scholarly journals Using machine-learning risk prediction models to triage the acuity of undifferentiated patients entering the emergency care system: a systematic review

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jamie Miles ◽  
Janette Turner ◽  
Richard Jacques ◽  
Julia Williams ◽  
Suzanne Mason
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Neural Networks ◽  
Logistic Regression ◽  
Emergency Care ◽  
Model Performance ◽  
Machine Learning Methods ◽  
C Statistic ◽  
Emergency Care System ◽  
Care System

Abstract Background The primary objective of this review is to assess the accuracy of machine learning methods in their application of triaging the acuity of patients presenting in the Emergency Care System (ECS). The population are patients that have contacted the ambulance service or turned up at the Emergency Department. The index test is a machine-learning algorithm that aims to stratify the acuity of incoming patients at initial triage. This is in comparison to either an existing decision support tool, clinical opinion or in the absence of these, no comparator. The outcome of this review is the calibration, discrimination and classification statistics. Methods Only derivation studies (with or without internal validation) were included. MEDLINE, CINAHL, PubMed and the grey literature were searched on the 14th December 2019. Risk of bias was assessed using the PROBAST tool and data was extracted using the CHARMS checklist. Discrimination (C-statistic) was a commonly reported model performance measure and therefore these statistics were represented as a range within each machine learning method. The majority of studies had poorly reported outcomes and thus a narrative synthesis of results was performed. Results There was a total of 92 models (from 25 studies) included in the review. There were two main triage outcomes: hospitalisation (56 models), and critical care need (25 models). For hospitalisation, neural networks and tree-based methods both had a median C-statistic of 0.81 (IQR 0.80-0.84, 0.79-0.82). Logistic regression had a median C-statistic of 0.80 (0.74-0.83). For critical care need, neural networks had a median C-statistic of 0.89 (0.86-0.91), tree based 0.85 (0.84-0.88), and logistic regression 0.83 (0.79-0.84). Conclusions Machine-learning methods appear accurate in triaging undifferentiated patients entering the Emergency Care System. There was no clear benefit of using one technique over another; however, models derived by logistic regression were more transparent in reporting model performance. Future studies should adhere to reporting guidelines and use these at the protocol design stage. Registration and funding This systematic review is registered on the International prospective register of systematic reviews (PROSPERO) and can be accessed online at the following URL: https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020168696 This study was funded by the NIHR as part of a Clinical Doctoral Research Fellowship.

scholarly journals Machine-learning to Improve Prediction of Mortality following Acute Myocardial Infarction: An Assessment in the NCDR-Chest Pain-Myocardial Infarction Registry

2019 ◽  
Author(s):  
Rohan Khera ◽  
Julian Haimovich ◽  
Nate Hurley ◽  
Robert McNamara ◽  
John A Spertus ◽  
...  
Keyword(s):  
Machine Learning ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Logistic Regression ◽  
Chest Pain ◽  
High Risk ◽  
Hospital Mortality ◽  
Gradient Descent ◽  
Machine Learning Methods ◽  
C Statistic

ABSTRACTIntroductionAccurate prediction of risk of death following acute myocardial infarction (AMI) can guide the triage of care services and shared decision-making. Contemporary machine-learning may improve risk-prediction by identifying complex relationships between predictors and outcomes.Methods and ResultsWe studied 993,905 patients in the American College of Cardiology Chest Pain-MI Registry hospitalized with AMI (mean age 64 ± 13 years, 34% women) between January 2011 and December 2016. We developed and validated three machine learning models to predict in-hospital mortality and compared the performance characteristics with a logistic regression model. In an independent validation cohort, we compared logistic regression with lasso regularization (c-statistic, 0.891 [95% CI, 0.890-0.892]), gradient descent boosting (c-statistic, 0.902 [0.901-0.903]), and meta-classification that combined gradient descent boosting with a neural network (c-statistic, 0.904 [0.903-0.905]) with traditional logistic regression (c-statistic, 0.882 [0.881-0.883]). There were improvements in classification of individuals across the spectrum of patient risk with each of the three methods; the meta-classifier model – our best performing model - reclassified 20.9% of individuals deemed high-risk for mortality in logistic regression appropriately as low-to-moderate risk, and 8.2% of deemed low-risk to moderate-to-high risk based consistent with the actual event rates.ConclusionsMachine-learning methods improved the prediction of in-hospital mortality for AMI compared with logistic regression. Machine learning methods enhance the utility of risk models developed using traditional statistical approaches through additional exploration of the relationship between variables and outcomes.

