Background: Several models for mortality prediction have been constructed for critically ill patients with haematological malignancies in recent years. These models have proven to be equally or more accurate in predicting hospital mortality in patients with haematological malignancies than ICU severity of illness scores such as the APACHE II or SAPS II [1]. The objective of this study is to compare the accuracy of predicting hospital mortality in patients with haematological malignancies admitted to the ICU between models based on multiple logistic regression (MLR) and support vector machine (SVM) based models.

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Introduction Tacrolimus is an important immunosuppressive drug for organ transplantation patients. It has a narrow therapeutic range, toxic side effects, and a blood concentration with wide intra-and interindividual variability. Hence, it is of the utmost importance to monitor tacrolimus blood concentration, thereby ensuring clinical effect and avoiding toxic side effects. Prediction models for tacrolimus blood concentration can improve clinical care by optimizing monitoring of these concentrations, especially in the initial phase after transplantation during intensive care unit (ICU) stay. This is the first study in the ICU in which support vector machines, as a new data modeling technique, are investigated and tested in their prediction capabilities of tacrolimus blood concentration. Linear support vector regression (SVR) and nonlinear radial basis function (RBF) SVR are compared with multiple linear regression (MLR).

BackgroundEcho-state networks (ESN) are part of a group of reservoir computing methods and are basically a form of recurrent artificial neural networks (ANN). These methods can perform classification tasks on time series data. The recurrent ANN of an echo-state network has an 'echo-state' characteristic. This 'echo-state' functions as a fading memory: samples that have been introduced into the network in a further past, are faded away. The echo-state approach for the training of recurrent neural networks was first described by Jaeger H. et al. In clinical medicine, until this moment, no original research articles have been published to examine the use of echo-state networks.MethodsThis study examines the possibility of using an echo-state network for prediction of dialysis in the ICU. Therefore, diuresis values and creatinine levels of the first three days after ICU admission were collected from 830 patients admitted to the intensive care unit (ICU) between May 31th 2003 and November 17th 2007. The outcome parameter was the performance by the echo-state network in predicting the need for dialysis between day 5 and day 10 of ICU admission. Patients with an ICU length of stay <10 days or patients that received dialysis in the first five days of ICU admission were excluded. Performance by the echo-state network was then compared by means of the area under the receiver operating characteristic curve (AUC) with results obtained by two other time series analysis methods by means of a support vector machine (SVM) and a naive Bayes algorithm (NB).ResultsThe AUC's in the three developed echo-state networks were 0.822, 0.818, and 0.817. These results were comparable to the results obtained by the SVM and the NB algorithm.ConclusionsThis proof of concept study is the first to evaluate the performance of echo-state networks in an ICU environment. This echo-state network predicted the need for dialysis in ICU patients. The AUC's of the echo-state networks were good and comparable to the performance of other classification algorithms. Moreover, the echo-state network was more easily configured than other time series modeling technologies.

Objective: Time series often appear in medical databases, but only few machine learning methods exist that process this kind of data properly. Most modeling techniques have been designed with a static data model in mind and are not suitable for coping with the dynamic nature of time series. Recurrent Neural Networks (RNN) are often used to process time series, but only a few training algorithms exist for RNNs which are complex and often yield poor results. Therefore, researchers often turn to traditional machine * Corresponding author: Tel.: +32 9 331 49 38, Fax: +32 9 331 48 99 learning approaches, such as support vector machines (SVM), which can easily be set up and trained and combine them with feature extraction (FE) and selection (FS) to process the high-dimensional temporal data. Recently, a new approach, called echo state networks (ESN), has been developed to simplify the training process of RNNs. This approach allows modeling the dynamics of a system based on time series data in a straightforward way.The objective of this study is to explore the advantages of using ESN in- Conclusion: It can be concluded that the use of ESN has an added value in predicting the need for dialysis through the analysis of time series data. The ESN requires significantly less processing time, needs no domain knowledge, is easy to implement, and can be configured using rules of thumb.