开发和验证一个公平的机器学习模型,以识别在电子健康记录数据中具有高护理连续性的患者
Yao An Lee1, Tiange Tang2, Yu Huang3,4,5,6
1Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
medRxiv : the preprint server for health sciences
|November 26, 2025
概括
电子健康记录 (EHR) 数据的不连续性可能导致错误分类. 开发了一种机器学习模型,以预测EHR的连续性,提高跨种族群体的公平性和加强EHR研究.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的机器学习
- 数据科学数据科学数据科学
背景情况:
- 电子健康记录 (EHR) 数据往往缺乏完整性,原因是单一卫生系统之外的护理,导致数据不连续.
- 这种不连续性可能导致临床变量的重大错误分类,并影响研究准确性.
- 量化和解决电子健康记录数据连续性对于可靠的健康研究至关重要.
研究的目的:
- 量化由于电子健康记录数据不连续性的错误分类,并建立最佳连续性值.
- 开发和验证一种机器学习 (ML) 模型,用于预测EHR的连续性,确保跨种族和民族群体的公平性.
- 用独立的数据集对开发的ML模型进行外部验证.
主要方法:
- 利用链接的EHR-Medicaid索赔数据用于模型开发和独立的EHR索赔数据用于外部验证.
- 应用了统一的遭遇比例得分 (HEPS) 来衡量患者级EHR数据连续性及其对错误分类的影响.
- 训练有素的ML模型使用结构化的EHR数据,包括人口统计,临床和医疗保健利用特征.
主要成果:
- 增加EHR数据连续性与减少错误分类率相关.
- 约30%的HEPS值被认为是确定足够数据连续性的有效值.
- ML模型在预测高连续性方面取得了强的表现 (AUROC=0.77) 并在偏差缓解后证明了更好的公平性,在外部验证中表现强.
结论:
- 开发了一种实用度量 (HEPS) 来量化EHR网络中的护理连续性.
- 该ML模型使用例行收集的EHR数据准确识别具有高护理连续性的患者.
- 创建了一个可通用的工具来分类护理连续性,增强基于EHR的跨系统研究的严格性.
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