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Clustering-Aided Approach for Predicting Patient Outcomes with Application to Elderly Healthcare in Ireland

AAAI Conferences

Predictive analytics have proved promising capabilities and opportunities to many aspects of healthcare practice. Data-driven insights can provide an important part of the solution for curbing rising costs and improving care quality. The paper implements machine learning techniques in an attempt to support decision making in relation to elderly healthcare in Ireland, with a particular focus on hip fracture care. We adopt a combination of unsupervised and supervised learning for predicting patient outcomes. Initially, elderly patients are grouped based on the similarity of age, length of stay (LOS) and elapsed time to surgery. Using the K-Means algorithm, our clustering experiments suggest the presence of three coherent clusters of patients. Subsequently, the discovered clusters are utilised to train prediction models that address a particular cluster of patients individually. In particular, two machine learning models are trained for every cluster of patients in order to predict the inpatient LOS, and discharge destination. The developed models are claimed to make predictions with relatively high accuracy. Furthermore, the potential usefulness of the clustering-guided approach of prediction is discussed in general.


Design of one-year mortality forecast at hospital admission based: a machine learning approach

arXiv.org Machine Learning

Background: Palliative care is referred to a set of programs for patients that suffer life-limiting illnesses. These programs aim to guarantee a minimum level of quality of life (QoL) for the last stage of life. They are currently based on clinical evaluation of risk of one-year mortality. Objectives: The main objective of this work is to develop and validate machine-learning based models to predict the exitus of a patient within the next year using data gathered at hospital admission. Methods: Five machine learning techniques were applied in our study to develop machine-learning predictive models: Support Vector Machines, K-neighbors Classifier, Gradient Boosting Classifier, Random Forest and Multilayer Perceptron. All models were trained and evaluated using the retrospective dataset. The evaluation was performed with five metrics computed by a resampling strategy: Accuracy, the area under the ROC curve, Specificity, Sensitivity, and the Balanced Error Rate. Results: All models for forecasting one-year mortality achieved an AUC ROC from 0.858 to 0.911. Specifically, Gradient Boosting Classifier was the best model, producing an AUC ROC of 0.911 (CI 95%, 0.911 to 0.912), a sensitivity of 0.858 (CI 95%, 0.856 to 0.86) and a specificity of 0.807 (CI 95%, 0.806 to 0808) and a BER of 0.168 (CI 95%, 0.167 to 0.169). Conclusions: The analysis of common information at hospital admission combined with machine learning techniques produced models with competitive discriminative power. Our models reach the best results reported in state of the art. These results demonstrate that they can be used as an accurate data-driven palliative care criteria inclusion.


Utilizing Artificial Intelligence in Critical Care: Adding A Handy Tool to Our Armamentarium

#artificialintelligence

As per the definition found in Britannica by Copeland, AI is commonly referred to as a computer system with human intellectual features, e.g., reasoning, discovering, generalizing, and learning from prior exposure [1,2]. U.S Food and Drug Administration (US-FDA) has also stated in 2019 that AI has the potential to transform the healthcare industry by its ability to derive new information from the vast dataset that feeds into it [2,3]. Machine learning (ML) can be simply understood as a subset of an application of AI in which machines analyze and use a large dataset to produce unique algorithms capable of "statistical learning" as described by Gutierrez [2]. The use of ML has surged in critical care in the field of the discovery of drugs, diagnostic tools, medical imaging, and therapeutics amongst others. It can potentially help us better understand the vast set of data available to us in an intensive care unit (ICU) and apply it to tackle a multitude of medical conditions [2,4]. ML can be divided into two main models based on learning tasks, which are supervised and unsupervised learning algorithms.


Machine Learning Approaches to Predict 6-Month Mortality Among Patients With Cancer

#artificialintelligence

Question Can machine learning algorithms identify oncology patients at risk of short-term mortality to inform timely conversations between patients and physicians regrading serious illness? Findings In this cohort study of 26 525 patients seen in oncology practices within a large academic health system, machine learning algorithms accurately identified patients at high risk of 6-month mortality with good discrimination and positive predictive value. When the gradient boosting algorithm was applied in real time, most patients who were classified as having high risk were deemed appropriate by oncology clinicians for a conversation regarding serious illness. Meaning In this study, machine learning algorithms accurately identified patients with cancer who were at risk of 6-month mortality, suggesting that these models could facilitate more timely conversations between patients and physicians regarding goals and values. Importance Machine learning algorithms could identify patients with cancer who are at risk of short-term mortality. However, it is unclear how different machine learning algorithms compare and whether they could prompt clinicians to have timely conversations about treatment and end-of-life preferences. Objectives To develop, validate, and compare machine learning algorithms that use structured electronic health record data before a clinic visit to predict mortality among patients with cancer. Design, Setting, and Participants Cohort study of 26 525 adult patients who had outpatient oncology or hematology/oncology encounters at a large academic cancer center and 10 affiliated community practices between February 1, 2016, and July 1, 2016.


Machine Learning to Predict Mortality and Critical Events in a Cohort of Patients With COVID-19 in New York City: Model Development and Validation

#artificialintelligence

Background: COVID-19 has infected millions of people worldwide and is responsible for several hundred thousand fatalities. The COVID-19 pandemic has necessitated thoughtful resource allocation and early identification of high-risk patients. However, effective methods to meet these needs are lacking. Objective: The aims of this study were to analyze the electronic health records (EHRs) of patients who tested positive for COVID-19 and were admitted to hospitals in the Mount Sinai Health System in New York City; to develop machine learning models for making predictions about the hospital course of the patients over clinically meaningful time horizons based on patient characteristics at admission; and to assess the performance of these models at multiple hospitals and time points. Methods: We used Extreme Gradient Boosting (XGBoost) and baseline comparator models to predict in-hospital mortality and critical events at time windows of 3, 5, 7, and 10 days from admission. Our study population included harmonized EHR data from five hospitals in New York City for 4098 COVID-19–positive patients admitted from March 15 to May 22, 2020. The models were first trained on patients from a single hospital (n 1514) before or on May 1, externally validated on patients from four other hospitals (n 2201) before or on May 1, and prospectively validated on all patients after May 1 (n 383). Finally, we established model interpretability to identify and rank variables that drive model predictions. Results: Upon cross-validation, the XGBoost classifier outperformed baseline models, with an area under the receiver operating characteristic curve (AUC-ROC) for mortality of 0.89 at 3 days, 0.85 at 5 and 7 days, and 0.84 at 10 days. XGBoost also performed well for critical event prediction, with an AUC-ROC of 0.80 at 3 days, 0.79 at 5 days, 0.80 at 7 days, and 0.81 at 10 days. In external validation, XGBoost achieved an AUC-ROC of 0.88 at 3 days, 0.86 at 5 days, 0.86 at 7 days, and 0.84 at 10 days for mortality prediction.