title: Use of genetic programming, logistic regression, and artificial neural nets to predict readmission after coronary artery bypass surgery.
abstract: As many as 14 % of patients undergoing coronary artery bypass surgery are readmitted within 30 days. Readmission is usually the result of morbidity and may lead to death. The purpose of this study is to develop and compare statistical and genetic programming models to predict readmission. Patients were divided into separate Construction and Validation populations. Using 88 variables, logistic regression, genetic programs, and artificial neural nets were used to develop predictive models. Models were first constructed and tested on the Construction populations, then validated on the Validation population. Areas under the receiver operator characteristic curves (AU ROC) were used to compare the models. Two hundred and two patients (7.6 %) in the 2,644 patient Construction group and 216 (8.0 %) of the 2,711 patient Validation group were re-admitted within 30 days of CABG surgery. Logistic regression predicted readmission with AU ROC = .675 ± .021 in the Construction group. Genetic programs significantly improved the accuracy, AU ROC = .767 ± .001, p < .001). Artificial neural nets were less accurate with AU ROC = 0.597 ± .001 in the Construction group. Predictive accuracy of all three techniques fell in the Validation group. However, the accuracy of genetic programming (AU ROC = .654 ± .001) was still trivially but statistically non-significantly better than that of the logistic regression (AU ROC = .644 ± .020, p = .61). Genetic programming and logistic regression provide alternative methods to predict readmission that are similarly accurate.
authors.affiliation: Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109-5861, USA. engorenm@med.umich.edu
authors.forename: Milo
authors.initials: M
authors.lastname: Engoren
authors.forename: Robert H
authors.initials: RH
authors.lastname: Habib
authors.forename: John J
authors.initials: JJ
authors.lastname: Dooner
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Schwann
mesh_terms: D000465:Algorithms; D019540:Area Under Curve; D001185:Artificial Intelligence; D002875:Chromosomes / Q000648:ultrastructure; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016571:Neural Networks, Computer; D010359:Patient Readmission; D011381:Programming Languages; D012372:ROC Curve; D011897:Random Allocation; D012044:Regression Analysis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012984:Software