Advancing Bloodstream Infection Prediction Using Explanable Artificial Intelligence Framework

Abstract

Bloodstream infections (BSIs) represent a critical public health concern, primarily due to their rapid progression and severe implications such as sepsis and septic shock. This study introduces an innovative Explanable Artificial Intelligence (XAI) framework, leveraging historical electronic health records (EHRs) to enhance BSI prediction. Unlike traditional models that rely heavily on real-time clinical data, our XAI-based approach utilizes a comprehensive dataset incorporating demographic data, laboratory results, and full medical histories from St. Olavs Hospital, Trondheim, Norway, covering 35,591 patients between 2015 and 2020. We developed models to differentiate between high-risk and low-risk BSI cases effectively, optimizing healthcare resource allocation and potentially reducing healthcare costs. Our results demonstrate superior predictive accuracy, particularly the tree-based models, which significantly outperformed contemporary models in both specificity and sensitivity metrics.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Yes

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The use of the EHRs data in this project has been approved by the Regional Commitees for Medical and Health Research Ethics (REK) in Central Norway by REK no. 2020/26184.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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