In current clinical practice, score-based mortality prediction systems, such as the series of the acute Predicting the risk of mortality for patients with acute physiology and chronic health evaluation (APACHE) scoring myocardial infarction (AMI) using electronic health records system, are widely used to help determine the treatment or (EHRs) data can help identify risky patients who might need medicine should be given to patients admitted into intensive more tailored care. In our previous work, we built care units (ICUs) . Nevertheless, these scoring systems computational models to predict one-year mortality of patients have significant limitations, e.g., 1) they are often restricted to admitted to an intensive care unit (ICU) with AMI or post only few predictors; 2) they have poor generalizability and may myocardial infarction syndrome. Our prior work only used the be less precise when applied to specific subpopulations other structured clinical data from MIMIC-III, a publicly available than the original population used for the initial development; ICU clinical database. In this study, we enhanced our work by and 3) they need to be periodically recalibrated to reflect adding the word embedding features from free-text discharge changes in clinical practice and patient demographics .
Current prognostic risk scores in cardiac surgery are based on statistics and do not yet benefit from machine learning. Statistical predictors are not robust enough to correctly identify patients who would benefit from Transcatheter Aortic Valve Implantation (TAVI). This research aims to create a machine learning model to predict one-year mortality of a patient after TAVI. We adopt a modern gradient boosting on decision trees algorithm, specifically designed for categorical features. In combination with a recent technique for model interpretations, we developed a feature analysis and selection stage, enabling to identify the most important features for the prediction. We base our prediction model on the most relevant features, after interpreting and discussing the feature analysis results with clinical experts. We validated our model on 270 TAVI cases, reaching an AUC of 0.83. Our approach outperforms several widespread prognostic risk scores, such as logistic EuroSCORE II, the STS risk score and the TAVI2-score, which are broadly adopted by cardiologists worldwide.
Risk prediction is central to both clinical medicine and public health. While many machine learning models have been developed to predict mortality, they are rarely applied in the clinical literature, where classification tasks typically rely on logistic regression. One reason for this is that existing machine learning models often seek to optimize predictions by incorporating features that are not present in the databases readily available to providers and policy makers, limiting generalizability and implementation. Here we tested a number of machine learning classifiers for prediction of six-month mortality in a population of elderly Medicare beneficiaries, using an administrative claims database of the kind available to the majority of health care payers and providers. We show that machine learning classifiers substantially outperform current widely-used methods of risk prediction but only when used with an improved feature set incorporating insights from clinical medicine, developed for this study. Our work has applications to supporting patient and provider decision making at the end of life, as well as population health-oriented efforts to identify patients at high risk of poor outcomes.
Acute myocardial infarction (AMI) -- or coronary heart disease -- is the leading cause of death in the U.S., and by 2035, it's estimated that nearly half of adults will suffer from some form of it. Troublingly, most incidences of AMI occur absent obvious symptoms like chest pain or shortness of breath. But researchers at Florida State University and the University of Florida, Gainesville are recruiting artificial intelligence (AI) to help predict one-year mortality in intensive care unit patients who have experienced an episode. One-year mortality was selected as the prediction window because it would allow for comparison to other studies, the researchers wrote, and because it would take into account patients that had multiple AMI-related ICU admissions within a two-year period. "Compared with risk assessment guidelines that require manual calculation of scores, machine learning based prediction for disease outcomes such as mortality can be utilized to save time and improve prediction accuracy," they wrote in a paper ("Building Computational Models to Predict One-Year Mortality in ICU Patients with Acute Myocardial Infarction and Post Myocardial Infarction Syndrome") published on the preprint server Arxiv.org.