title: Utilizing Chinese Admission Records for MACE Prediction of Acute Coronary Syndrome.
abstract: Clinical major adverse cardiovascular event (MACE) prediction of acute coronary syndrome (ACS) is important for a number of applications including physician decision support, quality of care assessment, and efficient healthcare service delivery on ACS patients. Admission records, as typical media to contain clinical information of patients at the early stage of their hospitalizations, provide significant potential to be explored for MACE prediction in a proactive manner.
  
  
  
  We propose a hybrid approach for MACE prediction by utilizing a large volume of admission records. Firstly, both a rule-based medical language processing method and a machine learning method (i.e., Conditional Random Fields (CRFs)) are developed to extract essential patient features from unstructured admission records. After that, state-of-the-art supervised machine learning algorithms are applied to construct MACE prediction models from data.
  
  
  
  We comparatively evaluate the performance of the proposed approach on a real clinical dataset consisting of 2930 ACS patient samples collected from a Chinese hospital. Our best model achieved 72% AUC in MACE prediction. In comparison of the performance between our models and two well-known ACS risk score tools, i.e., GRACE and TIMI, our learned models obtain better performances with a significant margin.
  
  
  
  Experimental results reveal that our approach can obtain competitive performance in MACE prediction. The comparison of classifiers indicates the proposed approach has a competitive generality with datasets extracted by different feature extraction methods. Furthermore, our MACE prediction model obtained a significant improvement by comparison with both GRACE and TIMI. It indicates that using admission records can effectively provide MACE prediction service for ACS patients at the early stage of their hospitalizations.
authors.affiliation: College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China. danqinghu1990@zju.edu.cn.
authors.forename: Danqing
authors.initials: D
authors.lastname: Hu
authors.affiliation: College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China. zhengxinghuang@zju.edu.cn.
authors.forename: Zhengxing
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Philips Research China-Healthcare, Shanghai 200233, China. Cyrus.chan@philips.com.
authors.forename: Tak-Ming
authors.initials: TM
authors.lastname: Chan
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China. 301dongw@sina.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China. lvxd@zju.edu.cn.
authors.forename: Xudong
authors.initials: X
authors.lastname: Lu
authors.affiliation: College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China. duanhl@zju.edu.cn.
authors.forename: Huilong
authors.initials: H
authors.lastname: Duan
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000503:physiopathology*; D000368:Aged; D000465:Algorithms; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011379:Prognosis; D018570:Risk Assessment
keywords: MACE prediction; acute coronary syndrome; admission record; hybrid model; risk factor identification