ABSTRACT
A digital-twin based three-tiered system is proposed to prioritise patients for urgent intensive care and ventilator support. The deep learning methods are used to build patient-specific digital-twins to identify and prioritise critical cases amongst severe pneumonia patients. The three-tiered strategy is proposed to generate severity indices to: (1) identify urgent cases, (2) assign critical care and mechanical ventilation, and (3) discontinue mechanical ventilation and critical care at the optimal time. The severity indices calculated in the present study are the probability of death and the probability of requiring mechanical ventilation. These enable the generation of patient prioritisation lists and facilitates the smooth flow of patients in and out of Intensive Therapy Units (ITUs). The proposed digital-twin is built on pre-trained deep learning models using data from more than 1895 pneumonia patients. The severity indices calculated in the present study are assessed using the standard benchmark of Area Under Receiving Operating Characteristic Curve (AUROC). The results indicate that the ITU and mechanical ventilation can be prioritised correctly to an AUROC value as high as 0.89. This model may be employed in its current form to COVID-19 patients, but transfer learning with COVID-19 patient data will improve the predictions. The digital-twin model developed and tested is available via accompanying Supplemental material.