scholarly journals Machine Learning Approach to Reduce Alert Fatigue Using a Disease Medication–Related Clinical Decision Support System: Model Development and Validation

10.2196/19489 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e19489
Author(s):  
Tahmina Nasrin Poly ◽  
Md.Mohaimenul Islam ◽  
Muhammad Solihuddin Muhtar ◽  
Hsuan-Chia Yang ◽  
Phung Anh (Alex) Nguyen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Prediction Models ◽  
Clinical Decision ◽  
Gradient Boosting ◽  
Support Vector ◽  
Learning Models ◽  
Alert Fatigue ◽  
Machine Learning Models

Background Computerized physician order entry (CPOE) systems are incorporated into clinical decision support systems (CDSSs) to reduce medication errors and improve patient safety. Automatic alerts generated from CDSSs can directly assist physicians in making useful clinical decisions and can help shape prescribing behavior. Multiple studies reported that approximately 90%-96% of alerts are overridden by physicians, which raises questions about the effectiveness of CDSSs. There is intense interest in developing sophisticated methods to combat alert fatigue, but there is no consensus on the optimal approaches so far. Objective Our objective was to develop machine learning prediction models to predict physicians’ responses in order to reduce alert fatigue from disease medication–related CDSSs. Methods We collected data from a disease medication–related CDSS from a university teaching hospital in Taiwan. We considered prescriptions that triggered alerts in the CDSS between August 2018 and May 2019. Machine learning models, such as artificial neural network (ANN), random forest (RF), naïve Bayes (NB), gradient boosting (GB), and support vector machine (SVM), were used to develop prediction models. The data were randomly split into training (80%) and testing (20%) datasets. Results A total of 6453 prescriptions were used in our model. The ANN machine learning prediction model demonstrated excellent discrimination (area under the receiver operating characteristic curve [AUROC] 0.94; accuracy 0.85), whereas the RF, NB, GB, and SVM models had AUROCs of 0.93, 0.91, 0.91, and 0.80, respectively. The sensitivity and specificity of the ANN model were 0.87 and 0.83, respectively. Conclusions In this study, ANN showed substantially better performance in predicting individual physician responses to an alert from a disease medication–related CDSS, as compared to the other models. To our knowledge, this is the first study to use machine learning models to predict physician responses to alerts; furthermore, it can help to develop sophisticated CDSSs in real-world clinical settings.

scholarly journals Machine Learning Approach to Reduce Alert Fatigue Using a Disease Medication–Related Clinical Decision Support System: Model Development and Validation (Preprint)

2020 ◽  
Author(s):  
Tahmina Nasrin Poly ◽  
Md.Mohaimenul Islam ◽  
Muhammad Solihuddin Muhtar ◽  
Hsuan-Chia Yang ◽  
Phung Anh (Alex) Nguyen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Prediction Models ◽  
Clinical Decision ◽  
Gradient Boosting ◽  
Support Vector ◽  
Learning Models ◽  
Alert Fatigue ◽  
Machine Learning Models

BACKGROUND Computerized physician order entry (CPOE) systems are incorporated into clinical decision support systems (CDSSs) to reduce medication errors and improve patient safety. Automatic alerts generated from CDSSs can directly assist physicians in making useful clinical decisions and can help shape prescribing behavior. Multiple studies reported that approximately 90%-96% of alerts are overridden by physicians, which raises questions about the effectiveness of CDSSs. There is intense interest in developing sophisticated methods to combat alert fatigue, but there is no consensus on the optimal approaches so far. OBJECTIVE Our objective was to develop machine learning prediction models to predict physicians’ responses in order to reduce alert fatigue from disease medication–related CDSSs. METHODS We collected data from a disease medication–related CDSS from a university teaching hospital in Taiwan. We considered prescriptions that triggered alerts in the CDSS between August 2018 and May 2019. Machine learning models, such as artificial neural network (ANN), random forest (RF), naïve Bayes (NB), gradient boosting (GB), and support vector machine (SVM), were used to develop prediction models. The data were randomly split into training (80%) and testing (20%) datasets. RESULTS A total of 6453 prescriptions were used in our model. The ANN machine learning prediction model demonstrated excellent discrimination (area under the receiver operating characteristic curve [AUROC] 0.94; accuracy 0.85), whereas the RF, NB, GB, and SVM models had AUROCs of 0.93, 0.91, 0.91, and 0.80, respectively. The sensitivity and specificity of the ANN model were 0.87 and 0.83, respectively. CONCLUSIONS In this study, ANN showed substantially better performance in predicting individual physician responses to an alert from a disease medication–related CDSS, as compared to the other models. To our knowledge, this is the first study to use machine learning models to predict physician responses to alerts; furthermore, it can help to develop sophisticated CDSSs in real-world clinical settings.

