Multiple organ failure (MOF) is a life-threatening condition. Due to its urgency and high mortality rate, early detection is critical for clinicians to provide appropriate treatment. In this paper, we perform quantitative analysis on early MOF prediction with comprehensive machine learning (ML) configurations, including data preprocessing (missing value treatment, label balancing, feature scaling), feature selection, classifier choice, and hyperparameter tuning. Results show that classifier choice impacts both the performance improvement and variation most among all the configurations. In general, complex classifiers including ensemble methods can provide better performance than simple classifiers. However, blindly pursuing complex classifiers is unwise as it also brings the risk of greater performance variation.

Survival analysis is a technique to predict the times of specific outcomes, and is widely used in predicting the outcomes for intensive care unit (ICU) trauma patients. Recently, deep learning models have drawn increasing attention in healthcare. However, there is a lack of deep learning methods that can model the relationship between measurements, clinical notes and mortality outcomes. In this paper we introduce BERTSurv, a deep learning survival framework which applies Bidirectional Encoder Representations from Transformers (BERT) as a language representation model on unstructured clinical notes, for mortality prediction and survival analysis. We also incorporate clinical measurements in BERTSurv. With binary cross-entropy (BCE) loss, BERTSurv can predict mortality as a binary outcome (mortality prediction). With partial log-likelihood (PLL) loss, BERTSurv predicts the probability of mortality as a time-to-event outcome (survival analysis). We apply BERTSurv on Medical Information Mart for Intensive Care III (MIMIC III) trauma patient data. For mortality prediction, BERTSurv obtained an area under the curve of receiver operating characteristic curve (AUC-ROC) of 0.86, which is an improvement of 3.6% over baseline of multilayer perceptron (MLP) without notes. For survival analysis, BERTSurv achieved a concordance index (C-index) of 0.7. In addition, visualizations of BERT's attention heads help to extract patterns in clinical notes and improve model interpretability by showing how the model assigns weights to different inputs.

Trauma mortality results from a multitude of non-linear dependent risk factors including patient demographics, injury characteristics, medical care provided, and characteristics of medical facilities; yet traditional approach attempted to capture these relationships using rigid regression models. We hypothesized that a transfer learning based machine learning algorithm could deeply understand a trauma patient's condition and accurately identify individuals at high risk for mortality without relying on restrictive regression model criteria. Anonymous patient visit data were obtained from years 2007-2014 of the National Trauma Data Bank. Patients with incomplete vitals, unknown outcome, or missing demographics data were excluded. All patient visits occurred in U.S. hospitals, and of the 2,007,485 encounters that were retrospectively examined, 8,198 resulted in mortality (0.4%). The machine intelligence model was evaluated on its sensitivity, specificity, positive and negative predictive value, and Matthews Correlation Coefficient. Our model achieved similar performance in age-specific comparison models and generalized well when applied to all ages simultaneously. While testing for confounding factors, we discovered that excluding fall-related injuries boosted performance for adult trauma patients; however, it reduced performance for children. The machine intelligence model described here demonstrates similar performance to contemporary machine intelligence models without requiring restrictive regression model criteria or extensive medical expertise.

Researchers from Maywood, Ill.-based Loyola Medicine and Loyola University Chicago used an artificial intelligence technique to identify alcohol misuse among trauma patients. The technique was able to differentiate between trauma patients who misused alcohol and those who did not in 78 percent of cases. Researchers published their findings in the Journal of the American Medical Informatics Association. One in three trauma patients misuse alcohol, and many trauma cases are alcohol-related, according to the study. These records included 91,405 EHR clinician notes.

The memory mechanisms of great pond snails could one day help develop drugs for trauma and dementia patients. If you think of a snail, and then think of a human, there are some obvious differences. But decades of studies say our memories might have more in common than some might guess. Memory, and its formation, has been the subject of neuroscientific research for quite some time, yet science has only made incremental steps in this extremely complicated field. One of the recent advances is the discovery that memory is likely similar across organisms, at least at a molecular level.

Identification of patients with overt cardiorespiratory insufficiency or at high risk of impending cardiorespiratory insufficiency is often difficult outside the venue of directly observed patients in highly staffed areas of the hospital, such as the operating room, intensive care unit (ICU) or emergency department. And even in these care locations, identification of cardiorespiratory insufficiency early or predicting its development beforehand is often challenging. The clinical literature has historically prized early recognition of cardiorespiratory insufficiency and its prompt correction as being valuable at minimizing patient morbidity and mortality while simultaneously reducing healthcare costs. Recent data support the statement that integrated monitoring systems that create derived fused parameters of stability or instability using machine learning algorithms, accurately identify cardiorespiratory insufficiency and can predict their occurrence. In this overview, we describe integrated monitoring systems based on established machine learning analysis using various established tools, including artificial neural networks, k?nearest neighbor, support vector machine, random forest classifier and others on routinely acquired non?invasive and invasive hemodynamic measures to identify cardiorespiratory insufficiency and display them in real?time with a high degree of precision.

Missing values are a common problem when applying classification algorithms to real-world medical data. This is especially true for trauma patients, where the emergent nature of the cases makes it difficult to collect all of the relevant data for each patient. Standard methods for handling missingness first learn a model to estimate missing data values, and subsequently train and evaluate a classifier using data imputed with this model. Recently, several proposed methods have demonstrated the benefits of jointly estimating the imputation model and classifier parameters. However, these methods make assumptions that limit their utility with many real-world medical datasets. For example, the assumption that data elements are missing at random is often invalid. We address this situation by exploring a novel approach for jointly learning the imputation model and classifier. Unlike previous algorithms, our approach makes no assumptions about the missingness of the data, can be used with arbitrary probabilistic data models and classification loss functions, and can be used when both the training and testing data have missing values. We investigate the utility of this approach on the prediction of several patient outcomes in a large national registry of trauma patients, and find that it significantly outperforms standard sequential methods.