title: Outcome Prediction in Clinical Treatment Processes.
abstract: Clinical outcome prediction, as strong implications for health service delivery of clinical treatment processes (CTPs), is important for both patients and healthcare providers. Prior studies typically use a priori knowledge, such as demographics or patient physical factors, to estimate clinical outcomes at early stages of CTPs (e.g., admission). They lack the ability to deal with temporal evolution of CTPs. In addition, most of the existing studies employ data mining or machine learning methods to generate a prediction model for a specific type of clinical outcome, however, a mathematical model that predicts multiple clinical outcomes simultaneously, has not yet been established. In this study, a hybrid approach is proposed to provide a continuous predictive monitoring service on multiple clinical outcomes. More specifically, a probabilistic topic model is applied to discover underlying treatment patterns of CTPs from electronic medical records. Then, the learned treatment patterns, as low-dimensional features of CTPs, are exploited for clinical outcome prediction across various stages of CTPs based on multi-label classification. The proposal is evaluated to predict three typical classes of clinical outcomes, i.e., length of stay, readmission time, and the type of discharge, using 3492 pieces of patients' medical records of the unstable angina CTP, extracted from a Chinese hospital. The stable model was characterized by 84.9% accuracy and 6.4% hamming-loss with 3 latent treatment patterns discovered from data, which outperforms the benchmark multi-label classification algorithms for clinical outcome prediction. Our study indicates the proposed approach can potentially improve the quality of clinical outcome prediction, and assist physicians to understand the patient conditions, treatment inventions, and clinical outcomes in an integrated view.
authors.affiliation: College of Biomedical Engineering and Instrument Science, Zhejiang University, Zhejiang, China. zhengxinghuang@zju.edu.cn.
authors.forename: Zhengxing
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Cardiology department of Chinese, PLA General Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: IT department of Chinese, PLA General Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ji
authors.affiliation: College of Biomedical Engineering and Instrument Science, Zhejiang University, Zhejiang, China.
authors.forename: Huilong
authors.initials: H
authors.lastname: Duan
mesh_terms: D000465:Algorithms; D057225:Data Mining; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D000069550:Machine Learning; D015233:Models, Statistical; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*
keywords: Clinical outcome prediction; Clinical treatment process; Electronic medical records; Treatment pattern discovery