Wenyu Song1,2, Linying Zhang3, Luwei Liu1, Michael Sainlaire1, Mehran Karvar2,4, Min-Jeoung Kang5, Avery Pullman1, Stuart Lipsitz1,2, Anthony Massaro1,2, Namrata Patil2,4, Ravi Jasuja1,2, Patricia C Dykes1,2. 1. Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA. 2. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Biomedical Informatics, Columbia University, New York, New York, USA. 4. Department of Surgery, Brigham & Women's Hospital, Boston, Massachusetts, USA. 5. Department of Nursing, College of Nursing, The Catholic University of Korea, Seoul, South Korea.
Abstract
OBJECTIVES: The coronavirus disease 2019 (COVID-19) is a resource-intensive global pandemic. It is important for healthcare systems to identify high-risk COVID-19-positive patients who need timely health care. This study was conducted to predict the hospitalization of older adults who have tested positive for COVID-19. METHODS: We screened all patients with COVID test records from 11 Mass General Brigham hospitals to identify the study population. A total of 1495 patients with age 65 and above from the outpatient setting were included in the final cohort, among which 459 patients were hospitalized. We conducted a clinician-guided, 3-stage feature selection, and phenotyping process using iterative combinations of literature review, clinician expert opinion, and electronic healthcare record data exploration. A list of 44 features, including temporal features, was generated from this process and used for model training. Four machine learning prediction models were developed, including regularized logistic regression, support vector machine, random forest, and neural network. RESULTS: All 4 models achieved area under the receiver operating characteristic curve (AUC) greater than 0.80. Random forest achieved the best predictive performance (AUC = 0.83). Albumin, an index for nutritional status, was found to have the strongest association with hospitalization among COVID positive older adults. CONCLUSIONS: In this study, we developed 4 machine learning models for predicting general hospitalization among COVID positive older adults. We identified important clinical factors associated with hospitalization and observed temporal patterns in our study cohort. Our modeling pipeline and algorithm could potentially be used to facilitate more accurate and efficient decision support for triaging COVID positive patients.
OBJECTIVES: The coronavirus disease 2019 (COVID-19) is a resource-intensive global pandemic. It is important for healthcare systems to identify high-risk COVID-19-positive patients who need timely health care. This study was conducted to predict the hospitalization of older adults who have tested positive for COVID-19. METHODS: We screened all patients with COVID test records from 11 Mass General Brigham hospitals to identify the study population. A total of 1495 patients with age 65 and above from the outpatient setting were included in the final cohort, among which 459 patients were hospitalized. We conducted a clinician-guided, 3-stage feature selection, and phenotyping process using iterative combinations of literature review, clinician expert opinion, and electronic healthcare record data exploration. A list of 44 features, including temporal features, was generated from this process and used for model training. Four machine learning prediction models were developed, including regularized logistic regression, support vector machine, random forest, and neural network. RESULTS: All 4 models achieved area under the receiver operating characteristic curve (AUC) greater than 0.80. Random forest achieved the best predictive performance (AUC = 0.83). Albumin, an index for nutritional status, was found to have the strongest association with hospitalization among COVID positive older adults. CONCLUSIONS: In this study, we developed 4 machine learning models for predicting general hospitalization among COVID positive older adults. We identified important clinical factors associated with hospitalization and observed temporal patterns in our study cohort. Our modeling pipeline and algorithm could potentially be used to facilitate more accurate and efficient decision support for triaging COVID positive patients.
Authors: Akhil Vaid; Suraj K Jaladanki; Jie Xu; Shelly Teng; Arvind Kumar; Samuel Lee; Sulaiman Somani; Ishan Paranjpe; Jessica K De Freitas; Tingyi Wanyan; Kipp W Johnson; Mesude Bicak; Eyal Klang; Young Joon Kwon; Anthony Costa; Shan Zhao; Riccardo Miotto; Alexander W Charney; Erwin Böttinger; Zahi A Fayad; Girish N Nadkarni; Fei Wang; Benjamin S Glicksberg Journal: JMIR Med Inform Date: 2021-01-27
Authors: David M Levine; Stuart R Lipsitz; Zoe Co; Wenyu Song; Patricia C Dykes; Lipika Samal Journal: J Gen Intern Med Date: 2020-12-03 Impact factor: 5.128
Authors: Yijun Shao; Ali Ahmed; Angelike P Liappis; Charles Faselis; Stuart J Nelson; Qing Zeng-Treitler Journal: J Healthc Inform Res Date: 2021-02-27