Institute for Infocomm Research, Agency for Science Technology & Research, Singapore.
Changi General Hospital, Singapore.
AMIA Annu Symp Proc. 2021 Jan 25;2020:432-441. eCollection 2020.
Heart failure (HF) is a leading cause of hospital readmissions. There is great interest in approaches to efficiently predict emerging HF-readmissions in the community setting. We investigate the possibility of leveraging streaming telemonitored vital signs data alongside readily accessible patient profile information for predicting evolving 30-day HF-related readmission risk. We acquired data within a non-randomized controlled study that enrolled 150 HF patients over a 1-year post-discharge telemonitoring and telesupport programme. Using the sequential data and associated ground truth readmission outcomes, we developed a recurrent neural network model for dynamic risk prediction. The model detects emerging readmissions with sensitivity > 71%, specificity > 75%, AUROC ~80%. We characterize model performance in relation to telesupport based nurse assessments, and demonstrate strong sensitivity improvements. Our approach enables early stratification of high-risk patients and could enable adaptive targeting of care resources for managing patients with the most urgent needs at any given time.
心力衰竭(HF)是导致住院再入院的主要原因。人们非常关注在社区环境中有效预测新发 HF 再入院的方法。我们研究了利用流式远程监测生命体征数据以及易于获得的患者个人资料信息来预测 30 天内 HF 相关再入院风险的可能性。我们在一项非随机对照研究中获取了数据,该研究在远程监测和远程支持计划后 1 年内招募了 150 名 HF 患者。使用顺序数据和相关的实际再入院结果,我们为动态风险预测开发了一个递归神经网络模型。该模型对新发再入院的检出率为灵敏度>71%,特异性>75%,AUROC~80%。我们根据基于远程监护的护士评估来描述模型性能,并证明了灵敏度的显著提高。我们的方法能够对高危患者进行早期分层,并能够针对最需要的患者进行自适应的护理资源分配。