scholarly journals A Machine Learning Model for Predicting Unscheduled 72 h Return Visits to the Emergency Department by Patients with Abdominal Pain

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 82
Author(s):  
Chun-Chuan Hsu ◽  
Cheng-CJ Chu ◽  
Ching-Heng Lin ◽  
Chien-Hsiung Huang ◽  
Chip-Jin Ng ◽  
...  
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Learning Model ◽  
Supervised Machine Learning ◽  
Support Vector ◽  
Research Database ◽  
Machine Learning Model ◽  
Extreme Gradient Boosting ◽  
Return Visits

Seventy-two-hour unscheduled return visits (URVs) by emergency department patients are a key clinical index for evaluating the quality of care in emergency departments (EDs). This study aimed to develop a machine learning model to predict 72 h URVs for ED patients with abdominal pain. Electronic health records data were collected from the Chang Gung Research Database (CGRD) for 25,151 ED visits by patients with abdominal pain and a total of 617 features were used for analysis. We used supervised machine learning models, namely logistic regression (LR), support vector machine (SVM), random forest (RF), extreme gradient boosting (XGB), and voting classifier (VC), to predict URVs. The VC model achieved more favorable overall performance than other models (AUROC: 0.74; 95% confidence interval (CI), 0.69–0.76; sensitivity, 0.39; specificity, 0.89; F1 score, 0.25). The reduced VC model achieved comparable performance (AUROC: 0.72; 95% CI, 0.69–0.74) to the full models using all clinical features. The VC model exhibited the most favorable performance in predicting 72 h URVs for patients with abdominal pain, both for all-features and reduced-features models. Application of the VC model in the clinical setting after validation may help physicians to make accurate decisions and decrease URVs.

scholarly journals Machine Learning Assisted Chimera and Solitary States in Networks

2021 ◽  
Vol 9 ◽  
Author(s):  
Niraj Kushwaha ◽  
Naveen Kumar Mendola ◽  
Saptarshi Ghosh ◽  
Ajay Deep Kachhvah ◽  
Sarika Jalan
Keyword(s):  
Machine Learning ◽  
Single Layer ◽  
Dynamical Evolution ◽  
Network Models ◽  
Learning Model ◽  
Supervised Machine Learning ◽  
Support Vector ◽  
Svm Classifier ◽  
Chimera States ◽  
Machine Learning Model

Chimera and Solitary states have captivated scientists and engineers due to their peculiar dynamical states corresponding to co-existence of coherent and incoherent dynamical evolution in coupled units in various natural and artificial systems. It has been further demonstrated that such states can be engineered in systems of coupled oscillators by suitable implementation of communication delays. Here, using supervised machine learning, we predict (a) the precise value of delay which is sufficient for engineering chimera and solitary states for a given set of system's parameters, as well as (b) the intensity of incoherence for such engineered states. Ergo, using few initial data points we generate a machine learning model which can then create a more refined phase plot as well as by including new parameter values. We demonstrate our results for two different examples consisting of single layer and multi layer networks. First, the chimera states (solitary states) are engineered by establishing delays in the neighboring links of a node (the interlayer links) in a 2-D lattice (multiplex network) of oscillators. Then, different machine learning classifiers, K-nearest neighbors (KNN), support vector machine (SVM) and multi-layer perceptron neural network (MLP-NN) are employed by feeding the data obtained from the network models. Once a machine learning model is trained using the limited amount of data, it predicts the precise value of critical delay as well as the intensity of incoherence for a given unknown systems parameters values. Testing accuracy, sensitivity, and specificity analysis reveal that MLP-NN classifier is better suited than Knn or SVM classifier for the predictions of parameters values for engineered chimera and solitary states. The technique provides an easy methodology to predict critical delay values as well as intensity of incoherence for that delay value for designing an experimental setup to create solitary and chimera states.

scholarly journals Exploring U.S. Shifts in Anti-Asian Sentiment with the Emergence of COVID-19

