Neural networks versus Logistic regression for 30 days all-cause readmission prediction

Heart failure (HF) is one of the leading causes of hospital admissions in the US. Readmission within 30 days after a HF hospitalization is both a recognized indicator for disease progression and a source of considerable financial burden to the healthcare system. Consequently, the identification of patients at risk for readmission is a key step in improving disease management and patient outcome. In this work, we used a large administrative claims dataset to (1)explore the systematic application of neural network-based models versus logistic regression for predicting 30 days all-cause readmission after discharge from a HF admission, and (2)to examine the additive value of patients' hospitalization timelines on prediction performance. Based on data from 272,778 (49% female) patients with a mean (SD) age of 73 years (14) and 343,328 HF admissions (67% of total admissions), we trained and tested our predictive readmission models following a stratified 5-fold cross-validation scheme. Among the deep learning approaches, a recurrent neural network (RNN) combined with conditional random fields (CRF) model (RNNCRF) achieved the best performance in readmission prediction with 0.642 AUC (95% CI, 0.640-0.645). Other models, such as those based on RNN, convolutional neural networks and CRF alone had lower performance, with a non-timeline based model (MLP) performing worst. A competitive model based on logistic regression with LASSO achieved a performance of 0.643 AUC (95%CI, 0.640-0.646). We conclude that data from patient timelines improve 30 day readmission prediction for neural network-based models, that a logistic regression with LASSO has equal performance to the best neural network model and that the use of administrative data result in competitive performance compared to published approaches based on richer clinical datasets

A New Method of Marking Fresh-water Mussels for Field Study

A review of previously used methods of marking mussels and a description of a new system developed for field use are presented. A code numbering system, utilizing holes drilled into the shell, is described and evaluated

Overcoming New Hire Obstacles with an Individualized RN Orientation in the Critical Care Area

To improve RN new hire orientation in the Cardiac Care Unit (CCU). Research reveals we tend to assign two patients to a new hire too early. They may not be able to safely care for two acutely ill patients, causing both the new hire and preceptor to become frustrated.https://digitalcommons.centracare.com/nursing_posters/1102/thumbnail.jp

Document image archive transfer from DOS to UNIX

An R&D division of the National Library of Medicine has developed a prototype system for automated document image delivery as an adjunct to the labor-intensive manual interlibrary loan service of the library. The document image archive is implemented by a PC controlled bank of optical disk drives which use 12 inch WORM platters containing bitmapped images of over 200,000 pages of medical journals. Following three years of routine operation which resulted in serving patrons with articles both by mail and fax, an effort is underway to relocate the storage environment from the DOS-based system to a UNIX-based jukebox whose magneto-optical erasable 5 1/4 inch platters hold the images. This paper describes the deficiencies of the current storage system, the design issues of modifying several modules in the system, the alternatives proposed and the tradeoffs involved

Automatic Segmentation of Subfigure Image Panels for Multimodal Biomedical Document Retrieval

Biomedical images are often referenced for clinical decision support (CDS), educational purposes, and research. The task of automatically finding the images in a scientific article that are most useful for the purpose of determining relevance to a clinical situation is traditionally done using text and is quite challenging. We propose to improve this by associating image features from the entire image and from relevant regions of interest with biomedical concepts described in the figure caption or discussion in the article. However, images used in scientific article figures are often composed of multiple panels where each sub-figure (panel) is referenced in the caption using alphanumeric labels, e.g. Figure 1(a), 2(c), etc. It is necessary to separate individual panels from a multi-panel figure as a first step toward automatic annotation of images. In this work we present methods that add make robust our previous efforts reported here. Specifically, we address the limitation in segmenting figures that do not exhibit explicit inter-panel boundaries, e.g. illustrations, graphs, and charts. We present a novel hybrid clustering algorithm based on particle swarm optimization (PSO) with fuzzy logic controller (FLC) to locate related figure components in such images. Results from our evaluation are very promising with 93.64% panel detection accuracy for regular (non-illustration) figure images and 92.1% accuracy for illustration images. A computational complexity analysis also shows that PSO is an optimal approach with relatively low computation time. The accuracy of separating these two type images is 98.11% and is achieved using decision tree

