scholarly journals An empirical characterization of fair machine learning for clinical risk prediction

2020 ◽  
pp. 103621
Author(s):  
Stephen R. Pfohl ◽  
Agata Foryciarz ◽  
Nigam H. Shah
Keyword(s):  
Machine Learning ◽  
Risk Prediction ◽  
Clinical Risk

Performance Metrics for the Comparative Analysis of Clinical Risk Prediction Models Employing Machine Learning

2021 ◽  
Author(s):  
Chenxi Huang ◽  
Shu-Xia Li ◽  
César Caraballo ◽  
Frederick A. Masoudi ◽  
John S. Rumsfeld ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Prediction ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Performance Metrics ◽  
Prediction Models ◽  
Learning Models ◽  
Risk Prediction Models ◽  
Clinical Risk ◽  
Machine Learning Models

Background: New methods such as machine learning techniques have been increasingly used to enhance the performance of risk predictions for clinical decision-making. However, commonly reported performance metrics may not be sufficient to capture the advantages of these newly proposed models for their adoption by health care professionals to improve care. Machine learning models often improve risk estimation for certain subpopulations that may be missed by these metrics. Methods and Results: This article addresses the limitations of commonly reported metrics for performance comparison and proposes additional metrics. Our discussions cover metrics related to overall performance, discrimination, calibration, resolution, reclassification, and model implementation. Models for predicting acute kidney injury after percutaneous coronary intervention are used to illustrate the use of these metrics. Conclusions: We demonstrate that commonly reported metrics may not have sufficient sensitivity to identify improvement of machine learning models and propose the use of a comprehensive list of performance metrics for reporting and comparing clinical risk prediction models.

scholarly journals Clinical risk prediction with random forests for survival, longitudinal, and multivariate (RF-SLAM) data analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Shannon Wongvibulsin ◽  
Katherine C. Wu ◽  
Scott L. Zeger
Keyword(s):  
Machine Learning ◽  
Data Analysis ◽  
Random Forest ◽  
Risk Prediction ◽  
Left Ventricular ◽  
Machine Learning Algorithms ◽  
Superior Performance ◽  
Time Varying ◽  
Clinical Risk ◽  
Multiple Variables

Abstract Background Clinical research and medical practice can be advanced through the prediction of an individual’s health state, trajectory, and responses to treatments. However, the majority of current clinical risk prediction models are based on regression approaches or machine learning algorithms that are static, rather than dynamic. To benefit from the increasing emergence of large, heterogeneous data sets, such as electronic health records (EHRs), novel tools to support improved clinical decision making through methods for individual-level risk prediction that can handle multiple variables, their interactions, and time-varying values are necessary. Methods We introduce a novel dynamic approach to clinical risk prediction for survival, longitudinal, and multivariate (SLAM) outcomes, called random forest for SLAM data analysis (RF-SLAM). RF-SLAM is a continuous-time, random forest method for survival analysis that combines the strengths of existing statistical and machine learning methods to produce individualized Bayes estimates of piecewise-constant hazard rates. We also present a method-agnostic approach for time-varying evaluation of model performance. Results We derive and illustrate the method by predicting sudden cardiac arrest (SCA) in the Left Ventricular Structural (LV) Predictors of Sudden Cardiac Death (SCD) Registry. We demonstrate superior performance relative to standard random forest methods for survival data. We illustrate the importance of the number of preceding heart failure hospitalizations as a time-dependent predictor in SCA risk assessment. Conclusions RF-SLAM is a novel statistical and machine learning method that improves risk prediction by incorporating time-varying information and accommodating a large number of predictors, their interactions, and missing values. RF-SLAM is designed to easily extend to simultaneous predictions of multiple, possibly competing, events and/or repeated measurements of discrete or continuous variables over time.Trial registration: LV Structural Predictors of SCD Registry (clinicaltrials.gov, NCT01076660), retrospectively registered 25 February 2010

A feature-based hybrid recommender system for risk prediction : Machine learning approach (Preprint)

2020 ◽  
Author(s):  
Uzair Bhatti
Keyword(s):  
Machine Learning ◽  
Risk Prediction ◽  
Predictive Accuracy ◽  
Correct Diagnosis ◽  
Recommendation Systems ◽  
Data Integrity ◽  
Machine Learning Algorithms ◽  
Patient Counseling ◽  
Hybrid Filtering ◽  
Novel Algorithm

BACKGROUND In the era of health informatics, exponential growth of information generated by health information systems and healthcare organizations demands expert and intelligent recommendation systems. It has become one of the most valuable tools as it reduces problems such as information overload while selecting and suggesting doctors, hospitals, medicine, diagnosis etc according to patients’ interests. OBJECTIVE Recommendation uses Hybrid Filtering as one of the most popular approaches, but the major limitations of this approach are selectivity and data integrity issues.Mostly existing recommendation systems & risk prediction algorithms focus on a single domain, on the other end cross-domain hybrid filtering is able to alleviate the degree of selectivity and data integrity problems to a better extent. METHODS We propose a novel algorithm for recommendation & predictive model using KNN algorithm with machine learning algorithms and artificial intelligence (AI). We find the factors that directly impact on diseases and propose an approach for predicting the correct diagnosis of different diseases. We have constructed a series of models with good reliability for predicting different surgery complications and identified several novel clinical associations. We proposed a novel algorithm pr-KNN to use KNN for prediction and recommendation of diseases RESULTS Beside that we compared the performance of our algorithm with other machine algorithms and found better performance of our algorithm, with predictive accuracy improving by +3.61%. CONCLUSIONS The potential to directly integrate these predictive tools into EHRs may enable personalized medicine and decision-making at the point of care for patient counseling and as a teaching tool. CLINICALTRIAL dataset for the trials of patient attached

