Prediction of In-hospital Mortality in Emergency Department Patients With Sepsis: A Local Big Data-Driven, Machine Learning Approach.

Journal: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
Published Date:

Abstract

OBJECTIVES: Predictive analytics in emergency care has mostly been limited to the use of clinical decision rules (CDRs) in the form of simple heuristics and scoring systems. In the development of CDRs, limitations in analytic methods and concerns with usability have generally constrained models to a preselected small set of variables judged to be clinically relevant and to rules that are easily calculated. Furthermore, CDRs frequently suffer from questions of generalizability, take years to develop, and lack the ability to be updated as new information becomes available. Newer analytic and machine learning techniques capable of harnessing the large number of variables that are already available through electronic health records (EHRs) may better predict patient outcomes and facilitate automation and deployment within clinical decision support systems. In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing CDRs and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case.

Authors

  • R Andrew Taylor
    Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
  • Joseph R Pare
    Department of Emergency Medicine, Yale University, Yale-New Haven Hospital, New Haven, CT.
  • Arjun K Venkatesh
    Department of Emergency Medicine, Yale University, Yale-New Haven Hospital, New Haven, CT.
  • Hani Mowafi
    Department of Emergency Medicine, Yale University, Yale-New Haven Hospital, New Haven, CT.
  • Edward R Melnick
    Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
  • William Fleischman
    Department of Emergency Medicine, Yale University, Yale-New Haven Hospital, New Haven, CT.
  • M Kennedy Hall
    Department of Emergency Medicine, Yale University, Yale-New Haven Hospital, New Haven, CT.