Design Comorbidity Portfolios to Improve Treatment Cost Prediction of Asthma Using Machine Learning
Autor: | Li Luo, Chunyang Li, Yonghong Gu, Zhilin Yong, Xinzhu Yu |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Decision tree Comorbidity Logistic regression Cross-validation Standard deviation Machine Learning 03 medical and health sciences 0302 clinical medicine Health Information Management Risk analysis (business) mental disorders medicine Humans 030212 general & internal medicine Electrical and Electronic Engineering Asthma business.industry Health Care Costs Odds ratio medicine.disease Computer Science Applications 030228 respiratory system Emergency medicine Neural Networks Computer business Biotechnology |
Zdroj: | IEEE Journal of Biomedical and Health Informatics. 25:2237-2247 |
ISSN: | 2168-2208 2168-2194 |
Popis: | Comorbidity is an important factor to consider when trying to predict the cost of treating asthma patients. When an asthmatic patient suffered from comorbidity, the cost of treating such a patient becomes dependent on the nature of the comorbidity. Therefore, lack of recognition of comorbidity on asthmatic patient poses a challenge in predicting the cost of treatment. In this study, we proposed a comorbidity portfolio design that improves the prediction cost of treating asthmatic patients by regrouping frequently occurred comorbidities in different cost groups. In the experiment, predictive models, including logistic regression, random forest, support vector machine, classification regression tree, and backpropagation neural network were trained with real-world data of asthmatic patients from 2012 to 2014 in a large city of China. The 10-fold cross validation and random search algorithm were employed to optimize the hyper-parameters. We recorded significant improvements using our model, which are attributed to comorbidity portfolios in area under curve (AUC) and sensitivity increase of 46.89% (standard deviation: 4.45%) and 101.07% (standard deviation: 44.94%), respectively. In risk analysis of comorbidity on cost, respiratory diseases with a cumulative proportion in the adjusted odds ratio of 36.38% (95%CI: 27.61%, 47.86%) and circulatory diseases with a cumulative proportion in the adjusted odds ratio of 23.83% (95%CI: 15.95%, 35.22%) are the dominant risks of asthmatic patients that affects the treatment cost. It is found that the comorbidity portfolio is robust, and provides a better prediction of the high-cost of treating asthmatic patients. The preliminary characterization of the joint risk of multiple comorbidities posed on cost are also reported. This study will be of great help in improving cost prediction and comorbidity management. |
Databáze: | OpenAIRE |
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