Application of Machine Learning to Predict Patient No-Shows in an Academic Pediatric Ophthalmology Clinic

Patient "no-shows" are missed appointments resulting in clinical inefficiencies, revenue loss, and discontinuity of care. Using secondary electronic health record (EHR) data, we used machine learning to predict patient no-shows in follow-up and new patient visits in pediatric ophthalmology and to evaluate features for importance. The best model, XGBoost, had an area under the receiver operating characteristics curve (AUC) score of 0.90 for predicting no-shows in follow-up visits. The key findings from this study are: (1) secondary use of EHR data can be used to build datasets for predictive modeling and successfully predict patient no-shows in pediatric ophthalmology, (2) models predicting no-shows for follow-up visits are more accurate than those for new patient visits, and (3) the performance of predictive models is more robust in predicting no-shows compared to individual important features. We hope these models will be used for more effective interventions to mitigate the impact ofpatient no-shows.