Predicting diabetes-related hospitalizations based on electronic health records

OBJECTIVE: To derive a predictive model to identify patients likely to be hospitalized during the following year due to complications attributed to Type II diabetes. METHODS: A variety of supervised machine learning classification methods were tested and a new method that discovers hidden patient clusters in the positive class (hospitalized) was developed while, at the same time, sparse linear support vector machine classifiers were derived to separate positive samples from the negative ones (non-hospitalized). The convergence of the new method was established and theoretical guarantees were proved on how the classifiers it produces generalize to a test set not seen during training. RESULTS: The methods were tested on a large set of patients from the Boston Medical Center - the largest safety net hospital in New England. It is found that our new joint clustering/classification method achieves an accuracy of 89% (measured in terms of area under the ROC Curve) and yields informative clusters which can help interpret the classification results, thus increasing the trust of physicians to the algorithmic output and providing some guidance towards preventive measures. While it is possible to increase accuracy to 92% with other methods, this comes with increased computational cost and lack of interpretability. The analysis shows that even a modest probability of preventive actions being effective (more than 19%) suffices to generate significant hospital care savings. CONCLUSIONS: Predictive models are proposed that can help avert hospitalizations, improve health outcomes and drastically reduce hospital expenditures. The scope for savings is significant as it has been estimated that in the USA alone, about $5.8 billion are spent each year on diabetes-related hospitalizations that could be prevented.Accepted manuscrip

Preterm Birth Prediction: Deriving Stable and Interpretable Rules from High Dimensional Data

Preterm births occur at an alarming rate of 10-15%. Preemies have a higher risk of infant mortality, developmental retardation and long-term disabilities. Predicting preterm birth is difficult, even for the most experienced clinicians. The most well-designed clinical study thus far reaches a modest sensitivity of 18.2-24.2% at specificity of 28.6-33.3%. We take a different approach by exploiting databases of normal hospital operations. We aims are twofold: (i) to derive an easy-to-use, interpretable prediction rule with quantified uncertainties, and (ii) to construct accurate classifiers for preterm birth prediction. Our approach is to automatically generate and select from hundreds (if not thousands) of possible predictors using stability-aware techniques. Derived from a large database of 15,814 women, our simplified prediction rule with only 10 items has sensitivity of 62.3% at specificity of 81.5%.Comment: Presented at 2016 Machine Learning and Healthcare Conference (MLHC 2016), Los Angeles, C

Mining health knowledge graph for health risk prediction

Nowadays classification models have been widely adopted in healthcare, aiming at supporting practitioners for disease diagnosis and human error reduction. The challenge is utilising effective methods to mine real-world data in the medical domain, as many different models have been proposed with varying results. A large number of researchers focus on the diversity problem of real-time data sets in classification models. Some previous works developed methods comprising of homogeneous graphs for knowledge representation and then knowledge discovery. However, such approaches are weak in discovering different relationships among elements. In this paper, we propose an innovative classification model for knowledge discovery from patients’ personal health repositories. The model discovers medical domain knowledge from the massive data in the National Health and Nutrition Examination Survey (NHANES). The knowledge is conceptualised in a heterogeneous knowledge graph. On the basis of the model, an innovative method is developed to help uncover potential diseases suffered by people and, furthermore, to classify patients’ health risk. The proposed model is evaluated by comparison to a baseline model also built on the NHANES data set in an empirical experiment. The performance of proposed model is promising. The paper makes significant contributions to the advancement of knowledge in data mining with an innovative classification model specifically crafted for domain-based data. In addition, by accessing the patterns of various observations, the research contributes to the work of practitioners by providing a multifaceted understanding of individual and public health

Centralized and distributed learning methods for predictive health analytics

The U.S. health care system is considered costly and highly inefficient, devoting substantial resources to the treatment of acute conditions in a hospital setting rather than focusing on prevention and keeping patients out of the hospital. The potential for cost savings is large; in the U.S. more than $30 billion are spent each year on hospitalizations deemed preventable, 31% of which is attributed to heart diseases and 20% to diabetes. Motivated by this, our work focuses on developing centralized and distributed learning methods to predict future heart- or diabetes- related hospitalizations based on patient Electronic Health Records (EHRs). We explore a variety of supervised classification methods and we present a novel likelihood ratio based method (K-LRT) that predicts hospitalizations and offers interpretability by identifying the K most significant features that lead to a positive prediction for each patient. Next, assuming that the positive class consists of multiple clusters (hospitalized patients due to different reasons), while the negative class is drawn from a single cluster (non-hospitalized patients healthy in every aspect), we present an alternating optimization approach, which jointly discovers the clusters in the positive class and optimizes the classifiers that separate each positive cluster from the negative samples. We establish the convergence of the method and characterize its VC dimension. Last, we develop a decentralized cluster Primal-Dual Splitting (cPDS) method for large-scale problems, that is computationally efficient and privacy-aware. Such a distributed learning scheme is relevant for multi-institutional collaborations or peer-to-peer applications, allowing the agents to collaborate, while keeping every participant's data private. cPDS is proved to have an improved convergence rate compared to existing centralized and decentralized methods. We test all methods on real EHR data from the Boston Medical Center and compare results in terms of prediction accuracy and interpretability

Machine Learning and Integrative Analysis of Biomedical Big Data.

