Cardiogenic Shock & Machine Learning: A Systematic Review on Prediction
Through Clinical Decision Support Softwares
Abstract
Background & Aim Cardiogenic shock (CS) withholds a significantly high
mortality rate between 40-60% despite advances in diagnosis and
medical/surgical intervention. To-date, machine learning(ML) is being
implemented to integrate numerous data to optimize early diagnostic
predictions and suggest clinical courses. This systematic review
summarizes the area under the curve (AUC) receiver operating
characteristics (ROC) accuracy for the early prediction of CS. Methods A
systematic review was conducted within databases of PubMed,
ScienceDirect, Clinical Key/MEDLINE, Embase, GoogleScholar, and
Cochrane. Cohort studies that assessed accuracy of early detection of CS
using ML software were included. Data extraction was focused on AUC-ROC
values directed towards early detection of CS. Results A total of 943
studies were included for systematic review. From the reviewed studies,
2.2% (N=21) evaluated patient outcomes, of which 14.3% (N=3) were
assessed. The collective patient cohort (N=698) consisted of 314(45.0%)
females, with an average age and body mass index (BMI) of 64.1years and
28.1kg/m2, respectively. Collectively, 159 (22.8%) mortalities were
reported following early CS detection. Altogether, the AUC-ROC value was
0.82 (alfa=0.05), deeming it of superb sensitivity and specificity.
Conclusions From the present comprehensively gathered data, this study
accounts the use of ML software for the early detection of CS in a
clinical setting as a valid tool to predict patients at risk of CS. The
complexity of ML and its parallel lack of clinical evidence implies that
further prospective randomized control trials are needed to draw
definitive conclusions prior to standardizing use of these technologies.