scholarly journals Machine learning models to identify low adherence to influenza vaccination among Korean adults with cardiovascular disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Moojung Kim ◽  
Young Jae Kim ◽  
Sung Jin Park ◽  
Kwang Gi Kim ◽  
Pyung Chun Oh ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cardiovascular Disease ◽  
Influenza Vaccination ◽  
Machine Learning Techniques ◽  
Gradient Boosting ◽  
Support Vector ◽  
Age Group ◽  
Learning Models ◽  
Extreme Gradient Boosting ◽  
Machine Learning Models

Abstract Background Annual influenza vaccination is an important public health measure to prevent influenza infections and is strongly recommended for cardiovascular disease (CVD) patients, especially in the current coronavirus disease 2019 (COVID-19) pandemic. The aim of this study is to develop a machine learning model to identify Korean adult CVD patients with low adherence to influenza vaccination Methods Adults with CVD (n = 815) from a nationally representative dataset of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) were analyzed. Among these adults, 500 (61.4%) had answered "yes" to whether they had received seasonal influenza vaccinations in the past 12 months. The classification process was performed using the logistic regression (LR), random forest (RF), support vector machine (SVM), and extreme gradient boosting (XGB) machine learning techniques. Because the Ministry of Health and Welfare in Korea offers free influenza immunization for the elderly, separate models were developed for the < 65 and ≥ 65 age groups. Results The accuracy of machine learning models using 16 variables as predictors of low influenza vaccination adherence was compared; for the ≥ 65 age group, XGB (84.7%) and RF (84.7%) have the best accuracies, followed by LR (82.7%) and SVM (77.6%). For the < 65 age group, SVM has the best accuracy (68.4%), followed by RF (64.9%), LR (63.2%), and XGB (61.4%). Conclusions The machine leaning models show comparable performance in classifying adult CVD patients with low adherence to influenza vaccination.

scholarly journals Machine Learning Models of Acute Kidney Injury Prediction in Acute Pancreatitis Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Cheng Qu ◽  
Lin Gao ◽  
Xian-qiang Yu ◽  
Mei Wei ◽  
Guo-quan Fang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Acute Kidney Injury ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Kidney Injury ◽  
Gradient Boosting ◽  
Support Vector ◽  
Learning Models ◽  
Extreme Gradient Boosting ◽  
Machine Learning Models

Background. Acute kidney injury (AKI) has long been recognized as a common and important complication of acute pancreatitis (AP). In the study, machine learning (ML) techniques were used to establish predictive models for AKI in AP patients during hospitalization. This is a retrospective review of prospectively collected data of AP patients admitted within one week after the onset of abdominal pain to our department from January 2014 to January 2019. Eighty patients developed AKI after admission (AKI group) and 254 patients did not (non-AKI group) in the hospital. With the provision of additional information such as demographic characteristics or laboratory data, support vector machine (SVM), random forest (RF), classification and regression tree (CART), and extreme gradient boosting (XGBoost) were used to build models of AKI prediction and compared to the predictive performance of the classic model using logistic regression (LR). XGBoost performed best in predicting AKI with an AUC of 91.93% among the machine learning models. The AUC of logistic regression analysis was 87.28%. Present findings suggest that compared to the classical logistic regression model, machine learning models using features that can be easily obtained at admission had a better performance in predicting AKI in the AP patients.

scholarly journals DEM- and GIS-Based Analysis of Soil Erosion Depth Using Machine Learning

2021 ◽  
Vol 10 (7) ◽  
pp. 452
Author(s):  
Kieu Anh Nguyen ◽  
Walter Chen
Keyword(s):  
Machine Learning ◽  
Soil Erosion ◽  
Land Degradation ◽  
Prediction Models ◽  
Biodiversity Loss ◽  
Gradient Boosting ◽  
Learning Models ◽  
Erosion Depth ◽  
Global Challenge ◽  
Machine Learning Models

