Individualized decision making in on-scene resuscitation time for out-of-hospital cardiac arrest using reinforcement learning.

ABSTRACT: On-scene resuscitation time is associated with out-of-hospital cardiac arrest (OHCA) outcomes. We developed and validated reinforcement learning models for individualized on-scene resuscitation times, leveraging nationwide Korean data. Adult OHCA patients with a medical cause of arrest were included (N = 73,905). The optimal policy was derived from conservative Q-learning to maximize survival. The on-scene return of spontaneous circulation hazard rates estimated from the Random Survival Forest were used as intermediate rewards to handle sparse rewards, while patients' historical survival was reflected in the terminal rewards. The optimal policy increased the survival to hospital discharge rate from 9.6% to 12.5% (95% CI: 12.2-12.8) and the good neurological recovery rate from 5.4% to 7.5%

SUBMITTER: Choi DH 

PROVIDER: S-EPMC11464506 | biostudies-literature | 2024 Oct

REPOSITORIES: biostudies-literature