{"id":"https://openalex.org/W4313267313","doi":"https://doi.org/10.1097/01.ccm.0000910384.64136.78","title":"1162: REINFORCEMENT LEARNING-BASED BLOOD PRODUCT RESUSCITATION IN GASTROINTESTINAL BLEEDING","display_name":"1162: REINFORCEMENT LEARNING-BASED BLOOD PRODUCT RESUSCITATION IN GASTROINTESTINAL BLEEDING","publication_year":2022,"publication_date":"2022-12-15","ids":{"openalex":"https://openalex.org/W4313267313","doi":"https://doi.org/10.1097/01.ccm.0000910384.64136.78"},"language":"en","primary_location":{"id":"doi:10.1097/01.ccm.0000910384.64136.78","doi":"https://doi.org/10.1097/01.ccm.0000910384.64136.78","is_oa":false,"landing_page_url":"https://doi.org/10.1097/01.ccm.0000910384.64136.78","pdf_url":null,"source":{"id":"https://openalex.org/S108732581","display_name":"Critical Care Medicine","issn_l":"0090-3493","issn":["0090-3493","1530-0293"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5068094660","display_name":"Tanner Wilson","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Tanner Wilson","raw_affiliation_strings":["University of Pittsburgh"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Pittsburgh","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082272833","display_name":"Gilles Clermont","orcid":"https://orcid.org/0000-0002-0163-1379","observed_orcids":["https://orcid.org/0000-0002-0163-1379"]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Gilles Clermont","raw_affiliation_strings":["University of Pittsburgh, Pittsburgh, PA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Pittsburgh, Pittsburgh, PA","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5082929960","display_name":"Harry Hochheiser","orcid":"https://orcid.org/0000-0001-8793-9982","observed_orcids":["https://orcid.org/0000-0001-8793-9982"]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Harry Hochheiser","raw_affiliation_strings":["University of Pittsburgh"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Pittsburgh","institution_ids":["https://openalex.org/I170201317"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I170201317"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.30350243,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"51","issue":"1","first_page":"579","last_page":"579"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10693","display_name":"Blood transfusion and management","score":0.4036000072956085,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10693","display_name":"Blood transfusion and management","score":0.4036000072956085,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11378","display_name":"Gastrointestinal Bleeding Diagnosis and Treatment","score":0.38350000977516174,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.038100000470876694,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/gastrointestinal-bleeding","display_name":"gastrointestinal bleeding","score":0.8619999885559082},{"id":"https://openalex.org/keywords/blood-product-resuscitation","display_name":"blood product resuscitation","score":0.8169999718666077},{"id":"https://openalex.org/keywords/transfusion-strategy","display_name":"transfusion strategy","score":0.6589999794960022},{"id":"https://openalex.org/keywords/reinforcement-learning","display_name":"reinforcement learning","score":0.75},{"id":"https://openalex.org/keywords/q-learning","display_name":"Q-learning","score":0.7839999794960022},{"id":"https://openalex.org/keywords/packed-red-blood-cells","display_name":"packed red blood cells","score":0.8389999866485596},{"id":"https://openalex.org/keywords/fresh-frozen-plasma","display_name":"fresh frozen plasma","score":0.9990000128746033},{"id":"https://openalex.org/keywords/platelets","display_name":"platelets","score":0.8080000281333923},{"id":"https://openalex.org/keywords/in-hospital-mortality","display_name":"in-hospital mortality","score":0.7120000123977661},{"id":"https://openalex.org/keywords/mimic-dataset","display_name":"MIMIC dataset","score":0.7369999885559082},{"id":"https://openalex.org/keywords/clinical-decision-support","display_name":"clinical decision support","score":0.6970000267028809},{"id":"https://openalex.org/keywords/k-means-clustering","display_name":"K-means clustering","score":0.5419999957084656},{"id":"https://openalex.org/keywords/hemoglobin-threshold","display_name":"hemoglobin threshold","score":0.5450000166893005}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.937251091003418},{"id":"https://openalex.org/C2780920261","wikidata":"https://www.wikidata.org/wiki/Q1363810","display_name":"Packed red blood cells","level":3,"score":0.6975873708724976},{"id":"https://openalex.org/C2777396833","wikidata":"https://www.wikidata.org/wiki/Q886722","display_name":"Blood product","level":2,"score":0.6462783813476562},{"id":"https://openalex.org/C66112548","wikidata":"https://www.wikidata.org/wiki/Q1225698","display_name":"Fresh frozen plasma","level":3,"score":0.5757145285606384},{"id":"https://openalex.org/C2778165595","wikidata":"https://www.wikidata.org/wiki/Q5491454","display_name":"Resuscitation","level":2,"score":0.5372709035873413},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.48080793023109436},{"id":"https://openalex.org/C2780014101","wikidata":"https://www.wikidata.org/wiki/Q183605","display_name":"Blood