Soil erosion is a form of land degradation. It is the process of moving surface soil with the action of external forces such as wind or water. Tillage also causes soil erosion. As outlined by the United Nations Sustainable Development Goal (UN SDG) #15, it is a global challenge to “combat desertification, and halt and reverse land degradation and halt biodiversity loss.” In order to advance this goal, we studied and modeled the soil erosion depth of a typical watershed in Taiwan using 26 morphometric factors derived from a digital elevation model (DEM) and 10 environmental factors. Feature selection was performed using the Boruta algorithm to determine 15 factors with confirmed importance and one tentative factor. Then, machine learning models, including the random forest (RF) and gradient boosting machine (GBM), were used to create prediction models validated by erosion pin measurements. The results show that GBM, coupled with 15 important factors (confirmed), achieved the best result in the context of root mean square error (RMSE) and Nash–Sutcliffe efficiency (NSE). Finally, we present the maps of soil erosion depth using the two machine learning models. The maps are useful for conservation planning and mitigating future soil erosion.

scholarly journals A Comparative Analysis of Machine Learning Models for Prediction of Insurance Uptake in Kenya

2020 ◽  
Author(s):  
Nelson Yego ◽  
Juma Kasozi ◽  
Joseph Nkrunziza
Keyword(s):  
Machine Learning ◽  
Random Forest ◽  
Characteristic Curve ◽  
Confusion Matrix ◽  
Gradient Boosting ◽  
Support Vector ◽  
Sampled Data ◽  
Learning Models ◽  
Extreme Gradient Boosting ◽  
Machine Learning Models

The role of insurance in financial inclusion as well as in economic growth is immense. However, low uptake seems to impede the growth of the sector hence the need for a model that robustly predicts uptake of insurance among potential clients. In this research, we compared the performances of eight (8) machine learning models in predicting the uptake of insurance. The classifiers considered were Logistic Regression, Gaussian Naive Bayes, Support Vector Machines, K Nearest Neighbors, Decision Tree, Random Forest, Gradient Boosting Machines and Extreme Gradient boosting. The data used in the classification was from the 2016 Kenya FinAccess Household Survey. Comparison of performance was done for both upsampled and downsampled data due to data imbalance. For upsampled data, Random Forest classifier showed highest accuracy and precision compared to other classifiers but for down sampled data, gradient boosting was optimal. It is noteworthy that for both upsampled and downsampled data, tree-based classifiers were more robust than others in insurance uptake prediction. However, in spite of hyper-parameter optimization, the area under receiver operating characteristic curve remained highest for Random Forest as compared to other tree-based models. Also, the confusion matrix for Random Forest showed least false positives, and highest true positives hence could be construed as the most robust model for predicting the insurance uptake. Finally, the most important feature in predicting uptake was having a bank product hence bancassurance could be said to be a plausible channel of distribution of insurance products.

scholarly journals Machine learning models for screening carotid atherosclerosis in asymptomatic adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jian Yu ◽  
Yan Zhou ◽  
Qiong Yang ◽  
Xiaoling Liu ◽  
Lili Huang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Physical Examination ◽  
Carotid Atherosclerosis ◽  
Gradient Boosting ◽  
Support Vector ◽  
Learning Models ◽  
Cerebrovascular Events ◽  
Extreme Gradient Boosting ◽  
Routine Physical Examination ◽  
Machine Learning Models

AbstractCarotid atherosclerosis (CAS) is a risk factor for cardiovascular and cerebrovascular events, but duplex ultrasonography isn’t recommended in routine screening for asymptomatic populations according to medical guidelines. We aim to develop machine learning models to screen CAS in asymptomatic adults. A total of 2732 asymptomatic subjects for routine physical examination in our hospital were included in the study. We developed machine learning models to classify subjects with or without CAS using decision tree, random forest (RF), extreme gradient boosting (XGBoost), support vector machine (SVM) and multilayer perceptron (MLP) with 17 candidate features. The performance of models was assessed on the testing dataset. The model using MLP achieved the highest accuracy (0.748), positive predictive value (0.743), F1 score (0.742), area under receiver operating characteristic curve (AUC) (0.766) and Kappa score (0.445) among all classifiers. It’s followed by models using XGBoost and SVM. In conclusion, the model using MLP is the best one to screen CAS in asymptomatic adults based on the results from routine physical examination, followed by using XGBoost and SVM. Those models may provide an effective and applicable method for physician and primary care doctors to screen asymptomatic CAS without risk factors in general population, and improve risk predictions and preventions of cardiovascular and cerebrovascular events in asymptomatic adults.

