A machine learning approach to triaging patients with chronic obstructive pulmonary disease

被引:59
作者
Swaminathan, Sumanth [1 ,2 ]
Qirko, Klajdi [1 ,2 ]
Smith, Ted [1 ]
Corcoran, Ethan [3 ]
Wysham, Nicholas G. [4 ,5 ]
Bazaz, Gaurav [1 ]
Kappel, George [1 ]
Gerber, Anthony N. [6 ]
机构
[1] Revon Syst Inc, Louisville, KY 40014 USA
[2] Univ Delaware, Dept Math, Newark, DE 19716 USA
[3] Kaiser Permanente, Dept Pulmonol, Clackamas, OR 97015 USA
[4] Vancouver Clin, Div Pulmonol & Crit Care, Vancouver, WA 98664 USA
[5] Washington State Univ, Sch Med, Spokane, WA 99210 USA
[6] Natl Jewish Hlth, Dept Med, Denver, CO 80206 USA
基金
美国国家科学基金会;
关键词
SELF-MANAGEMENT; LUNG-FUNCTION; COPD; EXACERBATION; PREDICTION;
D O I
10.1371/journal.pone.0188532
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set. Our results show that algorithm accuracy and safety indicators surpass all individual pulmonologists in both identifying exacerbations and predicting the consensus triage in a 101 case validation set. The algorithm is also the top performer in sensitivity, specificity, and ppv when predicting a patient's need for emergency care.
引用
收藏
页数:21
相关论文
共 48 条
[1]   The Effect of Smartphone Interventions on Patients With Chronic Obstructive Pulmonary Disease Exacerbations: A Systematic Review and Meta-Analysis [J].
Alwashmi, Meshari ;
Hawboldt, John ;
Davis, Erin ;
Marra, Carlo ;
Gamble, John-Michael ;
Abu Ashour, Waseem .
JMIR MHEALTH AND UHEALTH, 2016, 4 (03)
[2]   Telemedicine in chronic obstructive pulmonary disease [J].
Ambrosino, Nicolino ;
Vagheggini, Guido ;
Mazzoleni, Stefano ;
Vitacca, Michele .
BREATHE, 2016, 12 (04) :351-356
[3]  
American Thoracic Society, 2016, COPD ASS TEST CAT
[4]  
[Anonymous], 2007, GLOBAL SURVEILLANCE
[5]  
Ardestani ME, 2014, J RES MED SCI, V19, P257
[6]  
Australian Lung Foundation, 2015, COPD ACT PLAN
[7]  
Bahadori K., 2007, Int J Chron Obstruct Pulmon Dis, V2, P241
[8]   Chronic Obstructive Pulmonary Disease: A Concise Review [J].
Balkissoon, Ron ;
Lommatzsch, Steve ;
Carolan, Brendan .
MEDICAL CLINICS OF NORTH AMERICA, 2011, 95 (06) :1125-+
[9]  
Canadian Lung Association, 2016, BCMJ, V58, P39
[10]   Comorbidities of COPD [J].
Cavailles, Arnaud ;
Brinchault-Rabin, Graziella ;
Dixmier, Adrien ;
Goupil, Francois ;
Gut-Gobert, Christophe ;
Marchand-Adam, Sylvain ;
Meurice, Jean-Claude ;
Morel, Hugues ;
Person-Tacnet, Christine ;
Leroyer, Christophe ;
Diot, Patrice .
EUROPEAN RESPIRATORY REVIEW, 2013, 22 (130) :454-475