2020 ◽  
Vol 17 (19) ◽  
pp. 7032
Author(s):  
Thu T. Nguyen ◽  
Shaniece Criss ◽  
Pallavi Dwivedi ◽  
Dina Huang ◽  
Jessica Keralis ◽  
...  
Keyword(s):  
Machine Learning ◽  
Application Programming Interface ◽  
Learning Model ◽  
Systematic Investigation ◽  
Supervised Machine Learning ◽  
Support Vector ◽  
Time Period ◽  
Machine Learning Model ◽  
Life Impact ◽  
Application Programming

Background: Anecdotal reports suggest a rise in anti-Asian racial attitudes and discrimination in response to COVID-19. Racism can have significant social, economic, and health impacts, but there has been little systematic investigation of increases in anti-Asian prejudice. Methods: We utilized Twitter’s Streaming Application Programming Interface (API) to collect 3,377,295 U.S. race-related tweets from November 2019–June 2020. Sentiment analysis was performed using support vector machine (SVM), a supervised machine learning model. Accuracy for identifying negative sentiments, comparing the machine learning model to manually labeled tweets was 91%. We investigated changes in racial sentiment before and following the emergence of COVID-19. Results: The proportion of negative tweets referencing Asians increased by 68.4% (from 9.79% in November to 16.49% in March). In contrast, the proportion of negative tweets referencing other racial/ethnic minorities (Blacks and Latinx) remained relatively stable during this time period, declining less than 1% for tweets referencing Blacks and increasing by 2% for tweets referencing Latinx. Common themes that emerged during the content analysis of a random subsample of 3300 tweets included: racism and blame (20%), anti-racism (20%), and daily life impact (27%). Conclusion: Social media data can be used to provide timely information to investigate shifts in area-level racial sentiment.

scholarly journals An Autoencoder and Machine Learning Model to Predict Suicidal Ideation with Brain Structural Imaging

2020 ◽  
Vol 9 (3) ◽  
pp. 658 ◽  
Author(s):  
Jun-Cheng Weng ◽  
Tung-Yeh Lin ◽  
Yuan-Hsiung Tsai ◽  
Man Teng Cheok ◽  
Yi-Peng Eve Chang ◽  
...  
Keyword(s):  
Machine Learning ◽  
Suicidal Ideation ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Learning Model ◽  
Supervised Machine Learning ◽  
Gradient Boosting ◽  
Machine Learning Model ◽  
Extreme Gradient Boosting ◽  
Depressive Patients

It is estimated that at least one million people die by suicide every year, showing the importance of suicide prevention and detection. In this study, an autoencoder and machine learning model was employed to predict people with suicidal ideation based on their structural brain imaging. The subjects in our generalized q-sampling imaging (GQI) dataset consisted of three groups: 41 depressive patients with suicidal ideation (SI), 54 depressive patients without suicidal thoughts (NS), and 58 healthy controls (HC). In the GQI dataset, indices of generalized fractional anisotropy (GFA), isotropic values of the orientation distribution function (ISO), and normalized quantitative anisotropy (NQA) were separately trained in different machine learning models. A convolutional neural network (CNN)-based autoencoder model, the supervised machine learning algorithm extreme gradient boosting (XGB), and logistic regression (LR) were used to discriminate SI subjects from NS and HC subjects. After five-fold cross validation, separate data were tested to obtain the accuracy, sensitivity, specificity, and area under the curve of each result. Our results showed that the best pattern of structure across multiple brain locations can classify suicidal ideates from NS and HC with a prediction accuracy of 85%, a specificity of 100% and a sensitivity of 75%. The algorithms developed here might provide an objective tool to help identify suicidal ideation risk among depressed patients alongside clinical assessment.

scholarly journals Prediction of Flight Time Deviation for Lithuanian Airports Using Supervised Machine Learning Model

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Pavel Stefanovič ◽  
Rokas Štrimaitis ◽  
Olga Kurasova
Keyword(s):  
Machine Learning ◽  
Probabilistic Neural Network ◽  
Forest Tree ◽  
Learning Model ◽  
Flight Time ◽  
Supervised Machine Learning ◽  
Support Vector ◽  
Tree Model ◽  
Machine Learning Model ◽  
Random Forest Tree

