IEEE INTELLIGENT SYSTEMS Published by the IEEE Computer Society Time-to-Event Predictive Modeling for Chronic Conditions Using Electronic Health Records

chronic illness and the escalating cost of chronic care, the need to facilitate clinical decision making for chronic care has never been higher. However, existing healthcare systems are oriented toward acute problems and are inadequate in managing chronic conditions. To enable effective chronic care, it is critical to be able to capture and represent a patient's disease progression pattern over time so that timely and personalized interventions can be made. Electronic health records (EHRs) are a reliable source of longitudinal observations for monitoring the progression of chronic conditions in clinical practice. Recent years have seen surging interests in EHR data analytics for clinical decision support and knowledge discovery. Although significant progress has been made to move the current practice in this direction, prognostic modeling frameworks and tools tailored for longitudinal EHR data analysis to support chronic care management remain inadequate. Time-to-event modeling (also known as survival analysis) is a statistical technique for representing and predicting the length of time to an event occurrence based on an individual's traits. 1,2 Time-to-event analysis considers not only whether an event will occur, but also the length of time to its occurrence. We use the phrase "time-to-event analysis" instead of "survival analysis" because it's more descriptive of the method and because survival isn't our focus. Indeed, caring for patients with chronic conditions involves a wide array of events other than O ne hundred and forty-one million Americans-almost half the US population-were living with one or more chronic conditions in 2010, and the patient population is expected to increase at a speed of more than 10 million new cases per decade. Given the increasing number people of living with S m a r t a n d C o n n e C t e d H e a l t

Behind the screens: Clinical decision support methodologies - A review

Clinical decision support systems (CDSSs) are interactive software systems designed to assist clinicians with decision making tasks, such as determining diagnosis of patient data. CDSSs are a widely researched topic in the Computer Science community but their workings are less well understood by clinicians. The purpose of this review is to introduce clinicians and policy makers to the most commonly computer-based methodologies employed to construct decision models to compute clinical decisions in a non-technical manner. We hope that a better understanding of CDSSs will open up discussion about the future of CDSSs as a part of healthcare delivery as well as engage clinicians and policy makers in the development and deployment of CDSSs that can meaningfully help with decision making tasks

Prediction of progression in idiopathic pulmonary fibrosis using CT scans atbaseline: A quantum particle swarm optimization - Random forest approach

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterized by an unpredictable progressive declinein lung function. Natural history of IPF is unknown and the prediction of disease progression at the time ofdiagnosis is notoriously difficult. High resolution computed tomography (HRCT) has been used for the diagnosisof IPF, but not generally for monitoring purpose. The objective of this work is to develop a novel predictivemodel for the radiological progression pattern at voxel-wise level using only baseline HRCT scans. Mainly, thereare two challenges: (a) obtaining a data set of features for region of interest (ROI) on baseline HRCT scans andtheir follow-up status; and (b) simultaneously selecting important features from high-dimensional space, andoptimizing the prediction performance. We resolved the first challenge by implementing a study design andhaving an expert radiologist contour ROIs at baseline scans, depending on its progression status in follow-upvisits. For the second challenge, we integrated the feature selection with prediction by developing an algorithmusing a wrapper method that combines quantum particle swarm optimization to select a small number of featureswith random forest to classify early patterns of progression. We applied our proposed algorithm to analyzeanonymized HRCT images from 50 IPF subjects from a multi-center clinical trial. We showed that it yields aparsimonious model with 81.8% sensitivity, 82.2% specificity and an overall accuracy rate of 82.1% at the ROIlevel. These results are superior to other popular feature selections and classification methods, in that ourmethod produces higher accuracy in prediction of progression and more balanced sensitivity and specificity witha smaller number of selected features. Our work is the first approach to show that it is possible to use onlybaseline HRCT scans to predict progressive ROIs at 6 months to 1year follow-ups using artificial intelligence

Psoriasis prediction from genome-wide SNP profiles

<p>Abstract</p> <p>Background</p> <p>With the availability of large-scale genome-wide association study (GWAS) data, choosing an optimal set of SNPs for disease susceptibility prediction is a challenging task. This study aimed to use single nucleotide polymorphisms (SNPs) to predict psoriasis from searching GWAS data.</p> <p>Methods</p> <p>Totally we had 2,798 samples and 451,724 SNPs. Process for searching a set of SNPs to predict susceptibility for psoriasis consisted of two steps. The first one was to search top 1,000 SNPs with high accuracy for prediction of psoriasis from GWAS dataset. The second one was to search for an optimal SNP subset for predicting psoriasis. The sequential information bottleneck (sIB) method was compared with classical linear discriminant analysis(LDA) for classification performance.</p> <p>Results</p> <p>The best test harmonic mean of sensitivity and specificity for predicting psoriasis by sIB was 0.674(95% CI: 0.650-0.698), while only 0.520(95% CI: 0.472-0.524) was reported for predicting disease by LDA. Our results indicate that the new classifier sIB performs better than LDA in the study.</p> <p>Conclusions</p> <p>The fact that a small set of SNPs can predict disease status with average accuracy of 68% makes it possible to use SNP data for psoriasis prediction.</p

Analysis for warning factors of type 2 diabetes mellitus complications with Markov blanket based on a Bayesian network model

