Using statistical anomaly detection models to find clinical decision support malfunctions

Journal of the American Medical Informatics Association : JAMIA
Soumi RayAdam Wright

Abstract

Malfunctions in Clinical Decision Support (CDS) systems occur due to a multitude of reasons, and often go unnoticed, leading to potentially poor outcomes. Our goal was to identify malfunctions within CDS systems. We evaluated 6 anomaly detection models: (1) Poisson Changepoint Model, (2) Autoregressive Integrated Moving Average (ARIMA) Model, (3) Hierarchical Divisive Changepoint (HDC) Model, (4) Bayesian Changepoint Model, (5) Seasonal Hybrid Extreme Studentized Deviate (SHESD) Model, and (6) E-Divisive with Median (EDM) Model and characterized their ability to find known anomalies. We analyzed 4 CDS alerts with known malfunctions from the Longitudinal Medical Record (LMR) and Epic® (Epic Systems Corporation, Madison, WI, USA) at Brigham and Women's Hospital, Boston, MA. The 4 rules recommend lead testing in children, aspirin therapy in patients with coronary artery disease, pneumococcal vaccination in immunocompromised adults and thyroid testing in patients taking amiodarone. Poisson changepoint, ARIMA, HDC, Bayesian changepoint and the SHESD model were able to detect anomalies in an alert for lead screening in children and in an alert for pneumococcal conjugate vaccine in immunocompromised adults. EDM was able to detect anom...Continue Reading

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Citations

Dec 13, 2018·Health Informatics Journal·Dean F SittigHardeep Singh
Jul 31, 2018·Journal of the American Medical Informatics Association : JAMIA·Adam WrightDean F Sittig
Jul 25, 2019·BMC Medical Informatics and Decision Making·Hossein EstiriShawn N Murphy
Sep 13, 2019·Journal of the American Medical Informatics Association : JAMIA·Vaishnavi KannanSeth M Toomay
Dec 17, 2019·Health Systems·Olufemi A OmitaomuJonathan R Nebeker
Nov 10, 2020·Journal of the American Medical Informatics Association : JAMIA·Amol A VermaFahad Razak
Dec 7, 2021·Clinical Chemistry·Andrew E O Hughes, Ronald Jackups
Jan 14, 2022·Journal of the American Medical Informatics Association : JAMIA·Dean F SittigHardeep Singh
Nov 7, 2019··Periklis A. PapakonstantinouHafiz Asif

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