Using Machine Learning Algorithms to Predict Patient Portal Use Among Emergency Department Patients With Diabetes Mellitus
Bibliographic record
Abstract
Background: Different machine learning (ML) technologies have been applied in healthcare systems with diverse applications. We aimed to determine the model feasibility and accuracy of predicting patient portal use among diabetic patients by using six different ML algorithms. In addition, we also compared model performance accuracy with the use of only essential variables. Methods: This was a single-center retrospective observational study. From March 1, 2019 to February 28, 2020, we included all diabetic patients from the study emergency department (ED). The primary outcome was the status of patient portal use. A total of 18 variables consisting of patient sociodemographic characteristics, ED and clinic information, and patient medical conditions were included to predict patient portal use. Six ML algorithms (logistic regression, random forest (RF), deep forest, decision tree, multilayer perception, and support vector machine) were used for such predictions. During the initial step, ML predictions were performed with all variables. Then, the essential variables were chosen via feature selection. Patient portal use predictions were repeated with only essential variables. The performance accuracies (overall accuracy, sensitivity, specificity, and area under receiver operating characteristic curve (AUC)) of patient portal predictions were compared. Results: A total of 77,977 unique patients were placed in our final analysis. Among them, 23.4% (18,223) patients were diabetic mellitus (DM). Patient portal use was found in 26.9% of DM patients. Overall, the accuracy of predicting patient portal use was above 80% among five out of six ML algorithms. The RF outperformed the others when all variables were used for patient portal predictions (accuracy 0.9876, sensitivity 0.9454, specificity 0.9969, and AUC 0.9712). When only eight essential variables were chosen, RF still outperformed the others (accuracy 0.9876, sensitivity 0.9374, specificity 0.9932, and AUC 0.9769). Conclusion: It is possible to predict patient portal use outcomes when different ML algorithms are used with fair performance accuracy. However, with similar prediction accuracies, the use of feature selection techniques can improve the interpretability of the model by addressing the most relevant features.
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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 | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".