This study explores the creation of a machine learning model to automatically identify whether a Neonatal Intensive Care Unit (NICU) patient was diagnosed with neonatal jaundice during a particular hospitalization based on their associated clinical notes. We develop a number of techniques for text preprocessing and feature selection and compare the effectiveness of different classification models. We show that using ensemble decision tree classification, both with AdaBoost and with bagging, outperforms support vector machines (SVM), the current state-of-the-art technique for neonatal jaundice coding.
At least one previous attempt has been made to build an automatic coding model for neonatal jaundice; @cite_10 uses an SVM on the text of clinical notes. Our research improves on this model by employing an additional preprocessing step and using ensemble classification methods. We explore and compare these alternative classification techniques and analyze their efficacy.
@cite_10
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Background Existing risk adjustment models for intensive care unit (ICU) outcomes rely on manual abstraction of patient-level predictors from medical charts. Developing an automated method for abstracting these data from free text might reduce cost and data collection times. @PARASPLIT Objective To develop a support vector machine (SVM) classifier capable of identifying a range of procedures and diagnoses in ICU clinical notes for use in risk adjustment. @PARASPLIT Materials and methods We selected notes from 2001–2008 for 4191 neonatal ICU (NICU) and 2198 adult ICU patients from the MIMIC-II database from the Beth Israel Deaconess Medical Center. Using these notes, we developed an implementation of the SVM classifier to identify procedures (mechanical ventilation and phototherapy in NICU notes) and diagnoses (jaundice in NICU and intracranial hemorrhage (ICH) in adult ICU). On the jaundice classification task, we also compared classifier performance using n-gram features to unigrams with application of a negation algorithm (NegEx). @PARASPLIT Results Our classifier accurately identified mechanical ventilation (accuracy=0.982, F1=0.954) and phototherapy use (accuracy=0.940, F1=0.912), as well as jaundice (accuracy=0.898, F1=0.884) and ICH diagnoses (accuracy=0.938, F1=0.943). Including bigram features improved performance on the jaundice (accuracy=0.898 vs 0.865) and ICH (0.938 vs 0.927) tasks, and outperformed NegEx-derived unigram features (accuracy=0.898 vs 0.863) on the jaundice task. @PARASPLIT Discussion Overall, a classifier using n-gram support vectors displayed excellent performance characteristics. The classifier generalizes to diverse patient populations, diagnoses, and procedures. @PARASPLIT Conclusions SVM-based classifiers can accurately identify procedure status and diagnoses among ICU patients, and including n-gram features improves performance, compared to existing methods. This study proposes a methodology to support coding professionals in assigning ICD-9-CM codes to inpatient episodes. This subject has been predominantly addressed through the use of natural language processing methods, which show limited generalizability. To surpass this issue, this paper proposes a methodology entailing an adaptive data processing method based on structured electronic health record data, whereby raw clinical data is mapped into a feature set, and based on which supervised learning algorithms are trained. After applying a filter method for feature selection, support vector machine (SVM) classifiers are trained to obtain predictions for assigning codes to each episode. This approach is tested using a dataset of inpatient episodes from a department of Internal Medicine. Classifiers exhibited F1-measure values around 52 . Recall was generally higher than precision, which is considered valuable for coding support purposes. Analyzing results on an individual code basis sheds light on some key-issues regarding the use of structured electronic health record data in supporting clinical coding. Background and objective The volume of healthcare data is growing rapidly with the adoption of health information technology. We focus on automated ICD9 code assignment from discharge summary content and methods for evaluating such assignments. Methods We study ICD9 diagnosis codes and discharge summaries from the publicly available Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) repository. We experiment with two coding approaches: one that treats each ICD9 code independently of each other (flat classifier), and one that leverages the hierarchical nature of ICD9 codes into its modeling (hierarchy-based classifier). We propose novel evaluation metrics, which reflect the distances among gold-standard and predicted codes and their locations in the ICD9 tree. Experimental setup, code for modeling, and evaluation scripts are made available to the research community. Results The hierarchy-based classifier outperforms the flat classifier with F-measures of 39.5 and 27.6 , respectively, when trained on 20 533 documents and tested on 2282 documents. While recall is improved at the expense of precision, our novel evaluation metrics show a more refined assessment: for instance, the hierarchy-based classifier identifies the correct sub-tree of gold-standard codes more often than the flat classifier. Error analysis reveals that gold-standard codes are not perfect, and as such the recall and precision are likely underestimated. Conclusions Hierarchy-based classification yields better ICD9 coding than flat classification for MIMIC patients. Automated ICD9 coding is an example of a task for which data and tools can be shared and for which the research community can work together