{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T20:15:40Z","timestamp":1770408940094,"version":"3.49.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["No. 202419010342"],"award-info":[{"award-number":["No. 202419010342"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The in-hospital mortality of acute respiratory distress syndrome can reach 35\u201345%, with patients requiring a more convenient and accurate way to assess the disease condition, which can change even more rapidly in patients undergoing mechanical ventilation in intensive care units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eligible patients in MIMIC-IV v3.0and eICU Collaborative Research Database v2.0were screened by the Berlin definition to examine the comparison of the diagnostic abilities of SpO\n                      <jats:sub>2<\/jats:sub>\n                      *10\/FiO\n                      <jats:sub>2<\/jats:sub>\n                      *PEEP (S\/F*P), PaO\n                      <jats:sub>2<\/jats:sub>\n                      *10\/FiO\n                      <jats:sub>2<\/jats:sub>\n                      *PEEP (P\/F*P), and SpO\n                      <jats:sub>2<\/jats:sub>\n                      \/ FiO\n                      <jats:sub>2<\/jats:sub>\n                      (S\/F), with nine types of machine learning performed on S\/F*P for 10 cross-validations, validating the diagnostic ability of the models for ARDS patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ROC_AUC\u2009=\u20090.700(95 CI:0.624\u2009~\u20090.777) for S\/F, ROC_AUC\u2009=\u20090.720(95 CI:0.668\u2009~\u20090.772) for P\/F*P, and ROC_AUC\u2009=\u20090.761(95 CI:0.693\u2009~\u20090.830) for S\/F*P showed that S\/F had a better fit in diagnosing ARDS with slightly inferior efficacy to P\/F*P, had superior diagnostic efficacy after incorporating peep into S\/F, and S\/F*P showed good diagnostic efficacy in 9 machine learning and 10 cross-validations. In terms of predicting the prognosis of patients, the ability of S\/F*P is not as good as S\/F, but the grading of S\/F*P has a more positive significance for the evaluation of the prognosis of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>S\/F*P provides a more convenient judgment for mechanically ventilated patients, avoiding the phenomenon of clinical diagnosis of PEEP and oxygenation index separation as much as possible, minimizing invasive operation of patients and improving the selection of ARDS treatment modalities. Therefore, S\/F*P provides a reference for the early treatment of ARDS in the clinic to improve the resource allocation in the ICU and reduce the mortality of patients, Given all patients had ARDS diagnosis, this study evaluated relative diagnostic performance among indices rather than disease vs. non-disease discrimination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341004","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T18:26:42Z","timestamp":1770316002000},"page":"e0341004","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of oxygenation indices incorporating SpO\u2082 and PEEP for assessing ARDS severity: Evidence from the MIMIC-IV and eICU collaborative research database v2.0 databases"],"prefix":"10.1371","volume":"21","author":[{"given":"Zekun","family":"Wei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cunyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bolin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Can","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tejin","family":"Ba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7267-2438","authenticated-orcid":true,"given":"Li","family":"Kong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feihu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"issue":"18","key":"pone.0341004.ref001","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1056\/NEJM200005043421806","article-title":"The acute respiratory distress syndrome","volume":"342","author":"LB Ware","year":"2000","journal-title":"N Engl J Med"},{"key":"pone.0341004.ref002","article-title":"Mechanisms and clinical consequences of acute lung injury","author":"V Fanelli","year":"2015","journal-title":"Ann Am Thorac Soc"},{"issue":"23","key":"pone.0341004.ref003","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin definition","volume":"307","author":"ARDS Definition Task Force","year":"2012","journal-title":"JAMA"},{"issue":"1","key":"pone.0341004.ref004","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1164\/rccm.202303-0558WS","article-title":"A new global definition of acute respiratory distress syndrome","volume":"209","author":"MA Matthay","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"issue":"10300","key":"pone.0341004.ref005","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S0140-6736(21)00439-6","article-title":"Acute respiratory distress syndrome","volume":"398","author":"NJ Meyer","year":"2021","journal-title":"Lancet"},{"issue":"1","key":"pone.0341004.ref006","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/s13613-021-00908-3","article-title":"P\/FP ratio: incorporation of PEEP into the PaO2\/FiO2 ratio for prognostication and classification of acute respiratory distress syndrome","volume":"11","author":"S Palanidurai","year":"2021","journal-title":"Ann Intensive Care"},{"issue":"1","key":"pone.0341004.ref007","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12890-019-0803-0","article-title":"Prognostic values of the Berlin definition criteria, blood lactate level, and fibroproliferative changes on high-resolution computed tomography in ARDS patients","volume":"19","author":"T Kamo","year":"2019","journal-title":"BMC Pulm Med"},{"issue":"12","key":"pone.0341004.ref008","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1136\/thx.49.12.1251","article-title":"Contribution of multiple inert gas elimination technique to pulmonary medicine. 5. 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