利用传统机器学习模型从爱尔兰医院出院记录中预测患者早期再入院情况

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2024-10-29 DOI:10.3390/diagnostics14212405
Minh-Khoi Pham, Tai Tan Mai, Martin Crane, Malick Ebiele, Rob Brennan, Marie E Ward, Una Geary, Nick McDonald, Marija Bezbradica
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引用次数: 0

摘要

背景/目的:预测患者再入院是医疗风险管理的一项重要任务,因为它有助于预防不良事件、降低成本和改善患者预后。在本文中,我们在爱尔兰一家急症医院的电子出院记录多模态数据集上比较了各种传统机器学习模型和深度学习模型:我们评估了几种广泛使用的机器学习模型的有效性,这些模型利用患者人口统计学特征、历史住院记录和临床诊断代码来预测未来的临床风险。我们的工作重点是解决医疗领域的两大难题:数据不平衡和数据类型繁多,以提高机器学习算法的性能。此外,我们还采用了SHAPLE Additive Explanations(SHAP)值可视化来解释模型预测,并识别出与再入院风险相关的关键数据特征和疾病代码,确定了一组特定的诊断代码,它们是30天内再入院的重要预测因素:通过广泛的基准测试和各种特征工程技术的应用,我们成功地将测试数据集上所有模型的曲线下面积 (AUROC) 分数从 0.628 提高到 0.7。我们还发现,特定诊断(包括癌症、慢性阻塞性肺病和某些社会因素)是 30 天再入院风险的重要预测因素。相反,由于病例频率较低,细菌携带者状态似乎影响甚微:我们的研究展示了我们如何有效地利用日常收集的医院数据,通过使用传统的机器学习来预测患者的再入院情况,同时应用可解释的人工智能技术来探索数据特征与患者再入院率之间的相关性。
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Forecasting Patient Early Readmission from Irish Hospital Discharge Records Using Conventional Machine Learning Models.

Background/objectives: Predicting patient readmission is an important task for healthcare risk management, as it can help prevent adverse events, reduce costs, and improve patient outcomes. In this paper, we compare various conventional machine learning models and deep learning models on a multimodal dataset of electronic discharge records from an Irish acute hospital.

Methods: We evaluate the effectiveness of several widely used machine learning models that leverage patient demographics, historical hospitalization records, and clinical diagnosis codes to forecast future clinical risks. Our work focuses on addressing two key challenges in the medical fields, data imbalance and the variety of data types, in order to boost the performance of machine learning algorithms. Furthermore, we also employ SHapley Additive Explanations (SHAP) value visualization to interpret the model predictions and identify both the key data features and disease codes associated with readmission risks, identifying a specific set of diagnosis codes that are significant predictors of readmission within 30 days.

Results: Through extensive benchmarking and the application of a variety of feature engineering techniques, we successfully improved the area under the curve (AUROC) score from 0.628 to 0.7 across our models on the test dataset. We also revealed that specific diagnoses, including cancer, COPD, and certain social factors, are significant predictors of 30-day readmission risk. Conversely, bacterial carrier status appeared to have minimal impact due to lower case frequencies.

Conclusions: Our study demonstrates how we effectively utilize routinely collected hospital data to forecast patient readmission through the use of conventional machine learning while applying explainable AI techniques to explore the correlation between data features and patient readmission rate.

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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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