Characterization of Citrullination Sites in Neutrophils and Mast Cells Activated by Ionomycin via Integration of Mass Spectrometry and Machine Learning

2021 ◽  
Author(s):  
Raghothama Chaerkady ◽  
Yebin Zhou ◽  
Jared A. Delmar ◽  
Shao Huan Samuel Weng ◽  
Junmin Wang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mass Spectrometry ◽  
Mast Cells

scholarly journals A scalable approach for developing clinical risk prediction applications in different hospitals

2021 ◽  
pp. 103783
Author(s):  
Hong Sun ◽  
Kristof Depraetere ◽  
Laurent Meesseman ◽  
Jos De Roo ◽  
Martijn Vanbiervliet ◽  
...  
Keyword(s):  
Risk Prediction ◽  
Clinical Risk

scholarly journals Test characteristics of history, examination and investigations in the evaluation for septic arthritis in the child presenting with acute non-traumatic limp. A systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038088
Author(s):  
Jacky Tu ◽  
Peter Gowdie ◽  
Julian Cassar ◽  
Simon Craig
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Septic Arthritis ◽  
Quality Assessment ◽  
Likelihood Ratio ◽  
Risk Prediction ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Prediction Tools ◽  
Clinical Risk

BackgroundSeptic arthritis is an uncommon but potentially significant diagnosis to be considered when a child presents to the emergency department (ED) with non-traumatic limp. Our objective was to determine the diagnostic accuracy of clinical findings (history and examination) and investigation results (pathology tests and imaging) for the diagnosis of septic arthritis among children presenting with acute non-traumatic limp to the ED.MethodsSystematic review of the literature published between 1966 and June 2019 on MEDLINE and EMBASE databases. Studies were included if they evaluated children presenting with lower limb complaints and evaluated diagnostic performance of items from history, physical examination, laboratory testing or radiological examination. Data were independently extracted by two authors, and quality assessment was performed using the Quality Assessment Tool for Diagnostic Accuracy Studies 2 tool.Results18 studies were identified, and included 2672 children (560 with a final diagnosis of septic arthritis). There was substantial heterogeneity in inclusion criteria, study setting, definitions of specific variables and the gold standard used to confirm septic arthritis. Clinical and investigation findings were reported using varying definitions and cut-offs, and applied to differing study populations. Spectrum bias and poor-to-moderate study design quality limit their applicability to the ED setting.Single studies suggest that the presence of joint tenderness (n=189; positive likelihood ratio 11.4 (95% CI 5.9 to 22.0); negative likelihood ratio 0.2 (95% CI 0.0 to 1.2)) and joint effusion on ultrasound (n=127; positive likelihood ratio 8.4 (95% CI 4.1 to 17.1); negative likelihood ratio 0.2 (95% CI 0.1 to 0.3)) appear to be useful. Two promising clinical risk prediction tools were identified, however, their performance was notably lower when tested in external validation studies.DiscussionDifferentiating children with septic arthritis from non-emergent disorders of non-traumatic limp remains a key diagnostic challenge for emergency physicians. There is a need for prospectively derived and validated ED-based clinical risk prediction tools.

scholarly journals Identifying and characterizing high-risk clusters in a heterogeneous ICU population with deep embedded clustering

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
José Castela Forte ◽  
Galiya Yeshmagambetova ◽  
Maureen L. van der Grinten ◽  
Bart Hiemstra ◽  
Thomas Kaufmann ◽  
...  
Keyword(s):  
Machine Learning ◽  
High Risk ◽  
Mortality Risk ◽  
Clustering Algorithms ◽  
Kidney Injury ◽  
Risk Groups ◽  
Admission Diagnosis ◽  
Dutch Hospital ◽  
Cluster Membership

AbstractCritically ill patients constitute a highly heterogeneous population, with seemingly distinct patients having similar outcomes, and patients with the same admission diagnosis having opposite clinical trajectories. We aimed to develop a machine learning methodology that identifies and provides better characterization of patient clusters at high risk of mortality and kidney injury. We analysed prospectively collected data including co-morbidities, clinical examination, and laboratory parameters from a minimally-selected population of 743 patients admitted to the ICU of a Dutch hospital between 2015 and 2017. We compared four clustering methodologies and trained a classifier to predict and validate cluster membership. The contribution of different variables to the predicted cluster membership was assessed using SHapley Additive exPlanations values. We found that deep embedded clustering yielded better results compared to the traditional clustering algorithms. The best cluster configuration was achieved for 6 clusters. All clusters were clinically recognizable, and differed in in-ICU, 30-day, and 90-day mortality, as well as incidence of acute kidney injury. We identified two high mortality risk clusters with at least 60%, 40%, and 30% increased. ICU, 30-day and 90-day mortality, and a low risk cluster with 25–56% lower mortality risk. This machine learning methodology combining deep embedded clustering and variable importance analysis, which we made publicly available, is a possible solution to challenges previously encountered by clustering analyses in heterogeneous patient populations and may help improve the characterization of risk groups in critical care.

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