Recent developments in high-throughput technologies have accelerated the accumulation of massive amounts of omics data from multiple sources: genome, epigenome, transcriptome, proteome, metabolome, etc. Traditionally, data from each source (e.g., genome) is analyzed in isolation using statistical and machine learning (ML) methods. Integrative analysis of multi-omics and clinical data is key to new biomedical discoveries and advancements in precision medicine. However, data integration poses new computational challenges as well as exacerbates the ones associated with single-omics studies. Specialized computational approaches are required to effectively and efficiently perform integrative analysis of biomedical data acquired from diverse modalities. In this review, we discuss state-of-the-art ML-based approaches for tackling five specific computational challenges associated with integrative analysis: curse of dimensionality, data heterogeneity, missing data, class imbalance and scalability issues

A Review on Explainable Artificial Intelligence for Healthcare: Why, How, and When?

Artificial intelligence (AI) models are increasingly finding applications in the field of medicine. Concerns have been raised about the explainability of the decisions that are made by these AI models. In this article, we give a systematic analysis of explainable artificial intelligence (XAI), with a primary focus on models that are currently being used in the field of healthcare. The literature search is conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards for relevant work published from 1 January 2012 to 02 February 2022. The review analyzes the prevailing trends in XAI and lays out the major directions in which research is headed. We investigate the why, how, and when of the uses of these XAI models and their implications. We present a comprehensive examination of XAI methodologies as well as an explanation of how a trustworthy AI can be derived from describing AI models for healthcare fields. The discussion of this work will contribute to the formalization of the XAI field.Comment: 15 pages, 3 figures, accepted for publication in the IEEE Transactions on Artificial Intelligenc

Decision support continuum paradigm for cardiovascular disease: Towards personalized predictive models

Clinical decision making is a ubiquitous and frequent task physicians make in their daily clinical practice. Conventionally, physicians adopt a cognitive predictive modelling process (i.e. knowledge and experience learnt from past lecture, research, literature, patients, etc.) for anticipating or ascertaining clinical problems based on clinical risk factors that they deemed to be most salient. However, with the inundation of health data and the confounding characteristics of diseases, more effective clinical prediction approaches are required to address these challenges. Approximately a few century ago, the first major transformation of medical practice took place as science-based approaches emerged with compelling results. Now, in the 21st century, new advances in science will once again transform healthcare. Data science has been postulated as an important component in this healthcare reform and has received escalating interests for its potential for ‘personalizing’ medicine. The key advantages of having personalized medicine include, but not limited to, (1) more effective methods for disease prevention, management and treatment, (2) improved accuracy for clinical diagnosis and prognosis, (3) provide patient-oriented personal health plan, and (4) cost containment. In view of the paramount importance of personalized predictive models, this thesis proposes 2 novel learning algorithms (i.e. an immune-inspired algorithm called the Evolutionary Data-Conscious Artificial Immune Recognition System, and a neural-inspired algorithm called the Artificial Neural Cell System for classification) and 3 continuum-based paradigms (i.e. biological, time and age continuum) for enhancing clinical prediction. Cardiovascular disease has been selected as the disease under investigation as it is an epidemic and major health concern in today’s world. We believe that our work has a meaningful and significant impact to the development of future healthcare system and we look forward to the wide adoption of advanced medical technologies by all care centres in the near future.Open Acces

Mining and Integration of Structured and Unstructured Electronic Clinical Data for Dementia Detection

Dementia is an increasing problem for the aging population that incurs high medical costs, in part due to the lack of available treatment options. Accordingly, early detection is critical to potentially postpone symptoms and to prepare both healthcare providers and families for a patient\u27s management needs. Current detection methods are typically costly or unreliable, and could greatly benefit from improved recognition of early dementia markers. Identification of such markers may be possible through computational analysis of patients\u27 electronic clinical records. Prior work on has focused on structured data (e.g. test results), but these records often also contain natural language (text) data in the form of patient histories, visit summaries, or other notes, which may be valuable for disease prediction. This thesis has three main goals: to incorporate analysis of the aforementioned electronic medical texts into predictive models of dementia development, to explore the use of topic modeling as a form of interpretable dimensionality reduction to improve prediction and to characterize the texts, and to integrate these models with ones using structured data. This kind of computational modeling could be used in an automated screening system to identify and flag potentially problematic patients for assessment by clinicians. Results support the potential for unstructured clinical text data both as standalone predictors of dementia status when structured data are missing, and as complements to structured data

Data Mining Techniques for Complex User-Generated Data

Nowadays, the amount of collected information is continuously growing in a variety of different domains. Data mining techniques are powerful instruments to effectively analyze these large data collections and extract hidden and useful knowledge. Vast amount of User-Generated Data (UGD) is being created every day, such as user behavior, user-generated content, user exploitation of available services and user mobility in different domains. Some common critical issues arise for the UGD analysis process such as the large dataset cardinality and dimensionality, the variable data distribution and inherent sparseness, and the heterogeneous data to model the different facets of the targeted domain. Consequently, the extraction of useful knowledge from such data collections is a challenging task, and proper data mining solutions should be devised for the problem under analysis. In this thesis work, we focus on the design and development of innovative solutions to support data mining activities over User-Generated Data characterised by different critical issues, via the integration of different data mining techniques in a unified frame- work. Real datasets coming from three example domains characterized by the above critical issues are considered as reference cases, i.e., health care, social network, and ur- ban environment domains. Experimental results show the effectiveness of the proposed approaches to discover useful knowledge from different domains