Automated Mortality Prediction in Critically-ill Patients with Thrombosis using Machine Learning

Venous thromboembolism (VTE) is the third most common cardiovascular condition. Some high risk patients diagnosed with VTE need immediate treatment and monitoring in intensive care units (ICU) as the mortality rate is high. Most of the published predictive models for ICU mortality give information on in-hospital mortality using data recorded in the first day of ICU admission. The purpose of the current study is to predict in-hospital and after-discharge mortality in patients with VTE admitted to ICU using a machine learning (ML) framework. We studied 2,468 patients from the Medical Information Mart for Intensive Care (MIMIC-III) database, admitted to ICU with a diagnosis of VTE. We formed ML classification tasks for early and late mortality prediction. In total, 1,471 features were extracted for each patient, grouped in seven categories each representing a different type of medical assessment. We used an automated ML platform, JADBIO, as well as a class balancing combined with a Random Forest classifier, in order to evaluate the importance of class imbalance. Both methods showed significant ability in prediction of early mortality (AUC=0.92). Nevertheless, the task of predicting late mortality was less efficient (AUC=0.82). To the best of our knowledge, this is the first study in which ML is used to predict short-term and long-term mortality for ICU patients with VTE based on a multitude of clinical features collected over time

Predictive analytics framework for electronic health records with machine learning advancements : optimising hospital resources utilisation with predictive and epidemiological models

The primary aim of this thesis was to investigate the feasibility and robustness of predictive machine-learning models in the context of improving hospital resources’ utilisation with data- driven approaches and predicting hospitalisation with hospital quality assessment metrics such as length of stay. The length of stay predictions includes the validity of the proposed methodological predictive framework on each hospital’s electronic health records data source. In this thesis, we relied on electronic health records (EHRs) to drive a data-driven predictive inpatient length of stay (LOS) research framework that suits the most demanding hospital facilities for hospital resources’ utilisation context. The thesis focused on the viability of the methodological predictive length of stay approaches on dynamic and demanding healthcare facilities and hospital settings such as the intensive care units and the emergency departments. While the hospital length of stay predictions are (internal) healthcare inpatients outcomes assessment at the time of admission to discharge, the thesis also considered (external) factors outside hospital control, such as forecasting future hospitalisations from the spread of infectious communicable disease during pandemics. The internal and external splits are the thesis’ main contributions. Therefore, the thesis evaluated the public health measures during events of uncertainty (e.g. pandemics) and measured the effect of non-pharmaceutical intervention during outbreaks on future hospitalised cases. This approach is the first contribution in the literature to examine the epidemiological curves’ effect using simulation models to project the future hospitalisations on their strong potential to impact hospital beds’ availability and stress hospital workflow and workers, to the best of our knowledge. The main research commonalities between chapters are the usefulness of ensembles learning models in the context of LOS for hospital resources utilisation. The ensembles learning models anticipate better predictive performance by combining several base models to produce an optimal predictive model. These predictive models explored the internal LOS for various chronic and acute conditions using data-driven approaches to determine the most accurate and powerful predicted outcomes. This eventually helps to achieve desired outcomes for hospital professionals who are working in hospital settings

An explainable machine learning framework for lung cancer hospital length of stay prediction

This work introduces a predictive Length of Stay (LOS) framework for lung cancer patients using machine learning (ML) models. The framework proposed to deal with imbalanced datasets for classification-based approaches using electronic healthcare records (EHR). We have utilized supervised ML methods to predict lung cancer inpatients LOS during ICU hospitalization using the MIMIC-III dataset. Random Forest (RF) Model outperformed other models and achieved predicted results during the three framework phases. With clinical significance features selection, over-sampling methods (SMOTE and ADASYN) achieved the highest AUC results (98% with CI 95%: 95.3–100%, and 100% respectively). The combination of Over-sampling and under-sampling achieved the second-highest AUC results (98%, with CI 95%: 95.3–100%, and 97%, CI 95%: 93.7–100% SMOTE-Tomek, and SMOTE-ENN respectively). Under-sampling methods reported the least important AUC results (50%, with CI 95%: 40.2–59.8%) for both (ENN and Tomek- Links). Using ML explainable technique called SHAP, we explained the outcome of the predictive model (RF) with SMOTE class balancing technique to understand the most significant clinical features that contributed to predicting lung cancer LOS with the RF model. Our promising framework allows us to employ ML techniques in-hospital clinical information systems to predict lung cancer admissions into ICU

Computational intelligence contributions to readmisision risk prediction in Healthcare systems

136 p.The Thesis tackles the problem of readmission risk prediction in healthcare systems from a machine learning and computational intelligence point of view. Readmission has been recognized as an indicator of healthcare quality with primary economic importance. We examine two specific instances of the problem, the emergency department (ED) admission and heart failure (HF) patient care using anonymized datasets from three institutions to carry real-life computational experiments validating the proposed approaches. The main difficulties posed by this kind of datasets is their high class imbalance ratio, and the lack of informative value of the recorded variables. This thesis reports the results of innovative class balancing approaches and new classification architectures

Machine learning for real-time prediction of complications induced by flexible uretero-renoscopy with laser lithotripsy

It is not always easy to predict the outcome of a surgery. Peculiarly, when talking about the risks associated to a given intervention or the possible complications that it may bring about. Thus, predicting those potential complications that may arise during or after a surgery will help minimize risks and prevent failures to the greatest extent possible. Therefore, the objectif of this article is to propose an intelligent system based on machine learning, allowing predicting the complications related to a flexible uretero-renoscopy with laser lithotripsy for the treatment of kidney stones. The proposed method achieved accuracy with 100% for training and, 94.33% for testing in hard voting, 100% for testing and 95.38% for training in soft voting, with only ten optimal features. Additionally, we were able to evaluted the machine learning model by examining the most significant features using the shpley additive explanations (SHAP) feature importance plot, dependency plot, summary plot, and partial dependency plots

