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.
More successful automated coding models have utilized non-deep machine learning techniques such as support vector machines (SVMs) @cite_15 and focus on training a model to detect the presence of a single ICD code or class of related codes. Some of these methods also leverage structured data stored in health records in addition to free-text narratives @cite_22 .
@cite_15 @cite_22
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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. Using discriminative classifiers, such as Support Vector Machines (SVMs) in combination with, or as an alternative to, Hidden Markov Models (HMMs) has a number of advantages for difficult speech recognition tasks. For example, the models can make use of additional dependencies in the observation sequences than HMMs provided the appropriate form of kernel is used. However standard SVMs are binary classifiers, and speech is a multi-class problem. Furthermore, to train SVMs to distinguish word pairs requires that each word appears in the training data. This paper examines both of these limitations. Tree-based reduction approaches for multiclass classification are described, as well as some of the issues in applying them to dynamic data, such as speech. To address the training data issues, a simplified version of HMM-based synthesis can be used, which allows data for any word-pair to be generated. These approaches are evaluated on two noise corrupted digit sequence tasks: AURORA 2.0; and actual in-car collected data. 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. Recently, fully-connected and convolutional neural networks have been trained to achieve state-of-the-art performance on a wide variety of tasks such as speech recognition, image classification, natural language processing, and bioinformatics. For classification tasks, most of these "deep learning" models employ the softmax activation function for prediction and minimize cross-entropy loss. In this paper, we demonstrate a small but consistent advantage of replacing the softmax layer with a linear support vector machine. Learning minimizes a margin-based loss instead of the cross-entropy loss. While there have been various combinations of neural nets and SVMs in prior art, our results using L2-SVMs show that by simply replacing softmax with linear SVMs gives significant gains on popular deep learning datasets MNIST, CIFAR-10, and the ICML 2013 Representation Learning Workshop's face expression recognition challenge.