Comparing decision support methodologies for identifying asthma exacerbations.
OBJECTIVE
To apply and compare common machine learning techniques with an expert-built Bayesian Network to determine eligibility for asthma guidelines in pediatric emergency department patients.


METHODS
All patients 2-18 years of age presenting to a pediatric emergency department during a 2-month study period.


METHODS
We created an artificial neural network, a support vector machine, a Gaussian process, and a learned Bayesian network to compare each method's ability to detect patients eligible for asthma guidelines. Our outcome measures included the area under the receiver operating characteristic curves, sensitivity, specificity, predictive values, and likelihood ratios.


RESULTS
The data were randomly split into a training set (n=3017) and test set (n=1006) for analysis. The systems performed equally well. The area under the receiver operating characteristic curve was 0.959 for the expert-built Bayesian network, 0.962 for the automatically constructed Bayesian network, 0.956 for the Gaussian Process, and 0.937 for the artificial neural network.


CONCLUSIONS
All four evaluated machine learning methods achieved high accuracy. The automatically created Bayesian network performed similarly to the expert-built network. These methods could be applied to create a realtime detection system for identifying asthma patients.
Dexheimer
Judith W
JW
Department of Biomedical Informatics, Vanderbilt University, Nashville, TN 37232-8340, USA. judith.dexheimer@vanderbilt.edu
Brown
Laura E
LE
Leegon
Jeffrey
J
Aronsky
Dominik
D
D000293:Adolescent; D001185:Artificial Intelligence; D001249:Asthma / Q000175:diagnosis*; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D004636:Emergency Service, Hospital; D006801:Humans; D016013:Likelihood Functions; D016571:Neural Networks, Computer; D018579:Patient Selection; D012372:ROC Curve; D012680:Sensitivity and Specificity