A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission
Abstract The interest in applying machine learning in healthcare has grown rapidly in recent years. Most predictive algorithms requiring pathway implementations are evaluated using metrics focused on predictive performance, such as the c statistic. However, these metrics are of limited clinical valu...
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Nature Portfolio
2021
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| Acceso en línea: | https://doaj.org/article/ff0032ece6414e12b6d1579726ea9ab3 |
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oai:doaj.org-article:ff0032ece6414e12b6d1579726ea9ab32021-12-02T17:40:49ZA simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission10.1038/s41746-021-00468-72398-6352https://doaj.org/article/ff0032ece6414e12b6d1579726ea9ab32021-06-01T00:00:00Zhttps://doi.org/10.1038/s41746-021-00468-7https://doaj.org/toc/2398-6352Abstract The interest in applying machine learning in healthcare has grown rapidly in recent years. Most predictive algorithms requiring pathway implementations are evaluated using metrics focused on predictive performance, such as the c statistic. However, these metrics are of limited clinical value, for two reasons: (1) they do not account for the algorithm’s role within a provider workflow; and (2) they do not quantify the algorithm’s value in terms of patient outcomes and cost savings. We propose a model for simulating the selection of patients over time by a clinician using a machine learning algorithm, and quantifying the expected patient outcomes and cost savings. Using data on unplanned emergency department surgical readmissions, we show that factors such as the provider’s schedule and postoperative prediction timing can have major effects on the pathway cohort size and potential cost reductions from preventing hospital readmissions.Velibor V. MišićKumar RajaramEilon GabelNature PortfolioarticleComputer applications to medicine. Medical informaticsR858-859.7ENnpj Digital Medicine, Vol 4, Iss 1, Pp 1-11 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Computer applications to medicine. Medical informatics R858-859.7 |
| spellingShingle |
Computer applications to medicine. Medical informatics R858-859.7 Velibor V. Mišić Kumar Rajaram Eilon Gabel A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| description |
Abstract The interest in applying machine learning in healthcare has grown rapidly in recent years. Most predictive algorithms requiring pathway implementations are evaluated using metrics focused on predictive performance, such as the c statistic. However, these metrics are of limited clinical value, for two reasons: (1) they do not account for the algorithm’s role within a provider workflow; and (2) they do not quantify the algorithm’s value in terms of patient outcomes and cost savings. We propose a model for simulating the selection of patients over time by a clinician using a machine learning algorithm, and quantifying the expected patient outcomes and cost savings. Using data on unplanned emergency department surgical readmissions, we show that factors such as the provider’s schedule and postoperative prediction timing can have major effects on the pathway cohort size and potential cost reductions from preventing hospital readmissions. |
| format |
article |
| author |
Velibor V. Mišić Kumar Rajaram Eilon Gabel |
| author_facet |
Velibor V. Mišić Kumar Rajaram Eilon Gabel |
| author_sort |
Velibor V. Mišić |
| title |
A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| title_short |
A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| title_full |
A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| title_fullStr |
A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| title_full_unstemmed |
A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| title_sort |
simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/ff0032ece6414e12b6d1579726ea9ab3 |
| work_keys_str_mv |
AT veliborvmisic asimulationbasedevaluationofmachinelearningmodelsforclinicaldecisionsupportapplicationandanalysisusinghospitalreadmission AT kumarrajaram asimulationbasedevaluationofmachinelearningmodelsforclinicaldecisionsupportapplicationandanalysisusinghospitalreadmission AT eilongabel asimulationbasedevaluationofmachinelearningmodelsforclinicaldecisionsupportapplicationandanalysisusinghospitalreadmission AT veliborvmisic simulationbasedevaluationofmachinelearningmodelsforclinicaldecisionsupportapplicationandanalysisusinghospitalreadmission AT kumarrajaram simulationbasedevaluationofmachinelearningmodelsforclinicaldecisionsupportapplicationandanalysisusinghospitalreadmission AT eilongabel simulationbasedevaluationofmachinelearningmodelsforclinicaldecisionsupportapplicationandanalysisusinghospitalreadmission |
| _version_ |
1718379743544344576 |