Predicting diabetes mellitus using SMOTE and ensemble machine learning approach: The Henry Ford ExercIse Testing (FIT) project

Machine learning is becoming a popular and important approach in the field of medical research. In this study, we investigate the relative performance of various machine learning methods such as Decision Tree, Naïve Bayes, Logistic Regression, Logistic Model Tree and Random Forests for predicting incident diabetes using medical records of cardiorespiratory fitness. In addition, we apply different techniques to uncover potential predictors of diabetes. This FIT project study used data of 32,555 patients who are free of any known coronary artery disease or heart failure who underwent clinician-referred exercise treadmill stress testing at Henry Ford Health Systems between 1991 and 2009 and had a complete 5-year follow-up. At the completion of the fifth year, 5,099 of those patients have developed diabetes. The dataset contained 62 attributes classified into four categories: demographic characteristics, disease history, medication use history, and stress test vital signs. We developed an Ensembling-based predictive model using 13 attributes that were selected based on their clinical importance, Multiple Linear Regression, and Information Gain Ranking methods. The negative effect of the imbalance class of the constructed model was handled by Synthetic Minority Oversampling Technique (SMOTE). The overall performance of the predictive model classifier was improved by the Ensemble machine learning approach using the Vote method with three Decision Trees (Naïve Bayes Tree, Random Forest, and Logistic Model Tree) and achieved high accuracy of prediction (AUC = 0.92). The study shows the potential of ensembling and SMOTE approaches for predicting incident diabetes using cardiorespiratory fitness data

Class imbalance impact on the prediction of complications during home hospitalization: a comparative study.

© 2020 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting /republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other worksHome hospitalization (HH) is presented as a healthcare alternative capable of providing high standards of care when patients no longer need hospital facilities. Although HH seems to lower healthcare costs by shortening hospital stays and improving patient's quality of life, the lack of continuous observation at home may lead to complications in some patients. Since blood tests have been proven to provide relevant prognosis information in many diseases, this paper analyzes the impact of different sampling methods on the prediction of HH outcomes. After a first exploratory analysis, some variables extracted from routine blood tests performed at the moment of HH admission, such as hemoglobin, lymphocytes or creatinine, were found to unmask statistically significant differences between patients undergoing successful and unsucessful HH stays. Then, predictive models were built with these data, in order to identify unsuccessful cases eventually needing hospital facilities. However, since these hospital admissions during HH programs are rare, their identification through conventional machine-learning approaches is challenging. Thus, several sampling strategies designed to face class imbalance were herein overviewed and compared. Among the analyzed approaches, over-sampling strategies, such as ROSE (Random Over-Sampling Examples) and conventional random over-sampling, showed the best performances. Nevertheless, further improvements should be proposed in the future so as to better identify those patients not benefiting from HHPeer ReviewedPostprint (author's final draft

Developing A Fair Individualized Polysocial Risk Score (iPsRS) for Identifying Increased Social Risk of Hospitalizations in Patients with Type 2 Diabetes (T2D)

Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is therefore crucial to implement effective social risk management strategies at the point of care. Objective: To develop an EHR-based machine learning (ML) analytical pipeline to identify the unmet social needs associated with hospitalization risk in patients with T2D. Methods: We identified 10,192 T2D patients from the EHR data (from 2012 to 2022) from the University of Florida Health Integrated Data Repository, including contextual SDoH (e.g., neighborhood deprivation) and individual-level SDoH (e.g., housing stability). We developed an electronic health records (EHR)-based machine learning (ML) analytic pipeline, namely individualized polysocial risk score (iPsRS), to identify high social risk associated with hospitalizations in T2D patients, along with explainable AI (XAI) techniques and fairness assessment and optimization. Results: Our iPsRS achieved a C statistic of 0.72 in predicting 1-year hospitalization after fairness optimization across racial-ethnic groups. The iPsRS showed excellent utility for capturing individuals at high hospitalization risk; the actual 1-year hospitalization rate in the top 5% of iPsRS was ~13 times as high as the bottom decile. Conclusion: Our ML pipeline iPsRS can fairly and accurately screen for patients who have increased social risk leading to hospitalization in T2D patients

Detecting Heart Attacks Using Learning Classifiers

Cardiovascular diseases (CVDs) have emerged as a critical global threat to human life. The diagnosis of these diseases presents a complex challenge, particularly for inexperienced doctors, as their symptoms can be mistaken for signs of aging or similar conditions. Early detection of heart disease can help prevent heart failure, making it crucial to develop effective diagnostic techniques. Machine Learning (ML) techniques have gained popularity among researchers for identifying new patients based on past data. While various forecasting techniques have been applied to different medical datasets, accurate detection of heart attacks in a timely manner remains elusive. This article presents a comprehensive comparative analysis of various ML techniques, including Decision Tree, Support Vector Machines, Random Forest, Extreme Gradient Boosting (XGBoost), Adaptive Boosting, Multilayer Perceptron, Gradient Boosting, K-Nearest Neighbor, and Logistic Regression. These classifiers are implemented and evaluated in Python using data from over 300 patients obtained from the Kaggle cardiovascular repository in CSV format. The classifiers categorize patients into two groups: those with a heart attack and those without. Performance evaluation metrics such as recall, precision, accuracy, and the F1-measure are employed to assess the classifiers’ effectiveness. The results of this study highlight XGBoost classifier as a promising tool in the medical domain for accurate diagnosis, demonstrating the highest predictive accuracy (95.082%) with a calculation time of (0.07995 sec) on the dataset compared to other classifiers