Background and objective Type 2 diabetes mellitus (T2DM) complications seriously affect the quality of life and could not be cured completely. Actions should be taken for prevention and self-management. Analysis of warning factors is beneficial for patients, on which some previous studies focused. They generally used the professional medical test factors or complete factors to predict and prevent, but it was inconvenient and impractical for patients to self-manage. With this in mind, this study built a Bayesian network (BN) model, from the perspective of diabetic patients’ self-management and prevention, to predict six complications of T2DM using the selected warning factors which patients could have access from medical examination. Furthermore, the model was analyzed to explore the relationships between physiological variables and T2DM complications, as well as the complications themselves. The model aims to help patients with T2DM self-manage and prevent themselves from complications. Methods The dataset was collected from a well-known data center called the National Health Clinical Center between 1st January 2009 and 31st December 2009. After preprocess and impute the data, a BN model merging expert knowledge was built with Bootstrap and Tabu search algorithm. Markov Blanket (MB) was used to select the warning factors and predict T2DM complications. Moreover, a Bayesian network without prior information (BN-wopi) model learned using 10-fold cross-validation both in structure and in parameters was added to compare with other classifiers learned using 10-fold cross-validation fairly. The warning factors were selected according the structure learned in each fold and were used to predict. Finally, the performance of two BN models using warning features were compared with Naïve Bayes model, Random Forest model, and C5.0 Decision Tree model, which used all features to predict. Besides, the validation parameters of the proposed model were also compared with those in existing studies using some other variables in clinical data or biomedical data to predict T2DM complications. Results Experimental results indicated that the BN models using warning factors performed statistically better than their counterparts using all other variables in predicting T2DM complications. In addition, the proposed BN model were effective and significant in predicting diabetic nephropathy (DN) (AUC: 0.831), diabetic foot (DF) (AUC: 0.905), diabetic macrovascular complications (DMV) (AUC: 0.753) and diabetic ketoacidosis (DK) (AUC: 0.877) with the selected warning factors compared with other experiments. Conclusions The warning factors of DN, DF, DMV, and DK selected by MB in this research might be able to help predict certain T2DM complications effectively, and the proposed BN model might be used as a general tool for prevention, monitoring, and self-management

A Comparative Study of Data Mining Techniques for Credit Scoring in Banking

Shih-Chen Huang and Min-Yuh Day (2013), "A Comparative Study of Data Mining Techniques for Credit Scoring in Banking", in Proceedings of the IEEE International Conference on Information Reuse and Integration (IEEE IRI 2013), San Francisco, California, USA, August 14-16, 2013, pp. 684-691.[[abstract]]Credit is becoming one of the most important incomes of banking. Past studies indicate that the credit risk scoring model has been better for Logistic Regression and Neural Network. The purpose of this paper is to conduct a comparative study on the accuracy of classification models and reduce the credit risk. In this paper, we use data mining of enterprise software to construct four classification models, namely, decision tree, logistic regression, neural network and support vector machine, for credit scoring in banking. We conduct a systematic comparison and analysis on the accuracy of 17 classification models for credit scoring in banking. The contribution of this paper is that we use different classification methods to construct classification models and compare classification models accuracy, and the evidence demonstrates that the support vector machine models have higher accuracy rates and therefore outperform past classification methods in the context of credit scoring in banking.[[sponsorship]]IEEE[[incitationindex]]EI[[conferencetype]]國際[[conferencedate]]20130814~20130816[[booktype]]電子版[[iscallforpapers]]Y[[conferencelocation]]San Francisco, California, US

A hypoglycemic episode diagnosis system based on neural networks for Type 1 diabetes mellitus

Hypoglycemia (or low blood glucose) is dangerous for Type 1 diabetes mellitus (T1DM) patients, as this can cause unconsciousness or even death. However, it is impossible to monitor the hypoglycemia by measuring patients’ blood glucose levels all the time, especially at night. In this paper, a hypoglycemic episode diagnosis system is proposed to determine T1DM patients’ blood glucose levels based on these patients’ physiological parameters which can be measured online. It can be used not only to diagnose hypoglycemic episodes in T1DM patients, but also to generate a set of rules, which describe the domains of physiological parameters that lead to hypoglycemic episodes. The hypoglycemic episode diagnosis system addresses the limitations of the traditional neural network approaches which cannot generate implicit information. The performance of the proposed hypoglycemic episode diagnosis system is evaluated by using real T1DM patients’ data sets collected from the Department of Health, Government of Western Australia, Australia. Results show that satisfactory diagnosis accuracy can be obtained. Also, explicit knowledge can be produced such that the deficiency of traditional neural networks can be overcome. A clear understanding of how they perform diagnosis can be indicated

Diagnosis of hypoglycemic episodes using a neural network based rule discovery system

Hypoglycemia or low blood glucose is dangerous and can result in unconsciousness, seizures and even death for Type 1 diabetes mellitus (T1DM) patients. Based on the T1DM patients’ physiological parameters, corrected QT interval of the electrocardiogram (ECG) signal, change of heart rate, and the change of corrected QT interval, we have developed a neural network based rule discovery system with hybridizing the approaches of neural networks and genetic algorithm to identify the presences of hypoglycemic episodes for TIDM patients. The proposed neural network based rule discovery system is built and is validated by using the real T1DM patients’ data sets collected from Department of Health, Government of Western Australia. Experimental results show that the proposed neural network based rule discovery system can achieve more accurate results on both trained and unseen T1DM patients’ data sets compared with those developed based on the commonly used classification methods for medical diagnosis, statistical regression, fuzzy regression and genetic programming. Apart from the achievement of these better results, the proposed neural network based rule discovery system can provide explicit information in the form of production rules which compensate for the deficiency of traditional neural network method which do not provide a clear understanding of how they work in prediction as they are in an implicit black-box structure. This explicit information provided by the product rules can convince medical doctors to use the neural networks to perform diagnosis of hypoglycemia on T1DM patients