scholarly journals An Evaluation of Clinical Decision Support and Use of Machine Learning to Reduce Alert Fatigue

2019 ◽  
Vol 8 (1) ◽  
pp. 32-39
Author(s):  
Noura Khreis ◽  
◽  
Adela S. M. Lau ◽  
Ahmed Al-jedai ◽  
Salma M. Al-Khani ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Alert Fatigue

Biostatistiek versus machine learning: van traditionele predictiemodellen naar geautomatiseerde medische analyse

2021 ◽  
Author(s):  
M. VALKEMA ◽  
H. LINGSMA ◽  
P. LAMBIN ◽  
J. VAN LANSCHOT
Keyword(s):  
Machine Learning ◽  
Prediction Models ◽  
External Validation ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Learning Models ◽  
Selection Of Variables ◽  
Medical Analysis ◽  
Machine Learning Models ◽  
Selection Of

Biostatistics versus machine learning: from traditional prediction models to automated medical analysis Machine learning is increasingly applied to medical data to develop clinical prediction models. This paper discusses the application of machine learning in comparison with traditional biostatistical methods. Biostatistics is well-suited for structured datasets. The selection of variables for a biostatistical prediction model is primarily knowledge-driven. A similar approach is possible with machine learning. But in addition, machine learning allows for analysis of unstructured datasets, which are e.g. derived from medical imaging and written texts in patient records. In contrast to biostatistics, the selection of variables with machine learning is mainly data-driven. Complex machine learning models are able to detect nonlinear patterns and interactions in data. However, this requires large datasets to prevent overfitting. For both machine learning and biostatistics, external validation of a developed model in a comparable setting is required to evaluate a model’s reproducibility. Machine learning models are not easily implemented in clinical practice, since they are recognized as black boxes (i.e. non-intuitive). For this purpose, research initiatives are ongoing within the field of explainable artificial intelligence. Finally, the application of machine learning for automated imaging analysis and development of clinical decision support systems is discussed.

scholarly journals Machine learning models for predicting international tourist arrivals in Indonesia during the COVID-19 pandemic: a multisource Internet data approach

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dinda Thalia Andariesta ◽  
Meditya Wasesa
Keyword(s):  
Machine Learning ◽  
Prediction Models ◽  
Absolute Error ◽  
Percentage Error ◽  
Support Vector ◽  
Tourism Demand ◽  
Learning Models ◽  
Content Type ◽  
International Tourist ◽  
Machine Learning Models

PurposeThis research presents machine learning models for predicting international tourist arrivals in Indonesia during the COVID-19 pandemic using multisource Internet data.Design/methodology/approachTo develop the prediction models, this research utilizes multisource Internet data from TripAdvisor travel forum and Google Trends. Temporal factors, posts and comments, search queries index and previous tourist arrivals records are set as predictors. Four sets of predictors and three distinct data compositions were utilized for training the machine learning models, namely artificial neural networks (ANNs), support vector regression (SVR) and random forest (RF). To evaluate the models, this research uses three accuracy metrics, namely root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE).FindingsPrediction models trained using multisource Internet data predictors have better accuracy than those trained using single-source Internet data or other predictors. In addition, using more training sets that cover the phenomenon of interest, such as COVID-19, will enhance the prediction model's learning process and accuracy. The experiments show that the RF models have better prediction accuracy than the ANN and SVR models.Originality/valueFirst, this study pioneers the practice of a multisource Internet data approach in predicting tourist arrivals amid the unprecedented COVID-19 pandemic. Second, the use of multisource Internet data to improve prediction performance is validated with real empirical data. Finally, this is one of the few papers to provide perspectives on the current dynamics of Indonesia's tourism demand.

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