Multicenter Comparison of Machine Learning Methods and Conventional Regression for Predicting Clinical Deterioration on the Wards

Critical Care Medicine
Matthew M ChurpekDana P Edelson

Abstract

Machine learning methods are flexible prediction algorithms that may be more accurate than conventional regression. We compared the accuracy of different techniques for detecting clinical deterioration on the wards in a large, multicenter database. Observational cohort study. Five hospitals, from November 2008 until January 2013. Hospitalized ward patients None Demographic variables, laboratory values, and vital signs were utilized in a discrete-time survival analysis framework to predict the combined outcome of cardiac arrest, intensive care unit transfer, or death. Two logistic regression models (one using linear predictor terms and a second utilizing restricted cubic splines) were compared to several different machine learning methods. The models were derived in the first 60% of the data by date and then validated in the next 40%. For model derivation, each event time window was matched to a non-event window. All models were compared to each other and to the Modified Early Warning score, a commonly cited early warning score, using the area under the receiver operating characteristic curve (AUC). A total of 269,999 patients were admitted, and 424 cardiac arrests, 13,188 intensive care unit transfers, and 2,840 deaths occurred...Continue Reading

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Citations

Aug 16, 2016·Critical Care Medicine·Andrew J E Seely
Jul 26, 2017·Critical Care Medicine·Matthew Michael ChurpekUNKNOWN American Heart Association’s Get With The Guidelines-Resuscitation Investigators
Aug 23, 2017·Journal of Clinical Monitoring and Computing·Clemence PetitLouis Atallah
Dec 5, 2017·Journal of Intensive Care·Ryan R KrollUNKNOWN WEARable Information Technology for hospital INpatients (WEARIT-IN) study group
Feb 7, 2018·Journal of General Internal Medicine·S L CalcaterraK L Colborn
Mar 30, 2018·Critical Care Medicine·Jay L KoynerMatthew M Churpek
Jan 3, 2018·Critical Care Medicine·Claire ShappellUNKNOWN American Heart Association’s Get With The Guidelines-Resuscitation Investigators
Apr 10, 2018·Critical Care Medicine·Gary E WeissmanScott D Halpern
Jun 22, 2018·PloS One·Patrick C EschenfeldtChin Hur
May 23, 2018·Annals of the American Thoracic Society·Juan C RojasMatthew M Churpek
Jun 8, 2018·Pharmacotherapy·Seth R BauerSimon W Lam
Feb 28, 2018·Clinical Pharmacology and Therapeutics·Musaddique HussainXimei Wu
Sep 28, 2018·Intensive Care Medicine·Frederic MichardAndreas Taenzer
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