transfusion","level":2,"score":0.46224120259284973},{"id":"https://openalex.org/C2778080469","wikidata":"https://www.wikidata.org/wiki/Q1495657","display_name":"Gastrointestinal bleeding","level":2,"score":0.41395044326782227},{"id":"https://openalex.org/C89560881","wikidata":"https://www.wikidata.org/wiki/Q101026","display_name":"Platelet","level":2,"score":0.39580631256103516},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.3952631950378418},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.36377203464508057},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.35032761096954346},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.33264315128326416},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1097/01.ccm.0000910384.64136.78","doi":"https://doi.org/10.1097/01.ccm.0000910384.64136.78","is_oa":false,"landing_page_url":"https://doi.org/10.1097/01.ccm.0000910384.64136.78","pdf_url":null,"source":{"id":"https://openalex.org/S108732581","display_name":"Critical Care Medicine","issn_l":"0090-3493","issn":["0090-3493","1530-0293"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Critical Care Medicine","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9940000176429749}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2911948021","https://openalex.org/W4283750538","https://openalex.org/W2020820630","https://openalex.org/W3155005914","https://openalex.org/W4389743603","https://openalex.org/W4413908863","https://openalex.org/W2739703316","https://openalex.org/W7116307633","https://openalex.org/W4295941485","https://openalex.org/W2920898752"],"abstract_inverted_index":{"Introduction:":[0],"Indications":[1],"for":[2,81,102,144,290],"blood":[3,64,117,135,149,205],"transfusion":[4,171,207,254,271,294],"in":[5,34,53,256,264,296,308],"gastrointestinal":[6,86],"hemorrhage":[7,87,258],"are":[8,287],"frequently":[9],"under":[10],"scrutiny,":[11],"but":[12],"guidelines":[13],"and":[14,84,97,123,156,191,230,275,299],"trials":[15],"tend":[16],"to":[17,63,93,115,225],"focus":[18],"on":[19,77,125,165],"solitary":[20],"data":[21,76],"points,":[22],"like":[23],"hemoglobin":[24,176],"measurements.":[25],"Additionally,":[26],"few":[27],"studies":[28,291],"have":[29],"explored":[30],"balanced":[31,293],"resuscitation":[32,310],"techniques":[33],"this":[35],"population.":[36],"Reinforcement":[37,109],"learning":[38,59,248,303],"is":[39,45,61],"an":[40,208,252],"artificial":[41],"intelligence":[42],"technique":[43],"that":[44,259,301],"making":[46],"headlines":[47],"with":[48,162,223,277],"superhuman":[49],"levels":[50,177,186,196],"of":[51,146,172,210,272,281],"performance":[52],"Markovian":[54],"decision-making":[55],"problems.":[56],"This":[57],"machine":[58],"framework":[60],"well-suited":[62],"product":[65,118,136,206],"resuscitation.":[66],"Methods:":[67],"Using":[68],"the":[69,312],"MIMIC":[70],"dataset,":[71],"we":[72],"collected":[73],"structured":[74],"clinical":[75],"4,630":[78],"ICU":[79],"admissions":[80],"both":[82,288],"upper":[83],"lower":[85,184,237,282],"from":[88,261],"2008-2019.":[89],"Observations":[90],"were":[91],"discretized":[92],"1-hour":[94],"time":[95],"intervals,":[96],"K-mean":[98],"clustering":[99],"was":[100,113,138,221,236],"performed":[101],"patient":[103],"state":[104],"representation.":[105],"A":[106],"Gastrointestinal":[107],"Bleeding":[108],"Learning":[110],"agent,":[111,249],"GaBRieL,":[112,250],"trained":[114],"recommend":[116],"administration":[119,137],"using":[120],"offline":[121],"Q-learning":[122],"evaluated":[124],"a":[126,132,141,278,306],"20%":[127],"held-out":[128],"validation":[129,167],"set.":[130],"At":[131],"given":[133],"timestep,":[134],"treated":[139],"as":[140],"binary":[142],"decision":[143],"each":[145],"packed":[147],"red":[148],"cells":[150],"(PRBC),":[151],"fresh":[152],"frozen":[153],"plasma":[154],"(FFP),":[155],"platelets":[157],"(Plts).":[158],"Results:":[159],"When":[160],"compared":[161],"clinicians":[163,216],"acting":[164],"unseen":[166],"data,":[168],"GaBRieL":[169,201,267],"recommended":[170,227,268],"PRBC":[173,228],"at":[174,183,193,311],"higher":[175,194],"[8.91":[178],"vs":[179,188,198],"8.06,":[180],"p<.0001],":[181,190],"FFP":[182,231],"INR":[185],"[1.61":[187],"2.23,":[189],"Plts":[192],"platelet":[195],"[130":[197],"66.5,":[199],"p<.0001].":[200],"also":[202],"initiated":[203],"first":[204],"average":[209],"eight":[211],"hours":[212],"earlier":[213],"than":[214],"did":[215],"[p<.0001].":[217,244],"Higher":[218],"in-hospital":[219,234],"mortality":[220,235],"associated":[222,283],"failure":[224],"transfuse":[226],"[p<.0001]":[229],"[p=.03].":[232],"Overall,":[233],"when":[238],"clinician":[239,262],"action":[240,263],"matched":[241],"GaBRieL\u2019s":[242],"recommendation":[243],"Conclusions:":[245],"Our":[246],"reinforcement":[247,302],"learned":[251],"optimal":[253],"strategy":[255],"GI":[257],"differed":[260],"important":[265],"ways.":[266],"less":[269],"restrictive":[270],"PRBC,":[273],"FFP,":[274],"Plts,":[276],"strong":[279],"suggestion":[280],"mortality.":[284],"These":[285],"findings":[286],"hypothesis-generating":[289],"investigating":[292],"strategies":[295],"non-trauma":[297],"patients":[298],"suggest":[300],"may":[304],"play":[305],"role":[307],"guiding":[309],"bedside.":[313]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2023-01-06T00:00:00"}
