Recurrent exacerbations remain a common yet preventable outcome for many children with asthma. Machine learning (ML) algorithms using electronic medical records (EMR) could allow accurate identification of children at risk for exacerbations and facilitate referral for preventative comprehensive care to avoid this morbidity. We developed ML algorithms to predict repeat severe exacerbations (i.e. asthma-related emergency department (ED) visits or future hospital admissions) for children with a prior asthma ED visit at a tertiary care children's hospital. Retrospective pre-COVID19 (Feb 2017 - Feb 2019, N=2716) Epic EMR data from the Children's Hospital of Eastern Ontario (CHEO) linked with environmental pollutant exposure and neighbourhood marginalization information was used to train various ML models. We used boosted trees (LGBM, XGB) and 3 open-source large language model (LLM) approaches (DistilGPT2, Llama 3.2 1B and Llama-8b-UltraMedical). Models were tuned and calibrated then validated in a second retrospective post-COVID19 dataset (Jul 2022 - Apr 2023, N=1237) from CHEO. Models were compared using the area under the curve (AUC) and F1 scores, with SHAP values used to determine the most predictive features. The LGBM ML model performed best with the most predictive features in the final AIRE-KIDS_ED model including prior asthma ED visit, the Canadian triage acuity scale, medical complexity, food allergy, prior ED visits for non-asthma respiratory diagnoses, and age for an AUC of 0.712, and F1 score of 0.51. This is a nontrivial improvement over the current decision rule which has F1=0.334. While the most predictive features in the AIRE-KIDS_HOSP model included medical complexity, prior asthma ED visit, average wait time in the ED, the pediatric respiratory assessment measure score at triage and food allergy.

How conspiracy theories infiltrated the doctor's office Every day, physicians and therapists work to keep their patients safe. As anyone who has googled their symptoms and convinced themselves that they've got a brain tumor will attest, the internet makes it very easy to self-(mis)diagnose your health problems. And although social media and other digital forums can be a lifeline for some people looking for a diagnosis or community, when that information is wrong, it can put their well-being and even lives in danger. Unfortunately, this modern impulse to "do your own research" became even more pronounced during the coronavirus pandemic. We asked a number of health-care professionals about how this shifting landscape is changing their profession. They told us that they are being forced to adapt how they treat patients.

Timely access to laboratory values is critical for clinical decision-making, yet current approaches rely on invasive venous sampling and are intrinsically delayed. Electrocardiography (ECG), as a non-invasive and widely available signal, offers a promising modality for rapid laboratory estimation. Recent progress in deep learning has enabled the extraction of latent hematological signatures from ECGs. However, existing models are constrained by low signal-to-noise ratios, substantial inter-individual variability, limited data diversity, and suboptimal generalization, especially when adapted to low-lead wearable devices. In this work, we conduct an exploratory study leveraging transfer learning to fine-tune ECGFounder, a large-scale pre-trained ECG foundation model, on the Multimodal Clinical Monitoring in the Emergency Department (MC-MED) dataset from Stanford. We generated a corpus of more than 20 million standardized ten-second ECG segments to enhance sensitivity to subtle biochemical correlates. On internal validation, the model demonstrated strong predictive performance (area under the curve above 0.65) for thirty-three laboratory indicators, moderate performance (between 0.55 and 0.65) for fifty-nine indicators, and limited performance (below 0.55) for sixteen indicators. This study provides an efficient artificial-intelligence driven solution and establishes the feasibility scope for real-time, non-invasive estimation of laboratory values.

This study presents a deep learning-based framework for predicting emergency department (ED) boarding counts six hours in advance using only operational and contextual data, without patient-level information. Data from ED tracking systems, inpatient census, weather, holidays, and local events were aggregated hourly and processed with comprehensive feature engineering. The mean ED boarding count was 28.7 (standard deviation = 11.2). Multiple deep learning models, including ResNetPlus, TSTPlus, and TSiTPlus, were trained and optimized using Optuna, with TSTPlus achieving the best results (mean absolute error = 4.30, mean squared error = 29.47, R2 = 0.79). The framework accurately forecasted boarding counts, including during extreme periods, and demonstrated that broader input features improve predictive accuracy. This approach supports proactive hospital management and offers a practical method for mitigating ED overcrowding.

The effective management of Emergency Department (ED) overcrowding is essential for improving patient outcomes and optimizing healthcare resource allocation. This study validates hospital admission prediction models initially developed using a small local dataset from a Greek hospital by leveraging the comprehensive MIMIC-IV dataset. After preprocessing the MIMIC-IV data, five algorithms were evaluated: Linear Discriminant Analysis (LDA), K-Nearest Neighbors (KNN), Random Forest (RF), Recursive Partitioning and Regression Trees (RPART), and Support Vector Machines (SVM Radial). Among these, RF demonstrated superior performance, achieving an Area Under the Receiver Operating Characteristic Curve (AUC-ROC) of 0.9999, sensitivity of 0.9997, and specificity of 0.9999 when applied to the MIMIC-IV data. These findings highlight the robustness of RF in handling complex datasets for admission prediction, establish MIMIC-IV as a valuable benchmark for validating models based on smaller local datasets, and provide actionable insights for improving ED management strategies.