to build on shared models and advance the state of the art. This paper describes research methodologies and experimental settings for the task of relation identification and classification between pairs of medical entities, using clinical data. The models that we use represent a combination of lexical and syntactic features, medical semantic information, terms extracted from a vector-space model created using a random projection algorithm, and additional contextual information extracted at sentence-level. The best results are obtained using an SVM classification algorithm with a combination of the above mentioned features, plus a set of additional features that capture the distributional semantic correlation between the concepts and each relation of interest. This paper introduces a methodology for the detection of sleep apnea based on single-lead electrocardiogram (ECG) of the patient. In the proposed technique, each QRS complex of the ECG signal is approximated using a linear combination of the lower order Hermite basis functions. The coefficients of the Hermite expansion are then used to discriminate the apnea and normal segments along with three features based on R-R time series (mean of R-R intervals, the standard deviation of R-R intervals) and energy in the error of the QRS approximation. To perform classification between the apnea and normal segments, four different types of classifiers (K-nearest neighbor (KNN), multilayer perceptron neural network (MLPNN), support vector machine (SVM), and least-square support vector machine (LS-SVM)) are used in this work.In total, 70 ECG recordings from Apnea-ECG dataset are used in this study and the performance of the proposed algorithm is evaluated based on the minute-by-minute (per-segment) classification, and per-recording (where the entire ECG recording of a subject is discriminated as the apnea or normal one) classification. By considering the events of apnea and hypopnea together, an accuracy of about 84 is achieved on the minute-by-minute basis classification using the LS-SVM classifier with the Gaussian radial basis function (RBF) kernel.On the other hand, an accuracy of about 97.14 is achieved for per-recording classification using the SVM, and LS-SVM classifiers. From the results, it is observed that the proposed methodology provides comparable accuracy with the methods existing in the literature at reduced computational cost due to the lesser number of features selected for the classification. Sleep apnea detection from single-lead ECG based on QRS morphology.Hermite basis functions for tracking respiratory induced morphological variations in the QRS complexes.We performed the analysis on the Apnea-ECG database. Abstract The aim of this paper is to address the development of computer assisted malaria parasite characterization and classification using machine learning approach based on light microscopic images of peripheral blood smears. In doing this, microscopic image acquisition from stained slides, illumination correction and noise reduction, erythrocyte segmentation, feature extraction, feature selection and finally classification of different stages of malaria ( Plasmodium vivax and Plasmodium falciparum ) have been investigated. The erythrocytes are segmented using marker controlled watershed transformation and subsequently total ninety six features describing shape-size and texture of erythrocytes are extracted in respect to the parasitemia infected versus non-infected cells. Ninety four features are found to be statistically significant in discriminating six classes. Here a feature selection-cum-classification scheme has been devised by combining F -statistic, statistical learning techniques i.e., Bayesian learning and support vector machine (SVM) in order to provide the higher classification accuracy using best set of discriminating features. Results show that Bayesian approach provides the highest accuracy i.e., 84 for malaria classification by selecting 19 most significant features while SVM provides highest accuracy i.e., 83.5 with 9 most significant features. Finally, the performance of these two classifiers under feature selection framework has been compared toward malaria parasite classification. Objective: We sought to develop an intensive care unit research database applying automated techniques to aggregate high-resolution diagnostic and therapeutic data from a large, diverse population of adult intensive care unit patients. This freely available database is intended to support epidemiologic research in critical care medicine and serve as a resource to evaluate new clinical decision support and monitoring algorithms. Design: Data collection and retrospective analysis. Setting: All adult intensive care units (medical intensive care unit, surgical intensive care unit, cardiac care unit, cardiac surgery recovery unit) at a tertiary care hospital. Patients: Adult patients admitted to intensive care units between 2001 and 2007. Interventions: None. Measurements and Main Results: The Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database consists of 25,328 intensive care unit stays. The investigators collected detailed information about intensive care unit patient stays, including laboratory data, therapeutic intervention profiles such as vasoactive medication drip rates and ventilator settings, nursing progress notes, discharge summaries, radiology reports, provider order entry data, International Classification of Diseases, 9th Revision codes, and, for a subset of patients, high-resolution vital sign trends and waveforms. Data were automatically deidentified to comply with Health Insurance Portability and Accountability Act standards and integrated with relational database software to create electronic