Role of machine learning in clinical decision support (Presentation Recording)

2015 ◽  
Author(s):  
Tanveer F. Syeda-Mahmood
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision

scholarly journals Prospects and Challenges for Clinical Decision Support in the Era of Big Data

2018 ◽  
pp. 1-12 ◽  
Author(s):  
Issam El Naqa ◽  
Michael R. Kosorok ◽  
Judy Jin ◽  
Michelle Mierzwa ◽  
Randall K. Ten Haken
Keyword(s):  
Machine Learning ◽  
Big Data ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Learning Algorithms ◽  
Clinical Decision ◽  
Machine Learning Algorithms ◽  
Current Status ◽  
Analytical Approaches

Recently, there has been burgeoning interest in developing more effective and robust clinical decision support systems (CDSSs) for oncology. This has been primarily driven by the demands for more personalized and precise medical practice in oncology in the era of so-called big data (BD), an era that promises to harness the power of large-scale data flow to revolutionize cancer treatment. This interest in BD analytics has created new opportunities as well as new unmet challenges. These include: routine aggregation and standardization of clinical data, patient privacy, transformation of current analytical approaches to handle such noisy and heterogeneous data, and expanded use of advanced statistical learning methods on the basis of confluence of modern statistical methods and machine learning algorithms. In this review, we present the current status of CDSSs in oncology, the prospects and current challenges of BD analytics, and the promising role of integrated modern statistics and machine learning algorithms in predicting complex clinical end points, individualizing treatment rules, and optimizing dynamic personalized treatment regimens. We discuss issues pertaining to these topics and present application examples from an aggregate of experiences. We also discuss the role of human factors in improving the use and acceptance of such enhanced CDSSs and how to mitigate possible sources of human error to achieve optimal performance and wider acceptance.

scholarly journals NCOG-31. DEVELOPMENT AND EVALUATION OF PROGNOSTIC MODELS TO PREDICT SURVIVAL OF PATIENTS WITH GLIOBLASTOMA MULTIFORME

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii135-ii136
Author(s):  
John Lin ◽  
Michelle Mai ◽  
Saba Paracha
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Glioblastoma Multiforme ◽  
Random Forest ◽  
Regression Model ◽  
Clinical Decision Support ◽  
Multivariate Regression ◽  
Visual Analysis ◽  
Clinical Decision ◽  
Prognostic Models

Abstract Glioblastoma multiforme (GBM), the most common form of glioma, is a malignant tumor with a high risk of mortality. By providing accurate survival estimates, prognostic models have been identified as promising tools in clinical decision support. In this study, we produced and validated two machine learning-based models to predict survival time for GBM patients. Publicly available clinical and genomic data from The Cancer Genome Atlas (TCGA) and Broad Institute GDAC Firehouse were obtained through cBioPortal. Random forest and multivariate regression models were created to predict survival. Predictive accuracy was assessed and compared through mean absolute error (MAE) and root mean square error (RMSE) calculations. 619 GBM patients were included in the dataset. There were 381 (62.9%) cases of recurrence/progression and 53 (8.7%) cases of disease-free survival. The MAE and RMSE values were 0.553 and 0.887 years respectively for the random forest regression model, and they were 1.756 and 2.451 years respectively for the multivariate regression model. Both models accurately predicted overall survival. Comparison of models through MAE, RMSE, and visual analysis produced higher accuracy values for random forest than multivariate linear regression. Further investigation on feature selection and model optimization may improve predictive power. These findings suggest that using machine learning in GBM prognostic modeling will improve clinical decision support. *Co-first authors.

GUESS: projecting machine learning scores to well-calibrated probability estimates for clinical decision-making

2018 ◽  
Vol 35 (14) ◽  
pp. 2458-2465 ◽  
Author(s):  
Johanna Schwarz ◽  
Dominik Heider
Keyword(s):  
Machine Learning ◽  
Decision Support ◽  
Clinical Decision Support ◽  
State Of The Art ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Calibration Method ◽  
Probability Estimates ◽  
Calibration Methods ◽  
Novel Method

Abstract Motivation Clinical decision support systems have been applied in numerous fields, ranging from cancer survival toward drug resistance prediction. Nevertheless, clinical decision support systems typically have a caveat: many of them are perceived as black-boxes by non-experts and, unfortunately, the obtained scores cannot usually be interpreted as class probability estimates. In probability-focused medical applications, it is not sufficient to perform well with regards to discrimination and, consequently, various calibration methods have been developed to enable probabilistic interpretation. The aims of this study were (i) to develop a tool for fast and comparative analysis of different calibration methods, (ii) to demonstrate their limitations for the use on clinical data and (iii) to introduce our novel method GUESS. Results We compared the performances of two different state-of-the-art calibration methods, namely histogram binning and Bayesian Binning in Quantiles, as well as our novel method GUESS on both, simulated and real-world datasets. GUESS demonstrated calibration performance comparable to the state-of-the-art methods and always retained accurate class discrimination. GUESS showed superior calibration performance in small datasets and therefore may be an optimal calibration method for typical clinical datasets. Moreover, we provide a framework (CalibratR) for R, which can be used to identify the most suitable calibration method for novel datasets in a timely and efficient manner. Using calibrated probability estimates instead of original classifier scores will contribute to the acceptance and dissemination of machine learning based classification models in cost-sensitive applications, such as clinical research. Availability and implementation GUESS as part of CalibratR can be downloaded at CRAN.

An Assessment of Federated Machine Learning for Translational Research

2020 ◽  
pp. 123-142
Author(s):  
Manoj A. Thomas ◽  
Diya Suzanne Abraham ◽  
Dapeng Liu
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Decision Support ◽  
Translational Research ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
High Quality ◽  
Intermediate Data ◽  
Translational Informatics ◽  
Data Analytic

Translational research (TR) is the harnessing of knowledge from basic science and clinical research to advance healthcare. As a sister discipline, translational informatics (TI) concerns the application of informatics theories, methods, and frameworks to TR. This chapter builds upon TR concepts and aims to advance the use of machine learning (ML) and data analytics for improving clinical decision support. A federated machine learning (FML) architecture is described to aggregate multiple ML endpoints, and intermediate data analytic processes and products to output high quality knowledge discovery and decision making. The proposed architecture is evaluated for its operational performance based on three propositions, and a case for clinical decision support in the prediction of adult Sepsis is presented. The chapter illustrates contributions to the advancement of FML and TI.

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