An Antimicrobial Prescription Surveillance System That Learns from Experience
Bibliographic record
Abstract
Inappropriate prescribing of antimicrobials is a major clinical concern that affects as many as 50 percent of prescriptions. One of the difficulties of antimicrobial prescribing lies in the necessity to sequentially adjust the treatment of a patient as new clinical data become available. The lack of specialized health‐care resources and the overwhelming amount of information to process make manual surveillance unsustainable. To solve this problem, we have developed and deployed an automated antimicrobial prescription surveillance system that assists hospital pharmacists in identifying and reporting inappropriate prescriptions. Since its deployment, the system has improved antimicrobial prescribing and decreased antimicrobial use. However, the highly sensitive knowledge base used by the system leads to many false alerts. As a remedy, we are developing a machine‐learning algorithm that combines instance‐based learning and rule induction techniques to discover new rules for detecting inappropriate prescriptions from previous false alerts. In this article, we describe the system, point to results and lessons learned so far, and provide insight into the machine‐learning capability.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".