intensive care unit records for each patient stay. The data were made freely available in February 2010 through the Internet along with a detailed user’s guide and an assortment of data processing tools. The overall hospital mortality rate was 11.7 , which varied by critical care unit. The median intensive care unit length of stay was 2.2 days (interquartile range, 1.1‐4.4 days). According to the primary International Classification of Diseases, 9th Revision codes, the following disease categories each comprised at least 5 of the case records: diseases of the circulatory system (39.1 ); trauma (10.2 ); diseases of the digestive system (9.7 ); pulmonary diseases (9.0 ); infectious diseases (7.0 ); and neoplasms (6.8 ). Conclusions: MIMIC-II documents a diverse and very large population of intensive care unit patient stays and contains comprehensive and detailed clinical data, including physiological waveforms and minute-by-minute trends for a subset of records. It establishes a new public-access resource for critical care research, supporting a diverse range of analytic studies spanning epidemiology, clinical decision-rule development, and electronic tool development. (Crit Care Med 2011; 39:952‐960) Translating clinical practice guidelines into a computer-interpretable format is a challenging and laborious task. In this project we focus on supporting the early steps of the modeling process by automatically identifying conditional activities in guideline documents in order to model them automatically in further consequence. Therefore, we developed a rule-based, heuristic method that combines domain-independent information extraction rules and semantic pattern rules. The classification also uses a weighting coefficient to verify the relevance of the sentence in the context of other information aspects, such as effects, intentions, etc. Our evaluation results show that even with a small set of training data, we achieved a recall of 75 and a precision of 88 . This outcome shows that this method supports the modeling task and eases the translation of CPGs into a semi-formal model. In this paper we have designed and experimented novel convolution kernels for automatic classification of predicate arguments. Their main property is the ability to process structured representations. Support Vector Machines (SVMs), using a combination of such kernels and the flat feature kernel, classify Prop-Bank predicate arguments with accuracy higher than the current argument classification state-of-the-art.Additionally, experiments on FrameNet data have shown that SVMs are appealing for the classification of semantic roles even if the proposed kernels do not produce any improvement. Objective: The aim of this study was to develop an automated computer-aided diagnostic system for diagnosis of thyroid cancer pattern in fine needle aspiration cytology (FNAC) microscopic images with high degree of sensitivity and specificity using statistical texture features and a Support Vector Machine classifier (SVM). Materials and Methods: A training set of 40 benign and 40 malignant FNAC images and a testing set of 10 benign and 20 malignant FNAC images were used to perform the diagnosis of thyroid cancer. Initially, segmentation of region of interest (ROI) was performed by region-based morphology segmentation. The developed diagnostic system utilized statistical texture features derived from the segmented images using a Gabor filter bank at various wavelengths and angles. Finally, the SVM was used as a machine learning algorithm to identify benign and malignant states of thyroid nodules. Results: The SVMachieved a diagnostic accuracy of 96.7 with sensitivity and specificity of 95 and 100 , respectively, at a wavelength of 4 and an angle of 45. Conclusion: The results show that the diagnosis of thyroid cancer in FNAC images can be effectively performed using statistical texture information derived with Gabor filters in association with an SVM. The clinical notes in a given patient record contain much redundancy, in large part due to clinicians’ documentation habit of copying from previous notes in the record and pasting into a new note. Previous work has shown that this redundancy has a negative impact on the quality of text mining and topic modeling in particular. In this paper we describe a novel variant of Latent Dirichlet Allocation (LDA) topic modeling, Red-LDA, which takes into account the inherent redundancy of patient records when modeling content of clinical notes. To assess the value of Red-LDA, we experiment with three baselines and our novel redundancy-aware topic modeling method: given a large collection of patient records, (i) apply vanilla LDA to all documents in all input records; (ii) identify and remove all redundancy by chosing a single representative document for each record as input to LDA; (iii) identify and remove all redundant paragraphs in each record, leaving partial, non-redundant documents as input to LDA; and (iv) apply Red-LDA to all documents in all input records. Both quantitative evaluation carried out through log-likelihood on held-out data and topic coherence of produced topics and qualitative assessement of topics carried out by physicians show that Red-LDA produces superior models to all three baseline strategies. This research contributes to the emerging field of understanding the characteristics of the electronic health record and how to account for them in the framework of data mining. The code for the two redundancy-elimination baselines and Red-LDA is made publicly available to the community. Objective Build probabilistic topic model representations of hospital admissions processes and compare the ability of such models to predict clinical order patterns as compared to