AEP-DLA: Adverse Event Prediction in Hospitalized Adult Patients Using Deep Learning Algorithms

Abstract

Early prediction of clinical deterioration such as adverse events (AEs), improves patient safety. National Early Warning Score (NEWS) is widely used to predict AEs based on the aggregation of 6 physiological parameters. We took the same parameters as the features for AE prediction using deep learning algorithms (AEP-DLA) among hospitalized adult patients. The aim of this study is to get better performance than traditional naïve mathematical calculations by introducing novel vital sign data preprocessing schemes. We retrospectively collected the data from our electronic medical record data warehouse (2007 ~ 2017). AE rate of all 99,861 admissions was 6.2%. The dataset was divided into training and testing datasets from 2007–2015 and 2016–2017 respectively. In real-life clinical care, physiological parameters were not recorded every hour and missed frequently, for example, Glasgow Coma Scale (GCS). The expert domain suggested that missed GCS was rated as 15. We took two strategies (stack series records and align by hour) in the data preprocessing and tripling the values of negative samples for class balancing (CB). We used the last 28 hours’ serial data to predict AEs 3 hours later with Random Forest, XGBoost, Convolutional Neural Network (CNN) and Recurrent Neural Network (RNN). It is shown that CNN with CB and align by hour got the best results comparing to the other methods. The precision, recall and area under curve were 0.841, 0.928 and 0.995 respectively. The performance of the model is also better than those proposed in the published literatures.

Keywords

• Adverse event (AE)
• early deterioration indication
• early warning scores
• electronic medical record
• risk stratification