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.

Plos One
|January 7, 2026
PubMed

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.