Clustering Diagnoses From 58 Million Patient Visits in Finland Between 2015 and 2018
Bibliographic record
Abstract
BACKGROUND: Multiple chronic diseases in patients are a major burden on the health service system. Currently, diseases are mostly treated separately without paying sufficient attention to their relationships, which results in the fragmentation of the care process. The better integration of services can lead to the more effective organization of the overall health care system. OBJECTIVE: This study aimed to analyze the connections between diseases based on their co-occurrences to support decision-makers in better organizing health care services. METHODS: We performed a cluster analysis of diagnoses by using data from the Finnish Health Care Registers for primary and specialized health care visits and inpatient care. The target population of this study comprised those 3.8 million individuals (3,835,531/5,487,308, 69.90% of the whole population) aged ≥18 years who used health care services from the years 2015 to 2018. They had a total of 58 million visits. Clustering was performed based on the co-occurrence of diagnoses. The more the same pair of diagnoses appeared in the records of the same patients, the more the diagnoses correlated with each other. On the basis of the co-occurrences, we calculated the relative risk of each pair of diagnoses and clustered the data by using a graph-based clustering algorithm called the M-algorithm-a variant of k-means. RESULTS: The results revealed multimorbidity clusters, of which some were expected (eg, one representing hypertensive and cardiovascular diseases). Other clusters were more unexpected, such as the cluster containing lower respiratory tract diseases and systemic connective tissue disorders. The annual cost of all clusters was €10.0 billion, and the costliest cluster was cardiovascular and metabolic problems, costing €2.3 billion. CONCLUSIONS: The method and the achieved results provide new insights into identifying key multimorbidity groups, especially those resulting in burden and costs in health care services.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".