코로나19 위중증환자 최대질병중증도 미리 예측 가능해져

출처 : 강남세브란스병원
등록일 : 2021-11-05
조회 : 124

<div style="text-align: justify;" align="justify"><p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; margin-left: -6pt; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">코로나19&nbsp;위중증환자 최대질병중증도 미리 예측 가능해져<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">-&nbsp;강남세브란스 구교철‧이광석 교수팀,&nbsp;코로나19&nbsp;환자 조기 선별로 사망률 최소화<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">-&nbsp;코로나19&nbsp;환자 자가격리 및 병원이송 필요 여부 선별…중환자 병상 효율적 운영<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">&nbsp;단계적 일상회복(위드 코로나·with corona)&nbsp;전환이 본격화되면서 코로나19&nbsp;위중증 환자 관리가 중요해졌다.&nbsp;일상 회복이 이뤄지면 해외처럼 확진자가 급격히 늘어날 수 있어 선제 대응이 필수적이다.&nbsp;특히 중증환자의 사망률이 급증하지 않도록 조기 선별과 치료를 실시해야 한다.&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">&nbsp;국내 연구진이 코로나19&nbsp;환자의 개별적 임상 상태에 따라 최대질병 중증도(질병이 가장 악화했을 때의 상태)를 예측하는 시스템을 개발했다.&nbsp;신규확진자 발생시 자가격리(재택치료)&nbsp;또는 병원이송 필요성을 선별 분류할 수 있어 중증환자의 사망률을 최소화할 수 있게 됐다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="" align="justify">&nbsp;연세대 강남세브란스병원 비뇨의학과 구교철‧이광석 교수와&nbsp;KAIST&nbsp;경영대학 안재현 교수팀이 역치 최적화 시뮬레이션 기법을 이용한 코로나19&nbsp;환자의 최적 중등도 분류시스템에 관한 연구 결과를 발표했다.&nbsp;신규확진자 유입량 대비 가용한 병상수에 따라,&nbsp;반드시 중환자실이 필요한 환자에게 제한된 의료자원을 효율적으로 배분하는 시스템이다.<p style="margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" text-align:="" start;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;이번 연구는 범부처 의료기기개발 국책사업&nbsp;“공기매매-감염병 의증환자의 조기 선별진단과 확산 방지를 위한 스마트 알고리즘 개발 및 이동식 격리 연계시스템 개발”&nbsp;과제로 진행됐다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;연구팀은 국내 코로나19&nbsp;발생 시점부터 지난해&nbsp;4월까지 확진 판정된 코로나19&nbsp;환자&nbsp;5,601명을 대상으로 입원 중 최대 임상 중증도를 분석했다.&nbsp;질병관리본부(KDCA)의 코로나19&nbsp;확진자 임상자료(환자 당&nbsp;37개의 임상 및 검사결과 변수)를 활용했다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;연구팀은&nbsp;AI&nbsp;머신러닝 기술인&nbsp;XGBoost(Extreme Gradient Boosting)&nbsp;기계학습법 및 로지스틱 회귀 분석 교차 검증을 통해 예측 모델을 구현했다.&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;그 결과,&nbsp;중환자실 치료가 필요한 정도(기관 삽관,&nbsp;에크모 적용,&nbsp;사망)의 중증질환으로 이환될 확률을&nbsp;96.5%의 정확도로 예측할 수 있었다.&nbsp;이는 기존 해외 연구의 결과의 정확도(77~91%)에 비해 높은 수준이다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;또한 연구팀은 코로나19&nbsp;검사장비가 제한된 의료환경이나 자가진단시 사용할 수 있도록,&nbsp;혈액검사 등 변수들을 제외한 모델(variable restricted models)도 개발했다.&nbsp;제한된 모델의 예측 정확도 역시&nbsp;96.3%로 높은 수준을 나타냈다.&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;해당 알고리즘은 웹사이트(<a href="http://covid19severity.duckdns.org/" style="margin: 0px; padding: 0px; box-sizing: border-box; border-width: 0px 0px 1px; border-top-style: initial; border-right-style: initial; border-bottom-style: solid; border-left-style: initial; border-top-color: initial; border-right-color: initial; border-bottom-color: rgb(0, 148, 251); border-left-color: initial; border-image: initial; color: rgb(0, 148, 251); font-family: inherit;">http://covid19severity.duckdns.org</a>)를 통해 전 세계 누구나 이용할 수 있다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);="" text-align:="" center;"=""><span class="fr-img-caption fr-fic fr-dib" style="margin: 5px auto; padding: 0px; box-sizing: border-box; border: 0px; position: relative; max-width: 100%; display: block; float: none; vertical-align: top; width: 784px;"><a href="https://gs.severance.healthcare/gs/news/press/report.do?&mode=view&articleNo=113075&articleLimit=12" target="_blank"></a><img src="https://gs.severance.healthcare/_attach/yuhs/editor-image/2021/11/nQBOXRVftMNJzgCMhGciWYiBYO.png" data-path="/_attach/yuhs/editor-image/2021/11/nQBOXRVftMNJzgCMhGciWYiBYO.png" data-size="66314" data-success="true" data-file_name="nQBOXRVftMNJzgCMhGciWYiBYO.png" data-width="784" data-alt="screen shot" data-height="845" style="text-align: center; margin: auto; padding: 0px; box-sizing: border-box; border: 0px; vertical-align: middle; max-width: 100%; position: relative; display: block; width: 784px;"><span class="fr-inner" style="text-align: justify; margin: auto; padding: 5px 5px 10px; box-sizing: border-box; border: 0px; display: block; font-size: 11pt; opacity: 0.9; width: 784px; font-family: 돋움, dotum; color: rgb(0, 0, 0);"><a href="https://gs.severance.healthcare/gs/news/press/report.do?