A study of machine learning to predict NRDS severity based on lung ultrasound score and clinical indicators

Objective: To develop predictive models for neonatal respiratory distress syndrome (NRDS) using machine learning algorithms to improve the accuracy of severity predictions.

Methods: This double-blind cohort study included 230 neonates admitted to the neonatal intensive care unit (NICU) of Yantaishan Hospital between December 2020 and June 2023. Of these, 119 neonates were diagnosed with NRDS and placed in the NRDS group, while 111 neonates with other conditions formed the non-NRDS (N-NRDS) group. All neonates underwent lung ultrasound and various clinical assessments, with data collected on the oxygenation index (OI), sequential organ failure assessment (SOFA), respiratory index (RI), and lung ultrasound score (LUS). An independent sample test was used to compare the groups' LUS, OI, RI, SOFA scores, and clinical data. Use Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify predictor variables, and construct a model for predicting NRDS severity using logistic regression (LR), random forest (RF), artificial neural network (NN), and support vector machine (SVM) algorithms. The importance of predictive variables and performance metrics was evaluated for each model.

Results: The NRDS group showed significantly higher LUS, SOFA, and RI scores and lower OI values than the N-NRDS group (p < 0.01). LUS, SOFA, and RI scores were significantly higher in the severe NRDS group compared to the mild and moderate groups, while OI was markedly lower (p < 0.01). LUS, OI, RI, and SOFA scores were the most impactful variables for the predictive efficacy of the models. The RF model performed best of the four models, with an AUC of 0.894, accuracy of 0.808, and sensitivity of 0.706. In contrast, the LR, NN, and SVM models have lower AUC values than the RF model with 0.841, 0.828, and 0.726, respectively.

Conclusion: Four predictive models based on machine learning can accurately assess the severity of NRDS. Among them, the RF model exhibits the best predictive performance, offering more effective support for the treatment and care of neonates.