Data mining predictive models for pervasive intelligent decision support in intensive care medicine

The introduction of an Intelligent Decision Support System (IDSS) in a critical area like the Intensive Medicine is a complex and difficult process. In this area, their professionals don’t have much time to document the cases, because the patient direct care is always first. With the objective to reduce significantly the manual records and, enabling, at the same time, the possibility of developing an IDSS which can help in the decision making process, all data acquisition process and knowledge discovery in database phases were automated. From the data acquisition to the knowledge discovering, the entire process is autonomous and executed in real-time. On-line induced data mining models were used to predict organ failure and outcome. Preliminary results obtained with a limited population of patients showed that this approach can be applied successfully.Fundação para a Ciência e a Tecnologia (FCT

Using domain knowledge to improve intelligent decision support in intensive medicine - a study of bacteriological infections

Nowadays antibiotic prescription is object of study in many countries. The rate of prescription varies from country to country, without being found the reasons that justify those variations. In intensive care units the number of new infections rising each day is caused by multiple factors like inpatient length of stay, low defences of the body, chirurgical infections, among others. In order to complement the support of the decision process about which should be the most efficient antibiotic it was developed a heuristic based in domain knowledge extracted from biomedical experts. This algorithm is implemented by intelligent agents. When an alert appear on the presence of a new infection, an agent collects the microbiological results for cultures, it permits to identify the bacteria, then using the rules it searches for a role of antibiotics that can be administered to the patient, based on past results. At the end the agent presents to physicians the top-five sets and the success percentage of each antibiotic. This paper presents the approach proposed and a test with a particular bacterium using real data provided by an Intensive Care Unit.This work has been supported by FCT – Fundação para a Ciência e Tecnologia in the scope of the project: Pest-OE/EEI/UI0319/2014 and PEst-OE/EEI/UI0752/2014. The authors would like to thank FCT (Foundation of Science and Technology, Portugal) for the financial support through the contract PTDC/EEI-SII/1302/2012 (INTCare II)

Optimization techniques to detect early ventilation extubation in intensive care units

The decision support models in intensive care units are developed to support medical staff in their decision making process. However, the optimization of these models is particularly difficult to apply due to dynamic, complex and multidisciplinary nature. Thus, there is a constant research and development of new algorithms capable of extracting knowledge from large volumes of data, in order to obtain better predictive results than the current algorithms. To test the optimization techniques a case study with real data provided by INTCare project was explored. This data is concerning to extubation cases. In this dataset, several models like Evolutionary Fuzzy Rule Learning, Lazy Learning, Decision Trees and many others were analysed in order to detect early extubation. The hydrids Decision Trees Genetic Algorithm, Supervised Classifier System and KNNAdaptive obtained the most accurate rate 93.2%, 93.1%, 92.97% respectively, thus showing their feasibility to work in a real environment.This work has been supported by FCT-Fundação para a Ciência e Tecnologia within the Project Scope UID/CEC/00319/2013. The authors would like to thank FCT for the financial support through the contract PTDC/EEI - SII/1302/2012 (INTCare II

Pervasive Business Intelligence: A New Trend in Critical Healthcare

In the field of intensive medicine, presentation of medical information is identified as a major concern for the health professionals, since it can be a great aid when it is necessary to make decisions, of varying gravity, for the patient's state. The way in which this information is presented, and especially when it is presented, may make it difficult for the intensivists within intense healthcare units to understand a patient's state in a timely fashion. Should there be a need to cross various types of clinical data from various sources, the situation worsens considerably. To support the health professional's decision-making process, the Pervasive Business Intelligence (PBI) Systems are a forthcoming field. Based on this principle, the current study approaches the way to present information about the patients, after they are received in a BI system, making them available at any place and at any time for the intensivists that may need it for the decision-making. The patient's history will, therefore, be available, allowing examination of the vital signs data, what medicine that they might need, health checks performed, among others. Then, it is of vital importance, to make these conclusions available to the health professionals every time they might need, so as to aid them in the decision-making. This study aims to make a stance by approaching the theme of PBI in Critical Healthcare. The main objective is to understand the underlying concepts and the assets of BI solutions with Pervasive characteristics. Perhaps consider it a sort of guide or a path to follow for those who wish to insert Pervasive into Business Intelligence in Healthcare area.Fundação para a Ciência e Tecnologia within the Project Scope UID/CEC/00319/2013info:eu-repo/semantics/publishedVersio

Real-Time models to predict the use of vasopressors in monitored patients

The needs of reducing human error has been growing in every field of study, and medicine is one of those. Through the implementation of technologies is possible to help in the decision making process of clinics, therefore to reduce the difficulties that are typically faced. This study focuses on easing some of those difficulties by presenting real-time data mining models capable of predicting if a monitored patient, typically admitted in intensive care, will need to take vasopressors. Data Mining models were induced using clinical variables such as vital signs, laboratory analysis, among others. The best model presented a sensitivity of 94.94%. With this model it is possible reducing the misuse of vasopressors acting as prevention. At same time it is offered a better care to patients by anticipating their treatment with vasopressors

