Dipartimento di Ingegneria dell'Informazione, University of Florence, Florence, Italy.
Department of Computer and Systems Sciences, Stockholm University, Stockholm, Sweden.
BMC Med Inform Decis Mak. 2019 Jan 10;19(1):7. doi: 10.1186/s12911-018-0717-4.
Adverse drug events (ADEs) as well as other preventable adverse events in the hospital setting incur a yearly monetary cost of approximately $3.5 billion, in the United States alone. Therefore, it is of paramount importance to reduce the impact and prevalence of ADEs within the healthcare sector, not only since it will result in reducing human suffering, but also as a means to substantially reduce economical strains on the healthcare system. One approach to mitigate this problem is to employ predictive models. While existing methods have been focusing on the exploitation of static features, limited attention has been given to temporal features.
In this paper, we present a novel classification framework for detecting ADEs in complex Electronic health records (EHRs) by exploiting the temporality and sparsity of the underlying features. The proposed framework consists of three phases for transforming sparse and multi-variate time series features into a single-valued feature representation, which can then be used by any classifier. Moreover, we propose and evaluate three different strategies for leveraging feature sparsity by incorporating it into the new representation.
A large-scale evaluation on 15 ADE datasets extracted from a real-world EHR system shows that the proposed framework achieves significantly improved predictive performance compared to state-of-the-art. Moreover, our framework can reveal features that are clinically consistent with medical findings on ADE detection.
Our study and experimental findings demonstrate that temporal multi-variate features of variable length and with high sparsity can be effectively utilized to predict ADEs from EHRs. Two key advantages of our framework are that it is method agnostic, i.e., versatile, and of low computational cost, i.e., fast; hence providing an important building block for future exploitation within the domain of machine learning from EHRs.
仅在美国,医院环境中的药物不良事件(ADE)和其他可预防的不良事件每年造成约 35 亿美元的经济损失。因此,减少医疗保健领域 ADE 的影响和普遍性至关重要,这不仅因为它将减少人类的痛苦,而且还可以大大减轻医疗保健系统的经济压力。一种解决此问题的方法是采用预测模型。虽然现有方法一直专注于利用静态特征,但对时间特征的关注有限。
在本文中,我们通过利用潜在特征的时间性和稀疏性,提出了一种用于在复杂电子健康记录(EHR)中检测 ADE 的新颖分类框架。该框架由三个阶段组成,用于将稀疏和多变量时间序列特征转换为单个值特征表示,然后可以由任何分类器使用。此外,我们提出并评估了三种不同的策略,通过将特征稀疏性纳入新的表示形式来利用特征稀疏性。
在从真实 EHR 系统中提取的 15 个 ADE 数据集上进行的大规模评估表明,与最先进的方法相比,所提出的框架实现了显著提高的预测性能。此外,我们的框架可以揭示出在 ADE 检测方面与医学发现一致的特征。
我们的研究和实验结果表明,可以有效地利用时间多变量特征来预测来自 EHR 的 ADE,这些特征具有可变长度和高稀疏性。我们的框架有两个关键优势:它是方法不可知的,即多功能的,并且计算成本低,即快速;因此,它为未来在机器学习领域利用 EHR 提供了一个重要的构建模块。