Unbiased inference for echocardiogram urgency prediction using double machine learning
Yiqun Jiang1, Wenli Zhang2, Yu-Li Huang3
1Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, Iowa, United States of America.
Insights
This study introduces a double machine learning model to predict patient urgency for echocardiography appointments. The model effectively prioritizes patients using clinical and administrative data, improving resource allocation in cardiovascular diagnostics.
Area of Science:
- Cardiology
- Health Informatics
- Machine Learning
Background:
- Echocardiography is crucial for diagnosing cardiovascular conditions but faces challenges in patient prioritization due to limited test availability.
- Existing methods for assessing appointment urgency struggle with the complex interplay of clinical and administrative variables.
Purpose of the Study:
- To develop and evaluate a novel model for predicting patient urgency for echocardiography appointments.
- To leverage double machine learning techniques to accurately stratify patient urgency by disentangling variable relationships.
Main Methods:
- Utilized Electronic Health Record data, extracting both clinical and administrative variables.
- Applied double machine learning (DML) to model the urgency of echocardiography appointments.
- Compared the DML model's performance against traditional machine learning approaches.
Main Results:
- The developed double machine learning model significantly outperformed traditional methods in predicting appointment urgency.
- Identified administrative variables and cancer-related comorbidities as critical factors in patient prioritization.
- Provided robust estimations of variable effects, revealing complex interdependencies.
Conclusions:
- The double machine learning model enhances the efficiency and effectiveness of echocardiography utilization by improving patient prioritization.
- Actionable insights are provided for clinicians to identify urgent cases and optimize resource allocation.
- The methodology can be extended to prioritize other advanced, limited diagnostic tests.
Abstract:
The increased utilization of echocardiography in clinical practice has witnessed a substantial rise, underscoring its pivotal role as a diagnostic tool for various cardiovascular conditions. However, due to the relative scarcity of echocardiography tests, challenges persist in efficiently prioritizing patients for echocardiographic assessments. In this study, we develop a model to assess the urgency of appointments by considering both clinical and administrative variables extracted from Electronic Health Record data. We use double machine learning techniques to analyze these variables and improve our predictions of patient urgency. Traditional methods for estimating variable effects have limitations, particularly in our research context, where clinical and administrative variables may influence one another while also directly impacting the outcome (i.e., the urgency of appointments). In this work, we address this issue by developing an urgency stratification model using double machine learning, which disentangles the complex relationships between variables. Our evaluations demonstrate that the proposed model not only outperforms traditional machine learning methods in predicting appointment urgency but also provides robust estimations of variable effects. Specifically, our results underscore the critical roles of administrative variables and cancer-related comorbidity variables in patient prioritization and appointment urgency prediction. By leveraging double machine learning techniques, our method can enhance the efficiency and effectiveness of echocardiography utilization in clinical practice. It provides clinicians with actionable insights for patient prioritization, facilitating the timely identification of urgent cases and the optimal allocation of resources. Our work contributes to the advancement of healthcare practices by leveraging sophisticated analytics to improve patient care delivery and streamline clinical workflows in echocardiography laboratories. A similar research design can also be extended to other advanced yet limited laboratory tests to help prioritize medical resources.
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