A clustering approach for predicting readmissions in intensive medicine

Decision making assumes a critical role in the Intensive Medicine. Data Mining is emerging in the clinical area to provide processes and technologies for transforming data into useful knowledge to support clinical decision makers. Appling clustering techniques to the data available on the patients admitted into Intensive Care Units and knowing which ones correspond to readmissions, it is possible to create meaningful clusters that will represent the base characteristics of readmitted patients. Thus, exploring common characteristics it is possible to prevent discharges that will result into readmissions and then improve the patient outcome and reduce costs. Moreover, readmitted patients present greater difficulty to be recovered. In this work it was followed the Stability and Workload Index for Transfer (SWIFT). A subset of variables from SWIFT was combined with the results from laboratory exams, namely the Lactic Acid and the Leucocytes values, in order to create clusters to identify, in the moment of discharge, patients that probably will be readmitted

Real-time decision support in intensive medicine: an intelligent approach for monitoring data quality

Intensive Medicine is an area where big amounts of data are generated every day. The process to obtain knowledge from these data is extremely difficult and sometimes dangerous. The main obstacles of this process are the number of data collected manually and the quality of the data collected automatically. Information quality is a major constrain to the success of Intelligent Decision Support Systems (IDSS). This is the case of INTCare an IDSS which operates in real-time. Data quality needs to be ensured in a continuous way. The quality must be assured essentially in the data acquisition process and in the evaluation of the results obtained from data mining models. To automate this process a set of intelligent agents have been developed to perform a set of data quality tasks. This paper explores the data quality issues in IDSS and presents an intelligent approach for monitoring the data quality in INTCare system.Fundação para a Ciência e a Tecnologia (FCT

Pervasive intelligent decision support system: technology acceptance in intensive care units

Intensive Care Units are considered a critical environment where the decision needs to be carefully taken. The real-time recognition of the condition of the patient is important to drive the decision process efficiently. In order to help the decision process, a Pervasive Intelligent Decision Support System (PIDSS) was developed. To provide a better comprehension of the acceptance of the PIDSS it is very important to assess how the users accept the system at level of usability and their importance in the Decision Making Process. This assessment was made using the four constructs proposed by the Technology Acceptance Methodology and a questionnaire-based approach guided by the Delphi Methodology. The results obtained so far show that although the users are satisfied with the offered information recognizing its importance, they demand for a faster system.Fundação para a Ciência e a Tecnologia (FCT

Real-time predictive analytics for sepsis level and therapeutic plans in intensive care medicine

"Accepted for publication"This work aims to support doctor’s decision-making on predicting sepsis level and the best treatment for patients with microbiological problems. A set of Data Mining (DM) models was developed using forecasting techniques and classification models which will enable doctors’ decisions about the appropriate therapy to apply, as well as the most successful one. The data used in DM models were collected at the Intensive Care Unit (ICU) of the Centro Hospitalar do Porto, in Oporto, Portugal. Classification models where considered to predict sepsis level and therapeutic plan for patients with sepsis in a supervised learning approach. Models were induced making use of the following algorithms: Decision Trees, Support Vector Machines and Naïve Bayes classifier. Confusion Matrix, including associated metrics, and Cross-validation were used for the evaluation. Analysis of the total error rate, sensitivity, specificity and accuracy were the associated metrics used to identify the most relevant measures to predict sepsis level and treatment plan under study. In conclusion, it was possible to predict with great accuracy the sepsis level (2nd and 3rd), but not the therapeutic plan. Although the good results attained for sepsis (accuracy: 100%), therapeutic plan does not present the same level of accuracy (best: 62.8%).FCT -Fundação para a Ciência e a Tecnologia(PEst-OE/EEI/UI0319/2014

Real-time data mining models for predicting length of stay in intensive care units

Nowadays the efficiency of costs and resources planning in hospitals embody a critical role in the management of these units. Length Of Stay (LOS) is a good metric when the goal is to decrease costs and to optimize resources. In Intensive Care Units (ICU) optimization assumes even a greater importance derived from the high costs associated to inpatients. This study presents two data mining approaches to predict LOS in an ICU. The first approach considered the admission variables and some other physiologic variables collected during the first 24 hours of inpatient. The second approach considered admission data and supplementary clinical data of the patient (vital signs and laboratory results) collected in real-time. The results achieved in the first approach are very poor (accuracy of 73 %). However, when the prediction is made using the data collected in real-time, the results are very interesting (sensitivity of 96.104%). The models induced in second experiment are sensitive to the patient clinical situation and can predict LOS according to the monitored variables. Models for predicting LOS at admission are not suited to the ICU particularities. Alternatively, they should be induced in real-time, using online-learning and considering the most recent patient condition when the model is induced.(undefined