Prediction of sepsis patients using machine learning approach: A meta-analysis

Sepsis is a common and major health crisis in hospitals globally. An innovative and feasible tool for predicting sepsis remains elusive. However, early and accurate prediction of sepsis could help physicians with proper treatments and minimize the diagnostic uncertainty. Machine learning models could help to identify potential clinical variables and provide higher performance than existing traditional low-performance models. We therefore performed a meta-analysis of observational studies to quantify the performance of a machine learning model to predict sepsis. A comprehensive literature search was conducted through the electronic database (e.g. PubMed, Scopus, Google Scholar, EMBASE, etc.) between January 1, 2000, and March 1, 2018. All the studies published in English and reporting the sepsis prediction using machine learning algorithms were considered in this study. Two authors independently extracted valuable information from the included studies. Inclusion and exclusion of studies were based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A total of 7 out of 135 studies met all of our inclusion criteria. For machine learning models, the pooled area under receiving operating curve (SAUROC) for predicting sepsis onset 3 to 4 h before, was 0.89 (95%CI: 0.86–0.92); sensitivity 0.81 (95%CI:0.80–0.81), and specificity 0.72 (95%CI:0.72–0.72) whereas the pooled SAUROC for SIRS, MEWS, and SOFA was 0.70, 0.50, and 0.78. Additionally, diagnostic odd ratio for machine learning, SIRS, MEWS, and SOFA was 15.17 (95%CI: 9.51–24.20), 3.23 (95%CI: 1.52–6.87), 31.99 (95% CI: 1.54–666.74), and 3.75(95%CI: 2.06–6.83). Our study findings suggest that the machine learning approach had a better performance than the existing sepsis scoring systems in predicting sepsis.