Prediction of major adverse cardiac events in the emergency department using an artificial neural network with a systematic grid search
Dublin Core
Title
Prediction of major adverse cardiac events in the emergency department using an artificial neural network with a systematic grid search
Subject
Artificial intelligence, Emergency medicine, Cardiac arrest, Major adverse cardiovascular events, Validation
study
study
Description
Background The aim of our research was to design and evaluate an Artificial Neural Network (ANN) model using
a systemic grid search for the early prediction of major adverse cardiac events (MACE) among patients presenting
to the triage of an emergency department.
Methods This is a single-center, cross-sectional study using electronic health records from January 2017 to Decem-
ber 2020. The research population consists of adults coming to our emergency department triage at Aga Khan
University Hospital. The MACE during hospitalization was the main outcome. To enhance the architecture of an ANN
using triage data, we used a systematic grid search strategy. Four hidden ANN layers were used, followed by an out-
put layer. Following each hidden layer was back normalization and a dropout layer. MACE was predicted using three
binary classifiers: ANN, Random Forests (RF), and logistic regression (LR). The overall accuracy, sensitivity, specificity,
precision, and recall of these models were examined. Each model was evaluated using the receiver operating charac-
teristic curve (ROC) and an F1-score with a 95% confidence interval.
Results A total of 97,333 emergency department visits were recorded during the study period, with 33% of patients
having cardiovascular symptoms. The mean age was 54.08 (19.18) years old. The MACE was observed in 23,052 (23.7%)
of the patients, in-hospital (up to 30 days) mortality in 10,888 (11.2%) patients, and cardiac arrest in 5483 (5.6%)
patients. The data used for training and validation were 77,866 and 19,467 in an 80:20 ratio, respectively. The AUC
score for MACE with ANN was 0.97, which was greater than RF (0.96) and LR (0.96). Similarly, the precision-recall curve
for MACE utilizing ANN was greater (0.94 vs. 0.93 for RF and 0.93 for LR). The sensitivity for MACE prediction using ANN,
RF, and LR classifiers was 99.3%, 99.4%, and 99.2%, respectively, with the specificities being 94.5%, 94.2%, and 94.2%,
respectively.
Conclusion When triage data is used to predict MACE, death, and cardiac arrest, ANN with systemic grid search gives
precise and valid outcomes and will benefit in predicting MACE in emergency rooms with limited resources that have
to deal with a substantial number of patients.
Keywords Artificial intelligence, Emergency medicine, Cardiac arrest, Major adverse cardiovascular events, Validation
study
a systemic grid search for the early prediction of major adverse cardiac events (MACE) among patients presenting
to the triage of an emergency department.
Methods This is a single-center, cross-sectional study using electronic health records from January 2017 to Decem-
ber 2020. The research population consists of adults coming to our emergency department triage at Aga Khan
University Hospital. The MACE during hospitalization was the main outcome. To enhance the architecture of an ANN
using triage data, we used a systematic grid search strategy. Four hidden ANN layers were used, followed by an out-
put layer. Following each hidden layer was back normalization and a dropout layer. MACE was predicted using three
binary classifiers: ANN, Random Forests (RF), and logistic regression (LR). The overall accuracy, sensitivity, specificity,
precision, and recall of these models were examined. Each model was evaluated using the receiver operating charac-
teristic curve (ROC) and an F1-score with a 95% confidence interval.
Results A total of 97,333 emergency department visits were recorded during the study period, with 33% of patients
having cardiovascular symptoms. The mean age was 54.08 (19.18) years old. The MACE was observed in 23,052 (23.7%)
of the patients, in-hospital (up to 30 days) mortality in 10,888 (11.2%) patients, and cardiac arrest in 5483 (5.6%)
patients. The data used for training and validation were 77,866 and 19,467 in an 80:20 ratio, respectively. The AUC
score for MACE with ANN was 0.97, which was greater than RF (0.96) and LR (0.96). Similarly, the precision-recall curve
for MACE utilizing ANN was greater (0.94 vs. 0.93 for RF and 0.93 for LR). The sensitivity for MACE prediction using ANN,
RF, and LR classifiers was 99.3%, 99.4%, and 99.2%, respectively, with the specificities being 94.5%, 94.2%, and 94.2%,
respectively.
Conclusion When triage data is used to predict MACE, death, and cardiac arrest, ANN with systemic grid search gives
precise and valid outcomes and will benefit in predicting MACE in emergency rooms with limited resources that have
to deal with a substantial number of patients.
Keywords Artificial intelligence, Emergency medicine, Cardiac arrest, Major adverse cardiovascular events, Validation
study
Creator
Ahmed Raheem1
, Shahan Waheed1*, Musa Karim2
, Nadeem Ullah Khan1 and Rida Jawed1
, Shahan Waheed1*, Musa Karim2
, Nadeem Ullah Khan1 and Rida Jawed1
Source
https://doi.org/10.1186/s12245-023-00573-2
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Ahmed Raheem1
, Shahan Waheed1*, Musa Karim2
, Nadeem Ullah Khan1 and Rida Jawed1, “Prediction of major adverse cardiac events in the emergency department using an artificial neural network with a systematic grid search,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12248.