EHR-based machine learning modeling for preterm birth prediction: A systematic review (Preprint)

2021 ◽  
Author(s):  
Zahra Sharifiheris ◽  
Juho Laitala ◽  
Antti Airola ◽  
Amir M Rahmani ◽  
Miriam Bender
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Preterm Birth ◽  
Model Performance ◽  
Bibliographic Databases ◽  
Complementary Approach ◽  
Prisma Statement ◽  
Comprehensive Search ◽  
First Time

BACKGROUND Preterm birth (PTB) as a common pregnancy complication is responsible for 35% of the 3.1 million pregnancy-related deaths each year and significantly impacts around 15 million children annually across the world. Conventional approaches to predict PTB may neither be applicable for first-time mothers nor possess reliable predictive power. Recently, machine learning (ML) models have shown the potential as an appropriate complementary approach for PTB prediction. OBJECTIVE In this article we systematically reviewed the literature concerned with PTB prediction using ML modeling. METHODS This systematic review was conducted in accordance with the PRISMA statement. A comprehensive search was performed in seven bibliographic databases up until 15 May 2021. The quality of studies was assessed, and the descriptive information including socio-demographic characteristics, ML modeling processes, and model performance were extracted and reported. RESULTS A total of 732 papers were screened through title and abstract. Of these, 23 studies were screened by full text resulting in 13 papers that met the inclusion criteria. CONCLUSIONS We identified various ML models used for different EHR data resulting in a desirable performance for PTB prediction. However, evaluation metrics, software/package used, data size and type, and selected features, and importantly data management method often varied from study to study threatening the reliability and generalizability of the model. CLINICALTRIAL n.a.

scholarly journals Machine-learning in astronomy

2014 ◽  
Vol 10 (S306) ◽  
pp. 279-287 ◽  
Author(s):  
Michael Hobson ◽  
Philip Graff ◽  
Farhan Feroz ◽  
Anthony Lasenby
Keyword(s):  
Neural Network ◽  
Machine Learning ◽  
Neural Networks ◽  
Gamma Ray ◽  
Neural Network Training ◽  
Training Algorithm ◽  
Data Description ◽  
Astronomical Data ◽  
Machine Learning Methods ◽  
Network Training

AbstractMachine-learning methods may be used to perform many tasks required in the analysis of astronomical data, including: data description and interpretation, pattern recognition, prediction, classification, compression, inference and many more. An intuitive and well-established approach to machine learning is the use of artificial neural networks (NNs), which consist of a group of interconnected nodes, each of which processes information that it receives and then passes this product on to other nodes via weighted connections. In particular, I discuss the first public release of the generic neural network training algorithm, calledSkyNet, and demonstrate its application to astronomical problems focusing on its use in the BAMBI package for accelerated Bayesian inference in cosmology, and the identification of gamma-ray bursters. TheSkyNetand BAMBI packages, which are fully parallelised using MPI, are available athttp://www.mrao.cam.ac.uk/software/.

scholarly journals Acoustic feature-based sentiment analysis of call center data

2017 ◽  
Author(s):  
◽  
Zeshan Peng
Keyword(s):  
Machine Learning ◽  
Neural Networks ◽  
Emotion Recognition ◽  
Sentiment Analysis ◽  
Call Center ◽  
Machine Learning Algorithms ◽  
Language Recognition ◽  
Acoustic Features ◽  
Learning Methods ◽  
Machine Learning Methods

