Objective Poor outcomes in acute respiratory distress syndrome (ARDS) can be alleviated with tools that support early diagnosis. Current machine learning methods for detecting ARDS do not take full advantage of the multimodality of ARDS pathophysiology. We developed a multimodal deep learning model that uses imaging data, continuously collected ventilation data, and tabular data derived from a patient’s electronic health record (EHR) to make ARDS predictions.

Materials and Methods A chest radiograph (x-ray), at least two hours of ventilator waveform (VWD) data within the first 24 hours of intubation, and EHR-derived tabular data were used from 220 patients admitted to the ICU to train a deep learning model. The model uses pretrained encoders for the x-rays and ventilation data and trains a feature extractor on tabular data. Encoded features for a patient are combined to make a single ARDS prediction. Ablation studies for each modality assessed their effect on the model’s predictive capability.

Results The trimodal model achieved an area under the receiver operator curve (AUROC) of 0.86 with a 95% confidence interval of 0.01. This was a statistically significant improvement (p<0.05) over single modality models and bimodal models trained on VWD+tabular and VWD+x-ray data.

Discussion and Conclusion Our results demonstrate the potential utility of using deep learning to address complex conditions with heterogeneous data. More work is needed to determine the additive effect of modalities on ARDS detection. Our framework can serve as a blueprint for building performant multimodal deep learning models for conditions with small, heterogeneous datasets.

The authors have declared no competing interest.

This study was funded by NIH grant R01HL16351.

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

Yes

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

IRB 647002-8 and IRB 19-28933 of the University of California Davis gave ethical approval for this work.

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sabroeckerucdavis.edu

jyadamshealth.ucdavis.edu

gkumucdavis.edu

racallcuthealth.ucdavis.edu

yuaniucdavis.edu

strohmermath.ucdavis.edu

1 for first 24 hours post first ICU admission

Data for this study are not publicly available.