The Sydney Triage to Admission Risk Tool (START2) using machine learning techniques to support disposition decision‐making.

Objective: To further develop and refine an Emergency Department (ED) in‐patient admission prediction model using machine learning techniques. Methods: This was a retrospective analysis of state‐wide ED data from New South Wales, Australia. Six classification algorithms (Bayesian networks, decision...

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Publicado en:Emergency Medicine Australasia Vol. 31; no. 3; pp. 429 - 436
Autores principales: Rendell, Kathryn, Koprinska, Irena, Kyme, Andre, Ebker‐White, Anja A, Dinh, Michael M
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2019
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Emergency Medicine Australasia
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      dt: Jun2019
      vid: 31
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        136662182
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        10.1111/1742-6723.13199
        136662182
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        atl: The Sydney Triage to Admission Risk Tool (START2) using machine learning techniques to support disposition decision‐making.
      aug:
        au:
          Rendell, Kathryn
          Koprinska, Irena
          Kyme, Andre
          Ebker‐White, Anja A
          Dinh, Michael M
        affil: School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering and Information Technologies, The University of Sydney, Sydney New South Wales, Australia
      sug:
        subj:
          Decision Making, Clinical
          Machine Learning
          Risk Assessment
          Emergency Service
          Human
          Retrospective Design
          Australia
          Logistic Regression
          Scales
          Algorithms
          Confidence Intervals
          Descriptive Statistics
          Inpatients
          Patient Admission
          Decision Support Systems, Clinical
      ab: Objective: To further develop and refine an Emergency Department (ED) in‐patient admission prediction model using machine learning techniques. Methods: This was a retrospective analysis of state‐wide ED data from New South Wales, Australia. Six classification algorithms (Bayesian networks, decision trees, logistic regression, naïve Bayes, neural networks and nearest neighbour) and five feature selection techniques (none, manual, correlation‐based, information gain and wrapper) were examined. Presenting problem was categorised using broad (n = 20) and specific (n = 100) representations. Models were evaluated based on Area Under the Curve (AUC) and accuracy. The results were compared with the Sydney Triage to Admission Risk Tool (START), which uses logistic regression and six manually selected features. Results: Sixty admission prediction models were trained and validated using data from 1 721 294 patients. Under the broad representation of presenting problem, the nearest neighbour algorithm with manual feature selection had the best AUC of 0.8206 (95% CI ±0.0006), while the decision tree with no feature selection had the best accuracy of 74.83% (95% CI ±0.065). Under the specific representation, almost all models improved; the nearest neighbour with information gain feature selection had the best AUC of 0.8267 (95% CI ±0.0006), while the decision tree with wrapper or no feature selection had the best accuracy of 75.24% (95% CI ±0.064). Eleven of the machine learning models had slightly better AUC than the START model. Conclusion: Machine learning methods demonstrate similar performance to logistic regression for ED disposition prediction models using basic triage information. This should be investigated further, especially for larger data sets with more complex clinical information.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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