arXiv:2411.08048cs.LGstat.AP2024-11

用机器学习预测有学习障碍患者的住院时长,提升公平性。

Equitable Length of Stay Prediction for Patients with Learning Disabilities and Multiple Long-term Conditions Using Machine Learning

  • 基于电子病历数据构建随机森林模型预测住院时长
  • 模型对男女准确率均超69%,误判率约23%
  • 通过阈值优化降低不同族裔间预测偏差,提升公平性

英国及其他国家研究显示,学习障碍患者死亡率更高、寿命更短。本研究分析了威尔士地区9,618名确诊为学习障碍且伴有长期疾病的患者,利用SAIL数据银行的电子健康记录(EHR)数据,描述其人口特征、慢性病患病率、用药史、住院记录及生活方式。采用机器学习模型预测住院时长,随机森林(RF)模型在男性中达到AUC 0.759,女性为0.756,误判率分别为0.224和0.229,平衡准确率均为0.690。针对不同族裔群体的性能差异,应用阈值优化与指数梯度减少算法进行偏差缓解。阈值优化算法表现更优,在男性群体中各族裔间假阳性率与平衡准确率范围更低。研究表明,结合有效偏差缓解方法的机器学习模型可实现更公平的住院时长预测。

原文摘要 · Abstract (English)

People with learning disabilities have a higher mortality rate and premature deaths compared to the general public, as reported in published research in the UK and other countries. This study analyses hospitalisations of 9,618 patients identified with learning disabilities and long-term conditions for the population of Wales using electronic health record (EHR) data sources from the SAIL Databank. We describe the demographic characteristics, prevalence of long-term conditions, medication history, hospital visits, and lifestyle history for our study cohort, and apply machine learning models to predict the length of hospital stays for this cohort. The random forest (RF) model achieved an Area Under the Curve (AUC) of 0.759 (males) and 0.756 (females), a false negative rate of 0.224 (males) and 0.229 (females), and a balanced accuracy of 0.690 (males) and 0.689 (females). After examining model performance across ethnic groups, two bias mitigation algorithms (threshold optimization and the reductions algorithm using an exponentiated gradient) were applied to minimise performance discrepancies. The threshold optimizer algorithm outperformed the reductions algorithm, achieving lower ranges in false positive rate and balanced accuracy for the male cohort across the ethnic groups. This study demonstrates the potential of applying machine learning models with effective bias mitigation approaches on EHR data sources to enable equitable prediction of hospital stays by addressing data imbalances across groups.

机器学习医疗预测公平性电子病历

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