Is the bang worth the buck? A RAID performance study

Expecting a high data delivery rate as well as data protection, the Lister Hill National Center for Biomedical Communications procured a RAID system to house image files for image delivery applications. A study was undertaken to determine the configuration of the RAID system that would provide for the fastest retrieval of image files. Average retrieval times with single and with concurrent users were measured for several stripe widths and several numbers of disks for RAID levels 0, 0+1 and 5. These are compared to each other and to average retrieval times for non-RAID configurations of the same hardware. Although the study in ongoing, a few conclusions have emerged regarding the tradeoffs among the different configurations with respect to file retrieval speed and cost

Vertebra Shape Classification using MLP for Content-Based Image Retrieval

A desirable content-based image retrieval (CBIR) system would classify extracted image features to support some form of semantic retrieval. The Lister Hill National Center for Biomedical Communications, an intramural R&D division of the National Library for Medicine (NLM), maintains an archive of digitized X-rays of the cervical and lumbar spine taken as part of the second national health and nutrition examination survey (NHANES II). It is our goal to provide shape-based access to digitized X-rays including retrieval on automatically detected and classified pathology, e.g., anterior osteophytes. This is done using radius of curvature analysis along the anterior portion, and morphological analysis for quantifying protrusion regions along the vertebra boundary. Experimental results are presented for the classification of 704 cervical spine vertebrae by evaluating the features using a multi-layer perceptron (MLP) based approach. In this paper, we describe the design and current status of the content-based image retrieval (CBIR) system and the role of neural networks in the design of an effective multimedia information retrieval system

Regulatory Responsibility in the Atomic Energy Program ( A Symposium)

The regulatory actions taken by federal, state and local governments will exert a great impact on the present and future development of the civilian atomic energy program. All are aware of the tremendous potential that atomic energy holds for mankind. All are equally aware, on the negative side, of the potential radiation hazards associated with the use of radiation and radioactive materials. These hazards must be controlled so that the full realization of atomic energy benefits may be enjoyed

Graphical Image Classification Combining an Evolutionary Algorithm and Binary Particle Swarm Optimization

Biomedical journal articles contain a variety of image types that can be broadly classified into two categories: regular images, and graphical images. Graphical images can be further classified into four classes: diagrams, statistical figures, flow charts, and tables. Automatic figure type identification is an important step toward improved multimodal (text + image) information retrieval and clinical decision support applications. This paper describes a feature-based learning approach to automatically identify these four graphical figure types. We apply Evolutionary Algorithm (EA), Binary Particle Swarm Optimization (BPSO) and a hybrid of EA and BPSO (EABPSO) methods to select an optimal subset of extracted image features that are then classified using a Support Vector Machine (SVM) classifier. Evaluation performed on 1038 figure images extracted from ten BioMedCentral® journals with the features selected by EABPSO yielded classification accuracy as high as 87.5%

Live Wire Segmentation Tool for Osteophyte Detection in Lumbar Spine X-Ray Images

Computer-assisted vertebra segmentation in x-ray images is a challenging problem. Inter-subject variability and the generally poor contrast of digitized radiograph images contribute to the segmentation difficulty. In this paper, a semi-automated live wire approach is investigated for vertebrae segmentation. The live wire approach integrates initially selected user points with dynamic programming to generate a closed vertebra boundary. In order to assess the degree to which vertebra features are conserved using the live wire technique, convex hull-based features to characterize anterior osteophytes in lumbar vertebrae are determined for live wire and manually segmented vertebrae. Anterior osteophyte discrimination was performed over 405 lumbar vertebrae, 204 abnormal vertebrae with anterior osteophytes and 201 normal vertebrae. A leave-one-out standard back propagation neural network was used for vertebrae segmentation. Experimental results show that manual segmentation yielded slightly better discrimination results than the live wire technique