In the paper, the flight time deviation of Lithuania airports has been analyzed. The supervised machine learning model has been implemented to predict the interval of time delay deviation of new flights. The analysis has been made using seven algorithms: probabilistic neural network, multilayer perceptron, decision trees, random forest, tree ensemble, gradient boosted trees, and support vector machines. To find the best parameters which give the highest accuracy for each algorithm, the grid search has been used. To evaluate the quality of each algorithm, the five measures have been calculated: sensitivity/recall, precision, specificity, F-measure, and accuracy. All experimental investigation has been made using the newly collected dataset from Lithuania airports and weather information on departure/landing time. The departure flights and arrival flights have been investigated separately. To balance the dataset, the SMOTE technique is used. The research results showed that the highest accuracy is obtained using the tree model classifiers and the best algorithm of this type to predict is gradient boosted trees.

scholarly journals Machine Learning Model to Identify Sepsis Patients in the Emergency Department: Algorithm Development and Validation

2021 ◽  
Vol 11 (11) ◽  
pp. 1055
Author(s):  
Pei-Chen Lin ◽  
Kuo-Tai Chen ◽  
Huan-Chieh Chen ◽  
Md. Mohaimenul Islam ◽  
Ming-Chin Lin
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
Characteristic Curve ◽  
External Validation ◽  
Model Performance ◽  
Learning Model ◽  
Gradient Boosting ◽  
Machine Learning Model ◽  
Extreme Gradient Boosting ◽  
Development And Validation

Accurate stratification of sepsis can effectively guide the triage of patient care and shared decision making in the emergency department (ED). However, previous research on sepsis identification models focused mainly on ICU patients, and discrepancies in model performance between the development and external validation datasets are rarely evaluated. The aim of our study was to develop and externally validate a machine learning model to stratify sepsis patients in the ED. We retrospectively collected clinical data from two geographically separate institutes that provided a different level of care at different time periods. The Sepsis-3 criteria were used as the reference standard in both datasets for identifying true sepsis cases. An eXtreme Gradient Boosting (XGBoost) algorithm was developed to stratify sepsis patients and the performance of the model was compared with traditional clinical sepsis tools; quick Sequential Organ Failure Assessment (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS). There were 8296 patients (1752 (21%) being septic) in the development and 1744 patients (506 (29%) being septic) in the external validation datasets. The mortality of septic patients in the development and validation datasets was 13.5% and 17%, respectively. In the internal validation, XGBoost achieved an area under the receiver operating characteristic curve (AUROC) of 0.86, exceeding SIRS (0.68) and qSOFA (0.56). The performance of XGBoost deteriorated in the external validation (the AUROC of XGBoost, SIRS and qSOFA was 0.75, 0.57 and 0.66, respectively). Heterogeneity in patient characteristics, such as sepsis prevalence, severity, age, comorbidity and infection focus, could reduce model performance. Our model showed good discriminative capabilities for the identification of sepsis patients and outperformed the existing sepsis identification tools. Implementation of the ML model in the ED can facilitate timely sepsis identification and treatment. However, dataset discrepancies should be carefully evaluated before implementing the ML approach in clinical practice. This finding reinforces the necessity for future studies to perform external validation to ensure the generalisability of any developed ML approaches.

scholarly journals Predicting adult neuroscience intensive care unit admission from emergency department triage using a retrospective, tabular-free text machine learning approach

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eyal Klang ◽  
Benjamin R. Kummer ◽  
Neha S. Dangayach ◽  
Amy Zhong ◽  
M. Arash Kia ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Learning Model ◽  
Free Text ◽  
Combined Model ◽  
Text Data ◽  
Machine Learning Model ◽  
Record Data

