Bertsimas, Dimitris, Boussioux, Léonard, Wright, Ryan Cory, Delarue, Arthur, Digalakis, Vassilis Jr., Jacquillat, Alexandre, Kitane, Driss Lahlou, Lukin, Galit, Li, Michael Lingzhi, Mingardi, Luca, Nohadani, Omid, Orfanoudaki, Agni, Papalexopoulos, Theodore, Paskov, Ivan, Pauphilet, Jean, Lami, Omar Skali, Stellato, Bartolomeo, Bouardi, Hamza Tazi, Carballo, Kimberly Villalobos, Wiberg, Holly, Zeng, Cynthia
The COVID-19 pandemic has created unprecedented challenges worldwide. Strained healthcare providers make difficult decisions on patient triage, treatment and care management on a daily basis. Policy makers have imposed social distancing measures to slow the disease, at a steep economic price. We design analytical tools to support these decisions and combat the pandemic. Specifically, we propose a comprehensive data-driven approach to understand the clinical characteristics of COVID-19, predict its mortality, forecast its evolution, and ultimately alleviate its impact. By leveraging cohort-level clinical data, patient-level hospital data, and census-level epidemiological data, we develop an integrated four-step approach, combining descriptive, predictive and prescriptive analytics. First, we aggregate hundreds of clinical studies into the most comprehensive database on COVID-19 to paint a new macroscopic picture of the disease. Second, we build personalized calculators to predict the risk of infection and mortality as a function of demographics, symptoms, comorbidities, and lab values. Third, we develop a novel epidemiological model to project the pandemic's spread and inform social distancing policies. Fourth, we propose an optimization model to re-allocate ventilators and alleviate shortages. Our results have been used at the clinical level by several hospitals to triage patients, guide care management, plan ICU capacity, and re-distribute ventilators. At the policy level, they are currently supporting safe back-to-work policies at a major institution and equitable vaccine distribution planning at a major pharmaceutical company, and have been integrated into the US Center for Disease Control's pandemic forecast.
The rapid increase in the percentage of chronic disease patients along with the recent pandemic pose immediate threats on healthcare expenditure and elevate causes of death. This calls for transforming healthcare systems away from one-on-one patient treatment into intelligent health systems, to improve services, access and scalability, while reducing costs. Reinforcement Learning (RL) has witnessed an intrinsic breakthrough in solving a variety of complex problems for diverse applications and services. Thus, we conduct in this paper a comprehensive survey of the recent models and techniques of RL that have been developed/used for supporting Intelligent-healthcare (I-health) systems. This paper can guide the readers to deeply understand the state-of-the-art regarding the use of RL in the context of I-health. Specifically, we first present an overview for the I-health systems challenges, architecture, and how RL can benefit these systems. We then review the background and mathematical modeling of different RL, Deep RL (DRL), and multi-agent RL models. After that, we provide a deep literature review for the applications of RL in I-health systems. In particular, three main areas have been tackled, i.e., edge intelligence, smart core network, and dynamic treatment regimes. Finally, we highlight emerging challenges and outline future research directions in driving the future success of RL in I-health systems, which opens the door for exploring some interesting and unsolved problems.
Bartz-Beielstein, Thomas, Dröscher, Marcel, Gür, Alpar, Hinterleitner, Alexander, Mersmann, Olaf, Peeva, Dessislava, Reese, Lennard, Rehbach, Nicolas, Rehbach, Frederik, Sen, Amrita, Subbotin, Aleksandr, Zaefferer, Martin
Crises like the COVID-19 pandemic pose a serious challenge to health-care institutions. They need to plan the resources required for handling the increased load, for instance, hospital beds and ventilators. To support the resource planning of local health authorities from the Cologne region, BaBSim.Hospital, a tool for capacity planning based on discrete event simulation, was created. The predictive quality of the simulation is determined by 29 parameters. Reasonable default values of these parameters were obtained in detailed discussions with medical professionals. We aim to investigate and optimize these parameters to improve BaBSim.Hospital. First approaches with "out-of-the-box" optimization algorithms failed. Implementing a surrogate-based optimization approach generated useful results in a reasonable time. To understand the behavior of the algorithm and to get valuable insights into the fitness landscape, an in-depth sensitivity analysis was performed. The sensitivity analysis is crucial for the optimization process because it allows focusing the optimization on the most important parameters. We illustrate how this reduces the problem dimension without compromising the resulting accuracy. The presented approach is applicable to many other real-world problems, e.g., the development of new elevator systems to cover the last mile or simulation of student flow in academic study periods.
In countries that enabled patients to choose their own providers, a common problem is that the patients did not make rational decisions, and hence, fail to use healthcare resources efficiently. This might cause problems such as overwhelming tertiary facilities with mild condition patients, thus limiting their capacity of treating acute and critical patients. To address such maldistributed patient volume, it is essential to oversee patients choices before further evaluation of a policy or resource allocation. This study used nationwide insurance data, accumulated possible features discussed in existing literature, and used a deep neural network to predict the patients choices of hospital levels. This study also used explainable artificial intelligence methods to interpret the contribution of features for the general public and individuals. In addition, we explored the effectiveness of changing data representations. The results showed that the model was able to predict with high area under the receiver operating characteristics curve (AUC) (0.90), accuracy (0.90), sensitivity (0.94), and specificity (0.97) with highly imbalanced label. Generally, social approval of the provider by the general public (positive or negative) and the number of practicing physicians serving per ten thousand people of the located area are listed as the top effecting features. The changing data representation had a positive effect on the prediction improvement. Deep learning methods can process highly imbalanced data and achieve high accuracy. The effecting features affect the general public and individuals differently. Addressing the sparsity and discrete nature of insurance data leads to better prediction. Applications using deep learning technology are promising in health policy making. More work is required to interpret models and practice implementation.
Big data has changed the way we manage, analyze, and leverage data across industries. One of the most notable areas where data analytics is making big changes is healthcare. In fact, healthcare analytics has the potential to reduce costs of treatment, predict outbreaks of epidemics, avoid preventable diseases, and improve the quality of life in general. The average human lifespan is increasing across the world population, which poses new challenges to today's treatment delivery methods. Health professionals, just like business entrepreneurs, are capable of collecting massive amounts of data and look for the best strategies to use these numbers.