评估急诊室患者的重访风险:机器学习方法
Wang-Chuan Juang1,2,3, Zheng-Xun Cai4, Chia-Mei Chen4
1Quality Management Center, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung, 813414, Taiwan, 886 7-342-2121 ext 4191.
JMIR AI
|August 7, 2025
概括
机器学习可以预测患者可能在72小时内返回急诊室 (ED). 该框架使用结构化和非结构化数据来识别高风险患者,提高安全性和降低成本.
科学领域:
- 医疗保健中的人工智能
- 临床决策支持系统 临床决策支持系统
- 机器学习用于预测分析.
背景情况:
- 过度拥挤的急诊室 (ED) 可以影响护理质量和员工的工作量.
- 评估非计划的复诊 (URV) 对患者安全和降低成本至关重要.
- 机器学习 (ML) 为分析复杂的医疗数据提供了先进的工具.
研究的目的:
- 开发一个ML辅助的框架,在72小时内识别高风险的ED复诊患者.
- 评估各种ML模型,特征集和编码方法以进行最佳预测.
- 通过主动干预,提高患者安全,降低医疗保健成本.
主要方法:
- 开发了一个ML系统,集成结构化的电子健康记录和非结构化的临床笔记.
- 利用了来自第三级医疗中心的184,687次ED访问的5年数据集.
- 使用卷积神经网络从叙事笔记中提取特征,结合结构化数据.
主要成果:
- ML框架实现了接收器运行特征曲线下的面积为0.705和回忆值为0.718.
- 整合非结构化的医生笔记与结构化的生命体征和人口统计数据显著改善了预测性能.
- 该研究表明,结合各种数据源来进行URV预测的有效性.
结论:
- 一个ML辅助的框架可以作为一个有价值的决策支持工具为ED临床医生.
- 需要进一步探索,以完善临床实施和患者护理的模型.
- 拟议的框架显示了识别高风险患者及时干预的潜力.
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