Artificial Intelligence (AI) is revolutionizing emergency medicine by enhancing diagnostic processes and improving patient outcomes. This article provides a comprehensive review of the current applications of AI in emergency imaging studies, focusing on the last five years of advancements. AI technologies, particularly machine learning and deep learning, are pivotal in interpreting complex imaging data, offering rapid, accurate diagnoses and potentially surpassing traditional diagnostic methods. Studies highlighted within the article demonstrate AI's capabilities in accurately detecting conditions such as fractures, pneumothorax, and pulmonary diseases from various imaging modalities including X-rays, CT scans, and MRIs. Furthermore, AI's ability to predict clinical outcomes like mechanical ventilation needs illustrates its potential in crisis resource optimization. Despite these advancements, the integration of AI into clinical practice presents challenges such as data privacy, algorithmic bias, and the need for extensive validation across diverse settings. This review underscores the transformative potential of AI in emergency settings, advocating for a future where AI and clinical expertise synergize to elevate patient care standards.

One of the most urgent problems is the overcrowding in emergency departments (EDs), caused by an aging population and rising healthcare costs. Patient dispositions have become more complex as a result of the strain on hospital infrastructure and the scarcity of medical resources. Individuals with more dangerous health issues should be prioritized in the emergency room. Thus, our research aims to develop a prediction model for patient disposition using EF-Net. This model will incorporate categorical features into the neural network layer and add numerical features with the embedded categorical features. We combine the EF-Net and XGBoost models to attain higher accuracy in our results. The result is generated using the soft voting technique. In EF-Net, we attained an accuracy of 95.33%, whereas in the Ensemble Model, we achieved an accuracy of 96%. The experiment's analysis shows that EF-Net surpasses existing works in accuracy, AUROC, and F1-Score on the MIMIC-IV-ED dataset, demonstrating its potential as a scalable solution for patient disposition assessment. Our code is available at https://github.com/nafisa67/thesis

Over an extensive duration, administrators and clinicians have endeavoured to predict Emergency Department (ED) visits with precision, aiming to optimise resource distribution. Despite the proliferation of diverse AI-driven models tailored for precise prognostication, this task persists as a formidable challenge, besieged by constraints such as restrained generalisability, susceptibility to overfitting and underfitting, scalability issues, and complex fine-tuning hyper-parameters. In this study, we introduce a novel Meta-learning Gradient Booster (Meta-ED) approach for precisely forecasting daily ED visits and leveraging a comprehensive dataset of exogenous variables, including socio-demographic characteristics, healthcare service use, chronic diseases, diagnosis, and climate parameters spanning 23 years from Canberra Hospital in ACT, Australia. The proposed Meta-ED consists of four foundational learners-Catboost, Random Forest, Extra Tree, and lightGBoost-alongside a dependable top-level learner, Multi-Layer Perceptron (MLP), by combining the unique capabilities of varied base models (sub-learners). Our study assesses the efficacy of the Meta-ED model through an extensive comparative analysis involving 23 models. The evaluation outcomes reveal a notable superiority of Meta-ED over the other models in accuracy at 85.7% (95% CI ;85.4%, 86.0%) and across a spectrum of 10 evaluation metrics. Notably, when compared with prominent techniques, XGBoost, Random Forest (RF), AdaBoost, LightGBoost, and Extra Tree (ExT), Meta-ED showcases substantial accuracy enhancements of 58.6%, 106.3%, 22.3%, 7.0%, and 15.7%, respectively. Furthermore, incorporating weather-related features demonstrates a 3.25% improvement in the prediction accuracy of visitors' numbers. The encouraging outcomes of our study underscore Meta-ED as a foundation model for the precise prediction of daily ED visitors.

Bacteraemia, a bloodstream infection with high morbidity and mortality rates, poses significant diagnostic challenges. Accurate diagnosis through blood cultures is resource-intensive. Developing a machine learning model to predict blood culture outcomes in emergency departments offers potential for improved diagnosis, reduced healthcare costs, and mitigated antibiotic use.This thesis aims to identify optimal machine learning techniques for predicting bacteraemia and develop a predictive model using data from St. Antonius Hospital's emergency department. Based on current literature, CatBoost and Random Forest were selected as the most promising techniques. Model optimization using Optuna prioritized sensitivity.The final Random Forest model achieved an ROC AUC of 0.78 and demonstrated 0.92 sensitivity on the test set. Notably, it accurately identified 36.02% of patients at low risk of bacteraemia, with only 0.85% false negatives.Implementation of this model in St. Antonius Hospital's emergency department could reduce blood cultures, healthcare costs, and antibiotic treatments. Future studies should focus on external validation, exploring advanced techniques, and addressing potential confounders to ensure model generalizability.

Emergency department (ED) crowding is a global public health issue that has been repeatedly associated with increased mortality. Predicting future service demand would enable preventative measures aiming to eliminate crowding along with it's detrimental effects. Recent findings in our ED indicate that occupancy ratios exceeding 90% are associated with increased 10-day mortality. In this paper, we aim to predict these crisis periods using retrospective data from a large Nordic ED with a LightGBM model. We provide predictions for the whole ED and individually for it's different operational sections. We demonstrate that afternoon crowding can be predicted at 11 a.m. with an AUC of 0.82 (95% CI 0.78-0.86) and at 8 a.m. with an AUC up to 0.79 (95% CI 0.75-0.83). Consequently we show that forecasting mortality-associated crowding using anonymous administrative data is feasible.