AbstractEarly admission to the neurosciences intensive care unit (NSICU) is associated with improved patient outcomes. Natural language processing offers new possibilities for mining free text in electronic health record data. We sought to develop a machine learning model using both tabular and free text data to identify patients requiring NSICU admission shortly after arrival to the emergency department (ED). We conducted a single-center, retrospective cohort study of adult patients at the Mount Sinai Hospital, an academic medical center in New York City. All patients presenting to our institutional ED between January 2014 and December 2018 were included. Structured (tabular) demographic, clinical, bed movement record data, and free text data from triage notes were extracted from our institutional data warehouse. A machine learning model was trained to predict likelihood of NSICU admission at 30 min from arrival to the ED. We identified 412,858 patients presenting to the ED over the study period, of whom 1900 (0.5%) were admitted to the NSICU. The daily median number of ED presentations was 231 (IQR 200–256) and the median time from ED presentation to the decision for NSICU admission was 169 min (IQR 80–324). A model trained only with text data had an area under the receiver-operating curve (AUC) of 0.90 (95% confidence interval (CI) 0.87–0.91). A structured data-only model had an AUC of 0.92 (95% CI 0.91–0.94). A combined model trained on structured and text data had an AUC of 0.93 (95% CI 0.92–0.95). At a false positive rate of 1:100 (99% specificity), the combined model was 58% sensitive for identifying NSICU admission. A machine learning model using structured and free text data can predict NSICU admission soon after ED arrival. This may potentially improve ED and NSICU resource allocation. Further studies should validate our findings.

scholarly journals Machine-learning algorithm that can improve the diagnostic accuracy of septic arthritis of the knee

2021 ◽  
Author(s):  
Eun-Seok Choi ◽  
Jae Ang Sim ◽  
Young Gon Na ◽  
Jong- Keun Seon ◽  
Hyun Dae Shin
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Septic Arthritis ◽  
Inflammatory Arthritis ◽  
Supervised Machine Learning ◽  
Diagnostic Model ◽  
Extreme Gradient Boosting ◽  
Wbc Count

Abstract Purpose Prompt diagnosis and treatment of septic arthritis of the knee is crucial. Nevertheless, the quality of evidence for the diagnosis of septic arthritis is low. In this study, the authors developed a machine learning-based diagnostic algorithm for septic arthritis of the native knee using clinical data in an emergency department and validated its diagnostic accuracy. Methods Patients (n = 326) who underwent synovial fluid analysis at the emergency department for suspected septic arthritis of the knee were enrolled. Septic arthritis was diagnosed in 164 of the patients (50.3%) using modified Newman criteria. Clinical characteristics of septic and inflammatory arthritis were compared. Area under the receiver-operating characteristic (ROC) curve (AUC) statistics was applied to evaluate the efficacy of each variable for the diagnosis of septic arthritis. The dataset was divided into independent training and test sets (comprising 80% and 20%, respectively, of the data). Supervised machine-learning techniques (random forest and eXtreme Gradient Boosting: XGBoost) were applied to develop a diagnostic model using the training dataset. The test dataset was subsequently used to validate the developed model. The ROC curves of the machine-learning model and each variable were compared. Results Synovial white blood cell (WBC) count was significantly higher in septic arthritis than in inflammatory arthritis in the multivariate analysis (P = 0.001). In the ROC comparison analysis, synovial WBC count yielded a significantly higher AUC than all other single variables (P = 0.002). The diagnostic model using the XGBoost algorithm yielded a higher AUC (0.831, 95% confidence interval 0.751–0.923) than synovial WBC count (0.740, 95% confidence interval 0.684–0.791; P = 0.033). The developed algorithm was deployed as a free access web-based application (www.septicknee.com). Conclusion The diagnosis of septic arthritis of the knee might be improved using a machine learning-based prediction model. Level of evidence Diagnostic study Level III (Case–control study).

scholarly journals Machine Learning Model for Outcome Prediction of Patients Suffering from Acute Diverticulitis Arriving at the Emergency Department—A Proof of Concept Study

