用电子病历数据建模医护协作网络,预测癌症患者生存率。
Modeling and Interpreting Teamwork Dynamics in Cancer Care Outcome Prediction

- 将医生间协作转化为网络图谱,用机器学习挖掘其与预后的关联
- 发现特定协作模式与患者生存率显著相关,结果经多重验证稳定
- 为长期团队医疗提供可操作的改进依据,适合医疗管理研究者
癌症治疗需长期规划与持续交付,依赖多专业医护人员协作。尽管既往研究关注临床与人口学因素对治疗的影响,但对治疗执行阶段中团队协作动态的关注仍不足。本研究基于电子健康记录(EHR)系统捕捉的医护人员互动数据,构建协作网络,利用机器学习识别嵌入其中的患者生存预测信号,并通过网络特征与动态模式解释模型输出。通过稳健性分析确保结果不受训练随机性影响,且与医学文献假设一致,提供实证支持。研究提出可落地的协作分析流程,助力以数据驱动方式优化长期团队医疗,为医疗交付干预提供可行动洞察。
原文摘要 · Abstract (English)
Cancer care requires a longitudinal approach in which treatments are planned and delivered over time according to the needs of each individual patient. While prior research has thoroughly explored how clinical and demographic factors, such as comorbidities and age, inform treatment planning, far less attention has been devoted to the delivery phase of care. Yet planning and delivery are both team-based processes that depend on coordinated efforts among multiple healthcare professionals (HCPs). As such, the human factors embedded in these collaborative practices are crucial to optimizing patient outcomes. Despite this importance, the existing literature on human factors in cancer care is limited, and very few studies have investigated how collaboration within care teams evolves over the course of treatment. To fill this gap, this work examine how HCPs' collaboration, captured through electronic health record (EHR) systems, affects cancer patient outcomes, with particular emphasis on teamwork dynamics. We represent EHR-mediated HCP interactions as networks and apply machine learning methods to identify predictive signals of patient survival embedded in these collaborative structures. We further interpret model predictions by pinpointing network characteristics and dynamic patterns associated with particular outcomes. We evaluate our model through robustness analyses to ensure that the findings are stable and not driven by stochastic variation in training. Additionally, our insights align with hypotheses proposed in the medical literature, and our results provide the empirical, data-driven evidence supporting these claims. Overall, our work contributes a practical workflow for leveraging digital traces of collaboration to evaluate and strengthen longitudinal team-based healthcare, offering actionable insights to guide data-informed interventions in healthcare delivery.
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