Prediction of Incident Delirium Using a Random Forest classifier.

Delirium is a serious medical complication associated with poor outcomes. Given the complexity of the syndrome, prevention and early detection are critical in mitigating its effects. We used Confusion Assessment Method (CAM) screening and Electronic Health Record (EHR) data for 64,038 inpatient visi...

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Published in:Journal of Medical Systems Vol. 42; no. 12; pp. 1 - 2
Main Authors: Corradi, John P., Thompson, Stephen, Mather, Jeffrey F., Waszynski, Christine M., Dicks, Robert S.
Format: equations & formulas research tables/charts Journal Article
Published: Springer Nature Dec2018
Online Access:View this record in EBSCOhost
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      dt: Dec2018
      vid: 42
      iid: 12
      pid: 237
      pub: Springer Nature
      place: New York, New York
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        10.1007/s10916-018-1109-0
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        atl: Prediction of Incident Delirium Using a Random Forest classifier.
      aug:
        au:
          Corradi, John P.
          Thompson, Stephen
          Mather, Jeffrey F.
          Waszynski, Christine M.
          Dicks, Robert S.
        affil: Research Department, Hartford Hospital, 80 Seymour Street, ERD-223W, 06102, Hartford, CT, USA
      sug:
        subj:
          Delirium Epidemiology
          Electronic Health Records
          Decision Support Techniques
          Machine Learning
          Human
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Retrospective Design
          Algorithms
          Questionnaires
          Probability
          Data Mining
          Comorbidity
          Quality Improvement
          United States
          Delirium Prevention and Control
          Health Screening
          Early Diagnosis
          Decision Support Systems, Clinical
          Incidence
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Delirium is a serious medical complication associated with poor outcomes. Given the complexity of the syndrome, prevention and early detection are critical in mitigating its effects. We used Confusion Assessment Method (CAM) screening and Electronic Health Record (EHR) data for 64,038 inpatient visits to train and test a model predicting delirium arising in hospital. Incident delirium was defined as the first instance of a positive CAM occurring at least 48 h into a hospital stay. A Random Forest machine learning algorithm was used with demographic data, comorbidities, medications, procedures, and physiological measures. The data set was randomly partitioned 80% / 20% for training and validating the predictive model, respectively. Of the 51,240 patients in the training set, 2774 (5.4%) experienced delirium during their hospital stay; and of the 12,798 patients in the validation set, 701 (5.5%) experienced delirium. Under-sampling of the delirium negative population was used to address the class imbalance. The Random Forest predictive model yielded an area under the receiver operating characteristic curve (ROC AUC) of 0.909 (95% CI 0.898 to 0.921). Important variables in the model included previously identified predisposing and precipitating risk factors. This machine learning approach displayed a high degree of accuracy and has the potential to provide a clinically useful predictive model for earlier intervention in those patients at greatest risk of developing delirium.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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