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2102
Author(s):  
Eyal Klang ◽  
Robert Freeman ◽  
Matthew A. Levin ◽  
Shelly Soffer ◽  
Yiftach Barash ◽  
...  
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
Acute Diverticulitis ◽  
External Validation ◽  
White Blood Cells ◽  
Learning Model ◽  
Complicated Diverticulitis ◽  
Gradient Boosting ◽  
Proof Of Concept ◽  
Machine Learning Model

Background & Aims: We aimed at identifying specific emergency department (ED) risk factors for developing complicated acute diverticulitis (AD) and evaluate a machine learning model (ML) for predicting complicated AD. Methods: We analyzed data retrieved from unselected consecutive large bowel AD patients from five hospitals from the Mount Sinai health system, NY. The study time frame was from January 2011 through March 2021. Data were used to train and evaluate a gradient-boosting machine learning model to identify patients with complicated diverticulitis, defined as a need for invasive intervention or in-hospital mortality. The model was trained and evaluated on data from four hospitals and externally validated on held-out data from the fifth hospital. Results: The final cohort included 4997 AD visits. Of them, 129 (2.9%) visits had complicated diverticulitis. Patients with complicated diverticulitis were more likely to be men, black, and arrive by ambulance. Regarding laboratory values, patients with complicated diverticulitis had higher levels of absolute neutrophils (AUC 0.73), higher white blood cells (AUC 0.70), platelet count (AUC 0.68) and lactate (AUC 0.61), and lower levels of albumin (AUC 0.69), chloride (AUC 0.64), and sodium (AUC 0.61). In the external validation cohort, the ML model showed AUC 0.85 (95% CI 0.78–0.91) for predicting complicated diverticulitis. For Youden’s index, the model showed a sensitivity of 88% with a false positive rate of 1:3.6. Conclusions: A ML model trained on clinical measures provides a proof of concept performance in predicting complications in patients presenting to the ED with AD. Clinically, it implies that a ML model may classify low-risk patients to be discharged from the ED for further treatment under an ambulatory setting.

scholarly journals MEWS++: Enhancing the Prediction of Clinical Deterioration in Admitted Patients through a Machine Learning Model

2020 ◽  
Vol 9 (2) ◽  
pp. 343 ◽  
Author(s):  
Arash Kia ◽  
Prem Timsina ◽  
Himanshu N. Joshi ◽  
Eyal Klang ◽  
Rohit R. Gupta ◽  
...  
Keyword(s):  
Machine Learning ◽  
At Risk ◽  
Area Under The Curve ◽  
Learning Model ◽  
Clinical Deterioration ◽  
Early Warning Score ◽  
Support Vector ◽  
Adult Age ◽  
Machine Learning Model ◽  
Patients At Risk

Early detection of patients at risk for clinical deterioration is crucial for timely intervention. Traditional detection systems rely on a limited set of variables and are unable to predict the time of decline. We describe a machine learning model called MEWS++ that enables the identification of patients at risk of escalation of care or death six hours prior to the event. A retrospective single-center cohort study was conducted from July 2011 to July 2017 of adult (age > 18) inpatients excluding psychiatric, parturient, and hospice patients. Three machine learning models were trained and tested: random forest (RF), linear support vector machine, and logistic regression. We compared the models’ performance to the traditional Modified Early Warning Score (MEWS) using sensitivity, specificity, and Area Under the Curve for Receiver Operating Characteristic (AUC-ROC) and Precision-Recall curves (AUC-PR). The primary outcome was escalation of care from a floor bed to an intensive care or step-down unit, or death, within 6 h. A total of 96,645 patients with 157,984 hospital encounters and 244,343 bed movements were included. Overall rate of escalation or death was 3.4%. The RF model had the best performance with sensitivity 81.6%, specificity 75.5%, AUC-ROC of 0.85, and AUC-PR of 0.37. Compared to traditional MEWS, sensitivity increased 37%, specificity increased 11%, and AUC-ROC increased 14%. This study found that using machine learning and readily available clinical data, clinical deterioration or death can be predicted 6 h prior to the event. The model we developed can warn of patient deterioration hours before the event, thus helping make timely clinical decisions.

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