preconstructed order sets. @PARASPLIT Materials and Methods The authors evaluated the first 24 hours of structured electronic health record data for > 10 K inpatients. Drawing an analogy between structured items (e.g., clinical orders) to words in a text document, the authors performed latent Dirichlet allocation probabilistic topic modeling. These topic models use initial clinical information to predict clinical orders for a separate validation set of > 4 K patients. The authors evaluated these topic model-based predictions vs existing human-authored order sets by area under the receiver operating characteristic curve, precision, and recall for subsequent clinical orders. @PARASPLIT Results Existing order sets predict clinical orders used within 24 hours with area under the receiver operating characteristic curve 0.81, precision 16 , and recall 35 . This can be improved to 0.90, 24 , and 47 ( P < 10−20) by using probabilistic topic models to summarize clinical data into up to 32 topics. Many of these latent topics yield natural clinical interpretations (e.g., “critical care,” “pneumonia,” “neurologic evaluation”). @PARASPLIT Discussion Existing order sets tend to provide nonspecific, process-oriented aid, with usability limitations impairing more precise, patient-focused support. Algorithmic summarization has the potential to breach this usability barrier by automatically inferring patient context, but with potential tradeoffs in interpretability. @PARASPLIT Conclusion Probabilistic topic modeling provides an automated approach to detect thematic trends in patient care and generate decision support content. A potential use case finds related clinical orders for decision support. Clinicians spend a significant amount of time inputting free-form textual notes into Electronic Health Records (EHR) systems. Much of this documentation work is seen as a burden, reducing time spent with patients and contributing to clinician burnout. With the aspiration of AI-assisted note-writing, we propose a new language modeling task predicting the content of notes conditioned on past data from a patient's medical record, including patient demographics, labs, medications, and past notes. We train generative models using the public, de-identified MIMIC-III dataset and compare generated notes with those in the dataset on multiple measures. We find that much of the content can be predicted, and that many common templates found in notes can be learned. We discuss how such models can be useful in supporting assistive note-writing features such as error-detection and auto-complete. In the interest of deriving classifiers that are robust to outlier observations, we present integer programming formulations of Vapnik's support vector machine (SVM) with the ramp loss and hard margin loss. The ramp loss allows a maximum error of 2 for each training observation, while the hard margin loss calculates error by counting the number of training observations that are in the margin or misclassified outside of the margin. SVM with these loss functions is shown to be a consistent estimator when used with certain kernel functions. In computational studies with simulated and real-world data, SVM with the robust loss functions ignores outlier observations effectively, providing an advantage over SVM with the traditional hinge loss when using the linear kernel. Despite the fact that training SVM with the robust loss functions requires the solution of a quadratic mixed-integer program (QMIP) and is NP-hard, while traditional SVM requires only the solution of a continuous quadratic program (QP), we are able to find good solutions and prove optimality for instances with up to 500 observations. Solution methods are presented for the new formulations that improve computational performance over industry-standard integer programming solvers alone. Two-category support vector machines (SVM) have been very popular in the machine learning community for classification problems. Solving multicategory problems by a series of binary classifiers is quite common in the SVM paradigm; however, this approach may fail under various circumstances. We propose the multicategory support vector machine (MSVM), which extends the binary SVM to the multicategory case and has good theoretical properties. The proposed method provides a unifying framework when there are either equal or unequal misclassification costs. As a tuning criterion for the MSVM, an approximate leave-one-out cross-validation function, called Generalized Approximate Cross Validation, is derived, analogous to the binary case. The effectiveness of the MSVM is demonstrated through the applications to cancer classification using microarray data and cloud classification with satellite radiance profiles. In this paper, we first develop a direct Bayesian based support vector machine by combining the Bayesian analysis with the SVM. Unlike traditional SVM-based face recognition method that needs to train a large number of SVMs, the direct Bayesian SVM needs only one SVM trained to classify the face difference between intra-personal variation and extra-personal variation. However, the added simplicity means that the method has to separate two complex subspaces by one hyper-plane thus affects the recognition accuracy. In order to improve the recognition performance we develop three more Bayesian based SVMs, including the one-versus-all method, the hierarchical agglomerative clustering based method, and the adaptive clustering method. We show the improvement of the new algorithms over traditional subspace methods through experiments on two face databases, the FERET database and the XM2VTS database. The need for accurate, automated protein classification methods continues to increase as advances in