Multilayer dynamic ensemble model for intensive care unit mortality prediction of neonate patients.

Robust and rabid mortality prediction is crucial in intensive care units because it is considered one of the critical steps for treating patients with serious conditions. Combining mortality prediction with the length of stay (LoS) prediction adds another level of importance to these models. No studies in the literature predict such tasks for neonates, especially using time-series data and dynamic ensemble techniques. Dynamic ensembles are novel techniques that dynamically select the base classifiers for each new case. Medically, implementing an accurate machine learning model is insufficient to gain the trust of physicians. The model must be able to justify its decisions. While explainable AI (XAI) techniques can be used to handle this challenge, no studies have been done in this regard for neonate monitoring in the neonatal intensive care unit (NICU). This study utilizes advanced machine learning approaches to predict mortality and LoS through data-driven learning. We propose a multilayer dynamic ensemble-based model to predict mortality as a classification task and LoS as a regression task for neonates admitted to the NICU. The model has been built based on the patient's time-series data of the first 24 h in the NICU. We utilized a cohort of 3,133 infants from the MIMIC-III real dataset to build and optimize the selected algorithms. It has shown that the dynamic ensemble models achieved better results than other classifiers, and static ensemble regressors achieved better results than classical machine learning regressors. The proposed optimized model is supported by three well-known explainability techniques of SHAP, decision tree visualization, and rule-based system. To provide online assistance to physicians in monitoring and managing neonates in the NICU, we implemented a web-based clinical decision support system based on the most accurate models and selected XAI techniques. The code of the proposed models is publicly available at https://github.com/InfoLab-SKKU/neonateMortalityPrediction.

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Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.