Developing a machine learning model to predict patient need for computed tomography imaging in the emergency department

Abstract

Overcrowding is a well-known problem in hospitals and emergency departments (ED) that can negatively impact patients and staff. This study aims to present a machine learning model to detect a patient’s need for a Computed Tomography (CT) exam in the emergency department at the earliest possible time. The data for this work was collected from ED at Thunder Bay Regional Health Sciences Centre over one year (05/2016-05/2017) and contained administrative triage information. The target outcome was whether or not a patient required a CT exam. Multiple combinations of text embedding methods, machine learning algorithms, and data resampling methods were experimented with to find the optimal model for this task. The final model was trained with 81, 118 visits and tested on a hold-out test set with a size of 9, 013 visits. The best model achieved a ROC AUC score of 0.86 and had a sensitivity of 87.3% and specificity of 70.9%. The most important factors that led to a CT scan order were found to be chief complaint, treatment area, and triage acuity. The proposed model was able to successfully identify patients needing a CT using administrative triage data that is available at the initial stage of a patient’s arrival. By determining that a CT scan is needed early in the patient’s visit, the ED can allocate resources to ensure these investigations are completed quickly and patient flow is maintained to reduce overcrowding.