title: Impact of different training strategies on the accuracy of a Bayesian network for predicting hospital admission.
abstract: BACKGROUND
  The healthcare environment is constantly changing. Probabilistic clinical decision support systems need to recognize and incorporate the changing patterns and adjust the decision model to maintain high levels of accuracy.
  
  
  METHODS
  Using data from >75,000 ED patients during a 19-month study period we examined the impact of various static and dynamic training strategies on a decision support system designed to predict hospital admission status for ED patients. Training durations ranged from 1 to 12 weeks. During the study period major institutional changes occurred that affected the system's performance level.
  
  
  RESULTS
  The average area under the receiver operating characteristic curve was higher and more stable when longer training periods were used. The system showed higher accuracy when retrained an updated with more recent data as compared to static training period.
  
  
  CONCLUSIONS
  To adjust for temporal trends the accuracy of decision support systems can benefit from longer training periods and retraining with more recent data.
authors.affiliation: School of Informatics, University of Edinburgh, Edinburgh..
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Leegon
authors.forename: Dominik
authors.initials: D
authors.lastname: Aronsky
mesh_terms: D000328:Adult; D001185:Artificial Intelligence; D001499:Bayes Theorem; D020000:Decision Support Systems, Clinical; D004636:Emergency Service, Hospital; D005103:Expert Systems; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D016571:Neural Networks, Computer; D011336:Probability; D012372:ROC Curve