Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function.

Computerized survival prediction in healthcare identifying the risk of disease mortality, helps healthcare providers to effectively manage their patients by providing appropriate treatment options. In this study, we propose to apply a classification algorithm, Contrast Pattern Aided Logistic Regress...

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Publicado en:Journal of Biomedical Informatics Vol. 60; pp. 260 - 270
Autores principales: Taslimitehrani, Vahid, Dong, Guozhu, Pereira, Naveen L., Panahiazar, Maryam, Pathak, Jyotishman
Formato: research Journal Article
Publicado: Academic Press Inc. Apr2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2016
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      pub: Academic Press Inc.
      place: Burlington, Massachusetts
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        10.1016/j.jbi.2016.01.009
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        atl: Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function.
      aug:
        au:
          Taslimitehrani, Vahid
          Dong, Guozhu
          Pereira, Naveen L.
          Panahiazar, Maryam
          Pathak, Jyotishman
        affil: Department of Computer Science and Engineering, Kno.e.sis Center, Wright State University, Dayton, OH, USA
      sug:
        subj:
          Heart Failure Diagnosis
          Medical Informatics Methods
          False Positive Results
          Prognosis
          Human
          Probability
          Reproducibility of Results
          Prospective Studies
          Male
          Algorithms
          Comorbidity
          Relative Risk
          Aged
          ROC Curve
          Middle Age
          Linear Regression
          Logistic Regression
          Regression
          Pharmacokinetics
          Female
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Computerized survival prediction in healthcare identifying the risk of disease mortality, helps healthcare providers to effectively manage their patients by providing appropriate treatment options. In this study, we propose to apply a classification algorithm, Contrast Pattern Aided Logistic Regression (CPXR(Log)) with the probabilistic loss function, to develop and validate prognostic risk models to predict 1, 2, and 5year survival in heart failure (HF) using data from electronic health records (EHRs) at Mayo Clinic. The CPXR(Log) constructs a pattern aided logistic regression model defined by several patterns and corresponding local logistic regression models. One of the models generated by CPXR(Log) achieved an AUC and accuracy of 0.94 and 0.91, respectively, and significantly outperformed prognostic models reported in prior studies. Data extracted from EHRs allowed incorporation of patient co-morbidities into our models which helped improve the performance of the CPXR(Log) models (15.9% AUC improvement), although did not improve the accuracy of the models built by other classifiers. We also propose a probabilistic loss function to determine the large error and small error instances. The new loss function used in the algorithm outperforms other functions used in the previous studies by 1% improvement in the AUC. This study revealed that using EHR data to build prediction models can be very challenging using existing classification methods due to the high dimensionality and complexity of EHR data. The risk models developed by CPXR(Log) also reveal that HF is a highly heterogeneous disease, i.e., different subgroups of HF patients require different types of considerations with their diagnosis and treatment. Our risk models provided two valuable insights for application of predictive modeling techniques in biomedicine: Logistic risk models often make systematic prediction errors, and it is prudent to use subgroup based prediction models such as those given by CPXR(Log) when investigating heterogeneous diseases.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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