Support Vector Feature Selection for Early Detection of Anastomosis Leakage From Bag-of-Words in Electronic Health Records.

Journal: IEEE journal of biomedical and health informatics
Published Date:

Abstract

The free text in electronic health records (EHRs) conveys a huge amount of clinical information about health state and patient history. Despite a rapidly growing literature on the use of machine learning techniques for extracting this information, little effort has been invested toward feature selection and the features' corresponding medical interpretation. In this study, we focus on the task of early detection of anastomosis leakage (AL), a severe complication after elective surgery for colorectal cancer (CRC) surgery, using free text extracted from EHRs. We use a bag-of-words model to investigate the potential for feature selection strategies. The purpose is earlier detection of AL and prediction of AL with data generated in the EHR before the actual complication occur. Due to the high dimensionality of the data, we derive feature selection strategies using the robust support vector machine linear maximum margin classifier, by investigating: 1) a simple statistical criterion (leave-one-out-based test); 2) an intensive-computation statistical criterion (Bootstrap resampling); and 3) an advanced statistical criterion (kernel entropy). Results reveal a discriminatory power for early detection of complications after CRC (sensitivity 100%; specificity 72%). These results can be used to develop prediction models, based on EHR data, that can support surgeons and patients in the preoperative decision making phase.

Authors

  • Cristina Soguero-Ruiz
    Department of Signal Theory and Communications, Telematics and Computing Systems, Rey Juan Carlos University, Madrid, Spain. Electronic address: cristina.soguero@urjc.es.
  • Kristian Hindberg
  • José Luis Rojo-Álvarez
    Department of Signal Theory and Communications, Telematics and Computing, Universidad Rey Juan Carlos, Fuenlabrada 28943, Spain; Universidad de las Fuerzas Armadas-ESPE, Sangolquí 171-5-231B, Ecuador.
  • Stein Olav Skrøvseth
    Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway; Department of Mathematics and Statistics, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.
  • Fred Godtliebsen
  • Kim Mortensen
  • Arthur Revhaug
  • Rolv-Ole Lindsetmo
    Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.
  • Knut Magne Augestad
    Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway; Department of Surgery, Hammerfest Hospital, Hammerfest, Norway.
  • Robert Jenssen
    Department of Physics and Technology, University of Tromsø - The Arctic University of Norway, Tromsø, Norway; Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway.