Machine learning: how much does it improve the prediction of unplanned hospital admissions?
Bibliographic record
Abstract
IntroductionRisk prediction models can be used to inform decision-making in clinical settings. With large and detailed electronic medical record data, machine learning may improve predictions. The objective of this work is to determine the feasibility and accuracy of machine learning versus logistic regression to predict unplanned hospital admissions. Objectives and ApproachData from primary care electronic medical records for community-dwelling adults in Alberta, Canada available from the Canadian Primary Care Sentinel Surveillance Network will be linked to acute care administrative health data held by Alberta Health Services. Two regression methods (forward stepwise logistic, LASSO logistic) will be compared with three machine learning methods (classification tree, random forest, gradient boosted trees). Prior primary and acute care use will be used to predict three outcomes: ≥1 unplanned admission within 1 year, ≥1 unplanned admission within 90 days, and ≥1 unplanned admission within 1 year due to an ambulatory care sensitive condition. ResultsThe results of this work in progress will be presented at the conference. 41,142 patients will have their primary and acute care data linked. We anticipate that the machine learning methods will improve predictive performance but will be more challenging for clinicians and patients to understand, including why a given patient is predicted to be at higher risk. The primary comparison of machine learning and regression methods will be based on positive predictive values corresponding to the top 5% predicted risk threshold, and estimated via 10-fold cross-validation. Conclusion/ImplicationsThis project aims to help researchers decide which statistical methods to use for risk prediction models. When considering machine learning methods the best approach may be to try multiple methods, compare their predictive accuracy and interpretability, and then choose a final method.
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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 | 0.013 | 0.054 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.002 |
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".