Applying Supervised Machine Learning to Identify Which Patient Characteristics Identify the Highest Rates of Mortality Post-Interhospital Transfer. (March 2019)

• Record Type: Journal Article
• Authors: Reimer, Andrew P; Schiltz, Nicholas K; Ho, Vanessa P; Madigan, Elizabeth A; Koroukian, Siran M
• Is Part Of: Biomedical informatics insights. Volume 2019:Number 11(2019)
• Publication Date: 2019-03
• Subjects: Transportation of patients -- supervised machine learning -- patient outcome assessment; Medical informatics -- Periodicals; Medicine -- Periodicals; Medical Informatics; Medicine; Medical informatics; Medicine; Periodicals; Periodicals; 610.285
• DOI: 10.1177/1178222619835548
• Languages: English
• ISSNs: 1178-2226

Abstract

Objective: To demonstrate the usefulness of applying supervised machine-learning analyses to identify specific groups of patients that experience high levels of mortality post-interhospital transfer. Methods: This was a cross-sectional analysis of data from the Health Care Utilization Project 2013 National Inpatient Sample, that applied supervised machine-learning approaches that included (1) classification and regression tree to identify mutually exclusive groups of patients and their associated characteristics of those experiencing the highest levels of mortality and (2) random forest to identify the relative importance of each characteristic's contribution to post-transfer mortality. Results: A total of 21 independent groups of patients were identified, with 13 of those groups exhibiting at least double the national average rate of mortality post-transfer. Patient characteristics identified as influencing post-transfer mortality the most included: diagnosis of a circulatory disorder, comorbidity of coagulopathy, diagnosis of cancer, and age. Conclusions: Employing supervised machine-learning analyses enabled the computational feasibility to assess all potential combinations of available patient characteristics to identify groups of patients experiencing the highest rates of mortality post-interhospital transfer, providing potentially useful data to support developing clinical decision support systems in future work.