title: Predictability of Pressure Ulcers Based on Operation Duration, Transfer Activity, and Body Mass Index Through the Use of an Alternating Decision Tree.
abstract: OBJECTIVE
  To develop a prediction model for pressure ulcer cases that continue to occur at an acute care hospital with a low occurrence rate of pressure ulcers.
  
  
  METHODS
  Analyzing data were collected from patients hospitalized at Tokushima University Hospital during 2012 using an alternating decision tree (ADT) data mining method.
  
  
  RESULTS
  The ADT-based analysis revealed transfer activity, operation time, and low body mass index (BMI) as important factors for predicting pressure ulcer development.
  
  
  CONCLUSIONS
  Among the factors identified, only "transfer activity" can be modified by nursing intervention. While shear force and friction are known to lead to pressure ulcers, transfer activity has not been identified as such. Our results suggest that transfer activities creating shear force and friction correlate with pressure ulcer development. The ADT algorithm was effective in determining prediction factors, especially for highly imbalanced data. Our three stumps ADT yielded accuracy, sensitivity, and specificity values of 72.1%±3.7%, 79.3%±18.1%, and 72.1%±3.8%, respectively.
  
  
  CONCLUSIONS
  Transfer activity, identified as an interventional factor, can be modified through nursing interventions to prevent pressure ulcer formation. The ADT method was effective in identifying factors within largely imbalanced data. J. Med. Invest. 63: 248-255, August, 2016.
authors.affiliation: Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Setoguchi
authors.forename: A Ammar
authors.initials: AA
authors.lastname: Ghaibeh
authors.forename: Kazue
authors.initials: K
authors.lastname: Mitani
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Abe
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hashimoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Moriguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003663:Decision Trees; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D003668:Pressure Ulcer / Q000209:etiology*; D033081:Shear Strength