机器学习和后勤回归模型的比较,用于预测电子健康记录中的30天计划外再接收:一项开发和验证研究
Masao Iwagami1,2,3,4, Ryota Inokuchi1,2,5,6, Eiryo Kawakami7,8
1Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
PLOS digital health
|August 20, 2024
概括
梯度增强决策树 (GBDT) 在预测非计划性医院再入院方面,通常优于LASSO (LR-LASSO) 的后勤回归. 然而,随着更多的变量和包括血液检测结果,模型性能差异缩小了.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的机器学习
- 预测分析是一种预测分析.
背景情况:
- 电子健康记录 (EHR) 包含大量的数据,用于预测患者的结果.
- 机器学习 (ML) 模型与回归模型在使用电子健康记录 (EHR) 数据进行非计划性再接收预测方面的比较性能尚未得到充分证实.
- 数据复杂度的增加,包括变量数和类型,可能会影响模型性能.
研究的目的:
- 为了比较梯度增强决策树 (GBDT),随机森林 (RF),深度神经网络 (DNN) 和物流回归与最小绝对收缩和选择操作员 (LR-LASSO) 的预测性能,用于30天的计划外再接收.
- 评估不同数量的变量以及血液检测结果的包含如何影响模型性能.
主要方法:
- 利用来自38家医院 (2015-2018) 的EHR数据进行模型推导和验证.
- 包括患者特征,诊断,手术,程序,药物代码和血液检测结果.
- 创建了六个数据表模式,其中包含不同数量的二进制变量 (基于流行率值) 以及血液检测结果的包含/排除.
- 使用c-统计学评估模型性能.
主要成果:
- 梯度增强决策树 (GBDT) 在大多数场景中显示出最高的c统计.
- 对于最小的数据集 (102个变量,没有血液测试),GBDT达到0.740,其次是RF (0.734),LR-LASSO (0.720) 和DNN (0.664).
- 对于最大的数据集 (1543个变量,含血液检测),GBDT实现了0.764,LR-LASSO 0.755,RF 0.751和DNN 0.720,这表明GBDT和LR-LASSO之间的性能差距较小.
结论:
- 与LR-LASSO相比,GBDT在计划外再接收方面普遍表现出更好的预测性能.
- 随着变量数量的增加和血液检测结果的纳入,GBDT的性能优势减少了.
- 研究结果表明,虽然先进的机器学习模型提供了好处,但传统的回归模型仍然具有竞争力,特别是在具有全面数据的情况下.
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