖尿病和限制身体位置和营养的伤害也是已知的危险因素。存在指南和治疗方法,但它们的实施和成功在不同的医疗机构中有所不同。这主要是因为医疗保健从业人员a)在应对压溃疡方面的经验最少,b)普遍缺乏对压溃疡治疗的理解。管理不善的压力溃疡会导致严重的疼痛,质量差和大量医疗保健费用。在本文中,我们报告了由默西护理基金会基金会(Mersey Care NHS Foundation Trust)进行的一项临床试验的发现,该发现评估了基于区域的卷积神经网络和移动平台的性能,该卷积神经网络和移动平台对压力溃疡进行了分类和记录。神经网络将类别I,II,III和IV压力溃疡,深层组织损伤和不可停滞的压力溃疡进行分类。地区护士拍摄的压力溃疡的照片已在4/5G通信上传输到推理服务器进行分类。存储和审查分类图像,以评估模型的预测和相关性,作为临床决策和标准化报告的工具。研究的结果产生了平均平均精度= 0.6796,召回= 0.6997,F1得分= 0.6786,使用 @.75置信度得分阈值,为45个假阳性。

Pressure ulcers are a challenge for patients and healthcare professionals. In the UK, 700,000 people are affected by pressure ulcers each year. Treating them costs the National Health Service £3.8 million every day. Their etiology is complex and multifactorial. However, evidence has shown a strong link between old age, disease-related sedentary lifestyles and unhealthy eating habits. Pressure ulcers are caused by direct skin contact with a bed or chair without frequent position changes. Urinary and faecal incontinence, diabetes, and injuries that restrict body position and nutrition are also known risk factors. Guidelines and treatments exist but their implementation and success vary across different healthcare settings. This is primarily because healthcare practitioners have a) minimal experience in dealing with pressure ulcers, and b) a general lack of understanding of pressure ulcer treatments. Poorly managed, pressure ulcers lead to severe pain, poor quality of life, and significant healthcare costs. In this paper, we report the findings of a clinical trial conducted by Mersey Care NHS Foundation Trust that evaluated the performance of a faster region-based convolutional neural network and mobile platform that categorised and documented pressure ulcers. The neural network classifies category I, II, III, and IV pressure ulcers, deep tissue injuries, and unstageable pressure ulcers. Photographs of pressure ulcers taken by district nurses are transmitted over 4/5G communications to an inferencing server for classification. Classified images are stored and reviewed to assess the model's predictions and relevance as a tool for clinical decision making and standardised reporting. The results from the study generated a mean average Precision=0.6796, Recall=0.6997, F1-Score=0.6786 with 45 false positives using an @.75 confidence score threshold.

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