Office of eHealth Research and Business, Seoul National University Bundang Hospital, 172, Dolma-ro, Bundang-gu, Seongnam-si, 13605, Gyeonggi-do, Republic of Korea.
Department of Biomedical Engineering, College of Medicine, Seoul National University, 28 Yongon-Dong Chongro-Gu, Seoul, 110-799, Korea.
Sci Rep. 2021 Dec 2;11(1):23313. doi: 10.1038/s41598-021-02395-9.
Although several studies have attempted to develop a model for predicting 30-day re-hospitalization, few attempts have been made for sufficient verification and multi-center expansion for clinical use. In this study, we developed a model that predicts unplanned hospital readmission within 30 days of discharge; the model is based on a common data model and considers weather and air quality factors, and can be easily extended to multiple hospitals. We developed and compared four tree-based machine learning methods: decision tree, random forest, AdaBoost, and gradient boosting machine (GBM). Above all, GBM showed the highest AUC performance of 75.1 in the clinical model, while the clinical and W-score model showed the best performance of 73.9 for musculoskeletal diseases. Further, PM10, rainfall, and maximum temperature were the weather and air quality variables that most impacted the model. In addition, external validation has confirmed that the model based on weather and air quality factors has transportability to adapt to other hospital systems.
虽然已经有几项研究试图开发一种预测 30 天内再入院的模型,但很少有研究对其进行充分验证和扩展到多中心以用于临床。在本研究中,我们开发了一种可预测出院后 30 天内非计划性住院的模型;该模型基于通用数据模型,考虑了天气和空气质量因素,并且可以轻松扩展到多家医院。我们开发并比较了四种基于树的机器学习方法:决策树、随机森林、AdaBoost 和梯度提升机(GBM)。总的来说,GBM 在临床模型中的 AUC 性能最高,达到了 75.1,而临床和 W 评分模型在肌肉骨骼疾病方面的表现最好,为 73.9。此外,PM10、降雨量和最高温度是对模型影响最大的天气和空气质量变量。此外,外部验证已证实基于天气和空气质量因素的模型具有可移植性,能够适应其他医院系统。