Smart data-driven medical decisions through collective and individual anomaly detection in healthcare time series.

IF 3.7 2区 医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS International Journal of Medical Informatics Pub Date : 2024-11-17 DOI:10.1016/j.ijmedinf.2024.105696
Farbod Khanizadeh, Alireza Ettefaghian, George Wilson, Amirali Shirazibeheshti, Tarek Radwan, Cristina Luca
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Abstract

Background: Anomalies in healthcare refer to deviation from the norm of unusual or unexpected patterns or activities related to patients, diseases or medical centres. Detecting these anomalies is crucial for timely interventions and efficient decision-making, helping to identify issues like operational inefficiencies, fraud and emerging health complications.

Objectives: This study presents a novel method for detecting both collective and individual anomalies in healthcare data through time series analysis using unsupervised machine learning. The dual-strategy approach leverages two methodologies: a 'practice centre-based approach' which monitors changes across different practice centres and a 'process-based approach' which focuses on identifying anomalies within individual centres. The former allows for early detection of systemic issues, while the latter highlights specific irregularities within a centre's operations.

Methods: The study utilised a dataset over 500,000 medical records from multiple GP practice centres in the UK collected between 2018-2023. Data are clustered using DBSCAN to identify collective anomalies from deviations from linear trends in consecutive two-month scatterplots. Individual anomalies are identified by examining the SOM-clustered time series of various medical processes within a specific practice centre, where graphs show deviation from the typical pattern.

Findings: Our approach addresses some challenges posed by the complexity and sensitivity of healthcare data by not requiring personal information. The method offers accurate visual representations making the data accessible and interpretable for non-technical users. Unlike traditional methods focusing solely on subsequence anomalies, our technique analyses the collective behaviour across multiple time series providing a more comprehensive perspective.

Conclusion: This study underscores the importance of integrating unsupervised anomaly detection with clinical expertise to ensure that statistically anomalous patterns align with clinical relevance. The dual-strategy clustering method holds significant potential for enabling timely interventions, proactively identifying potential crises, and ultimately contributing to better decision-making and operational efficiency within the healthcare sector.

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通过医疗时间序列中的集体和个体异常检测,实现数据驱动的智能医疗决策。
背景:医疗保健中的异常现象是指与患者、疾病或医疗中心相关的异常或意外模式或活动偏离常规。检测这些异常现象对于及时干预和高效决策至关重要,有助于发现运营效率低下、欺诈和新出现的健康并发症等问题:本研究提出了一种新方法,利用无监督机器学习,通过时间序列分析检测医疗数据中的集体和个体异常。双策略方法利用了两种方法:一种是 "基于实践中心的方法",用于监控不同实践中心的变化;另一种是 "基于流程的方法",侧重于识别单个中心的异常情况。前者可以及早发现系统性问题,而后者则可以突出中心运营中的具体异常情况:研究利用了 2018-2023 年间从英国多个全科医生实践中心收集的超过 50 万份医疗记录的数据集。使用 DBSCAN 对数据进行聚类,从连续两个月散点图的线性趋势偏差中识别出集体异常。通过检查特定执业中心内各种医疗流程的 SOM 聚类时间序列,发现图示偏离典型模式的个别异常现象:我们的方法不需要个人信息,从而解决了医疗数据的复杂性和敏感性所带来的一些挑战。该方法提供了准确的可视化表示,使非技术用户也能访问和解释数据。与只关注子序列异常的传统方法不同,我们的技术分析了多个时间序列的集体行为,提供了一个更全面的视角:这项研究强调了将无监督异常检测与临床专业知识相结合的重要性,以确保统计异常模式与临床相关性相一致。双策略聚类方法在实现及时干预、主动识别潜在危机以及最终促进医疗保健领域更好的决策和运营效率方面具有巨大潜力。
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来源期刊
International Journal of Medical Informatics
International Journal of Medical Informatics 医学-计算机:信息系统
CiteScore
8.90
自引率
4.10%
发文量
217
审稿时长
42 days
期刊介绍: International Journal of Medical Informatics provides an international medium for dissemination of original results and interpretative reviews concerning the field of medical informatics. The Journal emphasizes the evaluation of systems in healthcare settings. The scope of journal covers: Information systems, including national or international registration systems, hospital information systems, departmental and/or physician''s office systems, document handling systems, electronic medical record systems, standardization, systems integration etc.; Computer-aided medical decision support systems using heuristic, algorithmic and/or statistical methods as exemplified in decision theory, protocol development, artificial intelligence, etc. Educational computer based programs pertaining to medical informatics or medicine in general; Organizational, economic, social, clinical impact, ethical and cost-benefit aspects of IT applications in health care.
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