Ben-Assuli Ofir, Padman Rema
Information Systems Department, Faculty of Business Administration, Ono Academic College, Kiryat Ono, Israel.
The H. John Heinz III College, Carnegie Mellon University, Pittsburgh, PA, USA.
Health Syst (Basingstoke). 2018 Nov 9;7(3):166-180. doi: 10.1080/20476965.2018.1510040. eCollection 2018.
Few studies have examined how to identify future readmission of patients with a large number of repeat emergency department (ED) visits. We explore 30-day readmission risk prediction using Microsoft's AZURE machine learning software and compare five classification methods: Logistic Regression, Boosted Decision Trees (BDTs), Support Vector Machine (SVM), Bayes Point Machine (BPM), and Two-Class Neural Network (TCNN). We predict the last readmission visit of frequent ED patients extracted from the electronic health records of their 8455 penultimate visits. The methods show differential improvement, with the BDT indicating marginally better AUC (area under the ROC curve) than logistic regression and BPM, followed by the TCNN and SVM. A comparison of BDT and Logistic Regression results for correct and incorrect classification highlights the similarities and differences in the significant predictors identified by each method. Future research may incorporate time-varying covariates to identify other longitudinal factors that can lead to readmission risk reduction.
很少有研究探讨如何识别有大量重复急诊科就诊史的患者未来的再入院情况。我们使用微软的AZURE机器学习软件探索30天再入院风险预测,并比较五种分类方法:逻辑回归、增强决策树(BDT)、支持向量机(SVM)、贝叶斯点机器(BPM)和二类神经网络(TCNN)。我们预测了从8455次倒数第二次就诊的电子健康记录中提取的频繁急诊科患者的最后一次再入院就诊情况。这些方法显示出不同程度的改进,BDT的ROC曲线下面积(AUC)略优于逻辑回归和BPM,其次是TCNN和SVM。BDT和逻辑回归结果在正确和错误分类方面的比较突出了每种方法所识别的显著预测因素的异同。未来的研究可能会纳入随时间变化的协变量,以识别其他可降低再入院风险的纵向因素。