Clinical evaluation of a machine learning-based early warning system for patient deterioration.

Journal: CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
PMID: 39284602

Abstract

BACKGROUND: The implementation and clinical impact of machine learning-based early warning systems for patient deterioration in hospitals have not been well described. We sought to describe the implementation and evaluation of a multifaceted, real-time, machine learning-based early warning system for patient deterioration used in the general internal medicine (GIM) unit of an academic medical centre.

Authors

  • Amol A Verma
    Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif. muhammad.mamdani@unityhealth.to amol.verma@mail.utoronto.ca.
  • Therese A Stukel
    Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.
  • Michael Colacci
    St. Michael's Hospital (Verma, Colacci, Bell, Ailon, Friedrich, Kuzulugil, Yang, Lee, Pou-Prom, Mamdani), Unity Health Toronto; Department of Medicine (Verma, Colacci, Ailon, Friedrich, Lee, Mamdani), and Institute of Health Policy, Management, and Evaluation (Verma, Stukel, Colacci, Murray, Mamdani), and Department of Laboratory Medicine and Pathobiology (Verma, Mamdani), University of Toronto; ICES Central (Stukel); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.
  • Shirley Bell
    St. Michael's Hospital (Verma, Colacci, Bell, Ailon, Friedrich, Kuzulugil, Yang, Lee, Pou-Prom, Mamdani), Unity Health Toronto; Department of Medicine (Verma, Colacci, Ailon, Friedrich, Lee, Mamdani), and Institute of Health Policy, Management, and Evaluation (Verma, Stukel, Colacci, Murray, Mamdani), and Department of Laboratory Medicine and Pathobiology (Verma, Mamdani), University of Toronto; ICES Central (Stukel); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.
  • Jonathan Ailon
    St. Michael's Hospital (Verma, Colacci, Bell, Ailon, Friedrich, Kuzulugil, Yang, Lee, Pou-Prom, Mamdani), Unity Health Toronto; Department of Medicine (Verma, Colacci, Ailon, Friedrich, Lee, Mamdani), and Institute of Health Policy, Management, and Evaluation (Verma, Stukel, Colacci, Murray, Mamdani), and Department of Laboratory Medicine and Pathobiology (Verma, Mamdani), University of Toronto; ICES Central (Stukel); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.
  • Jan O Friedrich
    St. Michael's Hospital (Verma, Colacci, Bell, Ailon, Friedrich, Kuzulugil, Yang, Lee, Pou-Prom, Mamdani), Unity Health Toronto; Department of Medicine (Verma, Colacci, Ailon, Friedrich, Lee, Mamdani), and Institute of Health Policy, Management, and Evaluation (Verma, Stukel, Colacci, Murray, Mamdani), and Department of Laboratory Medicine and Pathobiology (Verma, Mamdani), University of Toronto; ICES Central (Stukel); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.
  • Joshua Murray
    Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif.
  • Sebnem Kuzulugil
    St. Michael's Hospital (Verma, Colacci, Bell, Ailon, Friedrich, Kuzulugil, Yang, Lee, Pou-Prom, Mamdani), Unity Health Toronto; Department of Medicine (Verma, Colacci, Ailon, Friedrich, Lee, Mamdani), and Institute of Health Policy, Management, and Evaluation (Verma, Stukel, Colacci, Murray, Mamdani), and Department of Laboratory Medicine and Pathobiology (Verma, Mamdani), University of Toronto; ICES Central (Stukel); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.
  • Zhen Yang
    CAS Max-Planck Partner Institute for Computational Biology, Shanghai Institute of Biological Sciences, 320 Yue Yang Road, Shanghai, 200031, China.
  • Yuna Lee
    Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
  • Chloe Pou-Prom
    Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif.
  • Muhammad Mamdani
    Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif. muhammad.mamdani@unityhealth.to amol.verma@mail.utoronto.ca.

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