&mode=view&articleNo=113075&articleLimit=12" target="_blank">XGBoost&nbsp;활용 코로나19&nbsp;</a><a href="https://gs.severance.healthcare/gs/news/press/report.do?&mode=view&articleNo=113075&articleLimit=12" target="_blank">최대질병중증도 예측 시스템</a><p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;연구팀은 예측 모델을 통해 최적역치-조정 시스템도 설계했다.&nbsp;이는 신규확진자 유입 대비,&nbsp;중증으로 이환돼 사망할 환자 수를 최소화하는 시스템이다.&nbsp;가상의 확진자 유입량에 따른 시뮬레이션 결과,&nbsp;사망률을 최대&nbsp;18%까지 낮출 수 있는 것으로 확인했다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;연구를 주도한 구교철 교수는&nbsp;“이번 연구로 신규확진자 유입량 대비 가용한 의료자원(중환자실)에 따라 중증도 예측확률 역치를 조절함으로써&nbsp;COVID-19&nbsp;사망률을 낮출 수 있다”며&nbsp;“중환자실 치료가 반드시 필요한 환자들에게 병상이 배정되도록 하고,&nbsp;가용한 의료자원의 효율적인 배분이 가능해 위드 코로나 시대의 활용도가 높을 것”이라고 말했다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;한편,&nbsp;이번 연구 결과는 국제학술지인&nbsp;‘JMIR Medical Informatics’에&nbsp;「Optimal triage for COVID-19 patients under limited healthcare resources: Development of a parsimonious machine learning prediction model and threshold optimization using discrete-event simulation(역치 최적화 및 분리-이벤트 시뮬레이션 기법을 이용한&nbsp;COVID-19&nbsp;환자의 최적 중등도 분류시스템 개발)」이라는 제목으로 최근 게재됐다.<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;<a href="https://medinform.jmir.org/2021/11/e32726" target="_blank">👉 논문명: Optimal triage for COVID-19 patients under limited healthcare resources: Development of a parsimonious machine learning (JMIR Medical Informatics, 2021.11.02)</a> AbstractBackground:The COVID-19 pandemic has placed an unprecedented burden on health care systems. Objective:We aimed to effectively triage COVID-19 patients within situations of limited data availability and explore optimal thresholds to minimize mortality rates while maintaining health care system capacity. Methods:A nationwide sample of 5601 patients confirmed with COVID-19 until April 2020 was retrospectively reviewed. Extreme gradient boosting (XGBoost) and logistic regression analysis were used to develop prediction models for the maximum clinical severity during hospitalization, classified according to the World Health Organization Ordinal Scale for Clinical Improvement (OSCI). The recursive feature elimination technique was used to evaluate the maintenance of model performance when clinical and laboratory variables were eliminated. Using populations based on hypothetical patient influx scenarios, discrete-event simulation was performed to find an optimal threshold within limited resource environments that minimizes mortality rates. Results:The cross-validated area under the receiver operating characteristic curve (AUROC) of the baseline XGBoost model that utilized all 37 variables was 0.965 for OSCI ≥6. Compared to the baseline model’s performance, the AUROC of the feature-eliminated model that utilized 17 variables was maintained at 0.963 with statistical insignificance. Optimal thresholds were found to minimize mortality rates in a hypothetical patient influx scenario. The benefit of utilizing an optimal triage threshold was clear, reducing mortality up to 18.1%, compared with the conventional Youden index. Conclusions:Our adaptive triage model and its threshold optimization capability revealed that COVID-19 management can be achieved via the cooperation of both the medical and health care management sectors for maximum treatment efficacy. The model is available online for clinical implementation.<div> </div>&nbsp;<a href="https://medinform.jmir.org/2021/11/e32726" target="_blank">👉 논문보러가기: https://medinform.jmir.org/2021/11/e32726</a><div> </div><p style="text-align: justify; margin-top: 4px; margin-bottom: 4px; box-sizing: border-box; border: 0px; color: rgb(51, 51, 51); font-family: -apple-system, BlinkMacSystemFont, NanumGothic, malgungothic, " helvetica="" neue",="" arial,="" sans-serif,="" "apple="" color="" emoji",="" "segoe="" ui="" symbol",="" "noto="" emoji";="" font-size:="" 16px;="" letter-spacing:="" 0.32px;="" background-color:="" rgb(255,="" 255,="" 255);"="">&nbsp;</div><div style="text-align: justify;" align="justify">※ 자세한 내용은 URL을 확인하시기 바랍니다.</div>

URL : https://gs.severance.healthcare/gs/news/press/report.do?&mode=view&articleNo=113075&articleLimit=12

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