Department of Industrial and Systems Engineering, KAIST, Yusung-gu, Daejon, Republic of Korea.
College of Business, KAIST, Seoul, Republic of Korea.
J Biomed Inform. 2017 Nov;75:35-47. doi: 10.1016/j.jbi.2017.09.003. Epub 2017 Sep 27.
Wide variance exists among individuals and institutions for treating patients with medicine. This paper analyzes prescription patterns using a topic model with more than four million prescriptions. Specifically, we propose the disease-medicine pattern model (DMPM) to extract patterns from a large collection of insurance data by considering disease codes joined with prescribed medicines. We analyzed insurance prescription data from 2011 with DMPM and found prescription patterns that could not be identified by traditional simple disease classification, such as the International Classification of Diseases (ICD). We analyzed the identified prescription patterns from multiple aspects. First, we found that our model better explain unseen prescriptions than other probabilistic models. Second, we analyzed the similarities of the extracted patterns to identify their characteristics. Third, we compared the identified patterns from DMPM to the known disease categorization, ICD. This comparison showed what additional information can be provided by the data-oriented bottom-up patterns in contrast to the knowledge-based top-down categorization. The comparison results showed that the bottom-up categorization allowed for the identification of (1) diverse treatment options for the same disease symptoms, and (2) diverse disease cases sharing the same prescription options. Additionally, the extracted bottom-up patterns revealed treatment differences based on basic patient information better than the top-down categorization. We conclude that this data-oriented analysis will be an effective alternative method for analyzing the complex interwoven disease-prescription relationship.
个体和医疗机构在治疗患者方面存在广泛差异。本文使用超过四百万张处方的主题模型分析处方模式。具体来说,我们提出了疾病-药物模式模型(DMPM),通过考虑与所开药物相关的疾病代码,从大量保险数据中提取模式。我们使用 DMPM 分析了 2011 年的保险处方数据,发现了传统的简单疾病分类(如国际疾病分类(ICD))无法识别的处方模式。我们从多个方面分析了所识别的处方模式。首先,我们发现我们的模型比其他概率模型更好地解释未见过的处方。其次,我们分析了提取模式的相似性,以确定其特征。第三,我们将 DMPM 中识别的模式与已知的疾病分类 ICD 进行了比较。这种比较表明,与基于知识的自上而下的分类相比,数据导向的自下而上的模式可以提供哪些额外信息。比较结果表明,自下而上的分类允许识别出(1)同一疾病症状的多种治疗选择,以及(2)具有相同处方选择的多种疾病病例。此外,提取的自下而上的模式基于基本患者信息更好地揭示了治疗差异,优于自上而下的分类。我们得出结论,这种面向数据的分析将是分析复杂交织的疾病-处方关系的有效替代方法。