scholarly journals MACHINE LEARNING BASED CLINICAL DECISION SUPPORT SYSTEM TO PREDICT FETAL HYPOXIA IN WOMEN DURING ANTENATAL CHECK-UP.

2021 ◽  
pp. 82-90
Author(s):  
Sajal Baxi

BACKGROUND:Most under-five deaths occur within the first month after birth and intrapartum complications are a major contributor to the cause of death. These defects can be easily identified during the ante-natal check-up by use of a non-stress test. Due to the lack of availability of resources and medical experts in remote areas clinical decision support systems powered by machine learning models can provide information to the healthcare provider to make timely and better-informed decisions based on which course of treatment can be planned. AIM:The study aims to develop an accurate and sensitive clinical decision support system model that can identify pathological fetuses based on the fetal heart rate recordings taken during the non-stress test. METHOD: Foetal Heart rate recordings along with 10 other variables were collected from 1800 pregnant women in their third trimester. The data was put through a feature selection algorithm to identify important variables in the set. The data set was randomly divided into 2 independent random samples in the ratio of 70% for training and 30% for testing. After testing various machine learning algorithms based on specificity, sensitivity to accurately classify the fetus into normal, suspected, or pathological Random Forest algorithm was chosen. RESULT:The fetal status determined by Obstetrician 77.85% observations from the normal category, 19.88% from the suspected category, and 8.28% from the pathological category. The Boruta algorithm revealed that all 11 independent variables in the data set were important to predict the outcome in the test set. In the training set the model had an accuracy of 99.04% and in the testing set accuracy was 94.7% (p-value=< 2.2e-16) with the precision of 97.56% to detect the pathological category. CONCLUSION:With the ability of the model to accurately predict the pathological category the CDS can be used by healthcare providers in remote areas to identify high-risk pregnant women and take the decision on the medical care to be provided.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Gwang Hyeon Choi ◽  
Jihye Yun ◽  
Jonggi Choi ◽  
Danbi Lee ◽  
Ju Hyun Shim ◽  
...  

Abstract There is a significant discrepancy between the actual choice for initial treatment option for hepatocellular carcinoma (HCC) and recommendations from the currently used BCLC staging system. We develop a machine learning-based clinical decision support system (CDSS) for recommending initial treatment option in HCC and predicting overall survival (OS). From hospital records of 1,021 consecutive patients with HCC treated at a single centre in Korea between January 2010 and October 2010, we collected information on 61 pretreatment variables, initial treatment, and survival status. Twenty pretreatment key variables were finally selected. We developed the CDSS from the derivation set (N = 813) using random forest method and validated it in the validation set (N = 208). Among the 1,021 patients (mean age: 56.9 years), 81.8% were male and 77.0% had positive hepatitis B BCLC stages 0, A, B, C, and D were observed in 13.4%, 26.0%, 18.0%, 36.6%, and 6.3% of patients, respectively. The six multi-step classifier model was developed for treatment decision in a hierarchical manner, and showed good performance with 81.0% of accuracy for radiofrequency ablation (RFA) or resection versus not, 88.4% for RFA versus resection, and 76.8% for TACE or not. We also developed seven survival prediction models for each treatment option. Our newly developed HCC-CDSS model showed good performance in terms of treatment recommendation and OS prediction and may be used as a guidance in deciding the initial treatment option for HCC.


IEEE Access ◽  
2020 ◽  
Vol 8 ◽  
pp. 185676-185687
Author(s):  
Noha Ossama El-Ganainy ◽  
Ilangko Balasingham ◽  
Per Steinar Halvorsen ◽  
Leiv Arne Rosseland

2019 ◽  
Vol 26 (12) ◽  
pp. 1560-1565 ◽  
Author(s):  
G Segal ◽  
A Segev ◽  
A Brom ◽  
Y Lifshitz ◽  
Y Wasserstrum ◽  
...  

Abstract Background Drug prescription errors are made, worldwide, on a daily basis, resulting in a high burden of morbidity and mortality. Existing rule-based systems for prevention of such errors are unsuccessful and associated with substantial burden of false alerts. Objective In this prospective study, we evaluated the accuracy, validity, and clinical usefulness of medication error alerts generated by a novel system using outlier detection screening algorithms, used on top of a legacy standard system, in a real-life inpatient setting. Materials and Methods We integrated a novel outlier system into an existing electronic medical record system, in a single medical ward in a tertiary medical center. The system monitored all drug prescriptions written during 16 months. The department’s staff assessed all alerts for accuracy, clinical validity, and usefulness. We recorded all physician’s real-time responses to alerts generated. Results The alert burden generated by the system was low, with alerts generated for 0.4% of all medication orders. Sixty percent of the alerts were flagged after the medication was already dispensed following changes in patients’ status which necessitated medication changes (eg, changes in vital signs). Eighty-five percent of the alerts were confirmed clinically valid, and 80% were considered clinically useful. Forty-three percent of the alerts caused changes in subsequent medical orders. Conclusion A clinical decision support system that used a probabilistic, machine-learning approach based on statistically derived outliers to detect medication errors generated clinically useful alerts. The system had high accuracy, low alert burden and low false-positive rate, and led to changes in subsequent orders.


Sign in / Sign up

Export Citation Format

Share Document