With the advancement of machine learning methods, audio sentiment analysis has become an active research area in recent years. For example, business organizations are interested in persuasion tactics from vocal cues and acoustic measures in speech. A typical approach is to find a set of acoustic features from audio data that can indicate or predict a customer's attitude, opinion, or emotion state. For audio signals, acoustic features have been widely used in many machine learning applications, such as music classification, language recognition, emotion recognition, and so on. For emotion recognition, previous work shows that pitch and speech rate features are important features. This thesis work focuses on determining sentiment from call center audio records, each containing a conversation between a sales representative and a customer. The sentiment of an audio record is considered positive if the conversation ended with an appointment being made, and is negative otherwise. In this project, a data processing and machine learning pipeline for this problem has been developed. It consists of three major steps: 1) an audio record is split into segments by speaker turns; 2) acoustic features are extracted from each segment; and 3) classification models are trained on the acoustic features to predict sentiment. Different set of features have been used and different machine learning methods, including classical machine learning algorithms and deep neural networks, have been implemented in the pipeline. In our deep neural network method, the feature vectors of audio segments are stacked in temporal order into a feature matrix, which is fed into deep convolution neural networks as input. Experimental results based on real data shows that acoustic features, such as Mel frequency cepstral coefficients, timbre and Chroma features, are good indicators for sentiment. Temporal information in an audio record can be captured by deep convolutional neural networks for improved prediction accuracy.

scholarly journals Mitigation Policies and Emergency Care Management in Europe's Ground Zero for COVID-19

2020 ◽  
Author(s):  
Gabriele Ciminelli ◽  
Sílvia Garcia-Mandicó
Keyword(s):  
Emergency Care ◽  
Service Sector ◽  
Emergency Services ◽  
Factory Workers ◽  
Hospital Emergency ◽  
Employment Share ◽  
Emergency Care System ◽  
Physical Interactions ◽  
Critical Patients ◽  
Care System

This paper draws from daily death registry data on 4,000 Italian municipalities to investigate two crucial policies that can dramatically affect the toll of COVID-19: the shutdown of non-essential businesses and the management of the emergency care system. Our results, which are robust to controlling for a host of co-factors, offer strong evidence that the closure of service activities is very effective in reducing COVID-19 mortality - this was about 15% lower in municipalities with a 10 percentage points higher employment share in shut down services. Shutting down factories, instead, is much less effective, plausibly because factory workers engage in more limited physical interactions relative to those in the consumer-facing service sector. Concerning the management of the health care system, we find that mortality strongly increases with distance from the intensive care unit (ICU). Municipalities at 10 km from the closest ICU experienced up to 50% higher mortality. This effect - which is largest within the epicenter and in days of abnormally high volumes of calls to the emergency line - underscores the importance of improving pre-hospital emergency services and building ambulance capacity to ensure timely transportation of critical patients to the ICU.

scholarly journals Machine Learning Methods Applied for Modeling the Process of Obtaining Bricks Using Silicon-Based Materials

Materials ◽  
2021 ◽  
Vol 14 (23) ◽  
pp. 7232
Author(s):  
Costel Anton ◽  
Silvia Curteanu ◽  
Cătălin Lisa ◽  
Florin Leon
Keyword(s):  
Machine Learning ◽  
Neural Networks ◽  
Raw Materials ◽  
Optimization Procedure ◽  
Exhaust Emission ◽  
Energy Potential ◽  
Learning Methods ◽  
Machine Learning Methods ◽  
Emission Changes ◽  
The Impact

Most of the time, industrial brick manufacture facilities are designed and commissioned for a particular type of manufacture mix and a particular type of burning process. Productivity and product quality maintenance and improvement is a challenge for process engineers. Our paper aims at using machine learning methods to evaluate the impact of adding new auxiliary materials on the amount of exhaust emissions. Experimental determinations made in similar conditions enabled us to build a database containing information about 121 brick batches. Various models (artificial neural networks and regression algorithms) were designed to make predictions about exhaust emission changes when auxiliary materials are introduced into the manufacture mix. The best models were feed-forward neural networks with two hidden layers, having MSE < 0.01 and r2 > 0.82 and, as regression model, kNN with error < 0.6. Also, an optimization procedure, including the best models, was developed in order to determine the optimal values for the parameters that assure the minimum quantities for the gas emission. The Pareto front obtained in the multi-objective optimization conducted with grid search method allows the user the chose the most convenient values for the dry product mass, clay, ash and organic raw materials which minimize gas emissions with energy potential.

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