biotechnology uncover new proteins. G-protein coupled receptors (GPCRs) are a particularly difficult superfamily of proteins to classify due to extreme diversity among its members. Previous comparisons of BLAST, k-nearest neighbor (k-NN), hidden markov model (HMM) and support vector machine (SVM) using alignment-based features have suggested that classifiers at the complexity of SVM are needed to attain high accuracy. Here, analogous to document classification, we applied Decision Tree and Naive Bayes classifiers with chi-square feature selection on counts of n-grams (i.e. short peptide sequences of length n) to this classification task. Using the GPCR dataset and evaluation protocol from the previous study, the Naive Bayes classifier attained an accuracy of 93.0 and 92.4 in level I and level II subfamily classification respectively, while SVM has a reported accuracy of 88.4 and 86.3 . This is a 39.7 and 44.5 reduction in residual error for level I and level II subfamily classification, respectively. The Decision Tree, while inferior to SVM, outperforms HMM in both level I and level II subfamily classification. For those GPCR families whose profiles are stored in the Protein FAMilies database of alignments and HMMs (PFAM), our method performs comparably to a search against those profiles. Finally, our method can be generalized to other protein families by applying it to the superfamily of nuclear receptors with 94.5, 97.8 and 93.6 accuracy in family, level I and level II subfamily classification respectively. Proteins 2005. © 2005 Wiley-Liss, Inc. We present a framework for robustly estimating registration between a 3D volume image and a 2D projection image and evaluate its precision and robustness in spine interventions for vertebral localization in the presence of anatomical deformation. The framework employs a normalized gradient information similarity metric and multi-start covariance matrix adaptation evolution strategy optimization with local-restarts, which provided improved robustness against deformation and content mismatch. The parallelized implementation allowed orders-of-magnitude acceleration in computation time and improved the robustness of registration via multi-start global optimization. Experiments involved a cadaver specimen and two CT datasets (supine and prone) and 36 C-arm fluoroscopy images acquired with the specimen in four positions (supine, prone, supine with lordosis, prone with kyphosis), three regions (thoracic, abdominal, and lumbar), and three levels of geometric magnification (1.7, 2.0, 2.4). Registration accuracy was evaluated in terms of projection distance error (PDE) between the estimated and true target points in the projection image, including 14 400 random trials (200 trials on the 72 registration scenarios) with initialization error up to ±200 mm and ±10°. The resulting median PDE was better than 0.1 mm in all cases, depending somewhat on the resolution of input CT and fluoroscopy images. The cadaver experiments illustrated the tradeoff between robustness and computation time, yielding a success rate of 99.993 in vertebral labeling (with 'success' defined as PDE <5 mm) using 1,718 664 ± 96 582 function evaluations computed in 54.0 ± 3.5 s on a mid-range GPU (nVidia, GeForce GTX690). Parameters yielding a faster search (e.g., fewer multi-starts) reduced robustness under conditions of large deformation and poor initialization (99.535 success for the same data registered in 13.1 s), but given good initialization (e.g., ±5 mm, assuming a robust initial run) the same registration could be solved with 99.993 success in 6.3 s. The ability to register CT to fluoroscopy in a manner robust to patient deformation could be valuable in applications such as radiation therapy, interventional radiology, and an assistant to target localization (e.g., vertebral labeling) in image-guided spine surgery. In this paper, we propose an automatic method for constructing an active shape model (ASM) to segment the complete cardiac left ventricle in 3D ultrasound (3DUS) images, which avoids costly manual landmarking. The automatic construction of the ASM has already been addressed in the literature; however, the direct application of these methods to 3DUS is hampered by a high level of noise and artefacts. Therefore, we propose to construct the ASM by fusing the multidetector computed tomography data, to learn the shape, with the artificially generated 3DUS, in order to learn the neighbourhood of the boundaries. Our artificial images were generated by two approaches: a faster one that does not take into account the geometry of the transducer, and a more comprehensive one, implemented in Field II toolbox. The segmentation accuracy of our ASM was evaluated on 20 patients with left-ventricular asynchrony, demonstrating plausibility of the approach. In this paper we present the application of ensemble learning to epileptic seizure detection problem. We propose a robust learning framework to mitigate class imbalance in large CHB-MIT (982 hrs) scalp EEG dataset. The algorithm being used is RUSBoost which is a hybrid data sampling and boosting technique designed especially for skewed classes. The data that is being used in this study has severe class imbalance, with average representation of 0.38 of seizure class to that of 99.62 of non-seizure class. The proposed approach shows the power of RUSBoost in terms of robustness and generalization. We compared our method with the most successful Support Vector Machine (SVM) based approach and report competitive results of 97 seizure detection accuracy, mean detection delay of 2.7s and false detection rate of 0.08 seizure hr. We also report fast training times of just under three minutes on average for average training data of 21 hrs.