A novel GA-ELM model for patient-specific mortality prediction over large-scale lab event data

Abstract Patient-specific mortality prediction models are an essential component of Clinical Decision Support Systems developed for caregivers in Intensive Care Units (ICUs), that enable timely decisions towards effective patient care and optimized ICU resource management. While high prediction accuracy is a fundamental requirement for any mortality prediction application, being able to so with minimal patient-specific data is a major plus point that can help in improving care delivery and cost optimization. Most existing scoring techniques and prediction models utilize a multitude of lab tests and patient events to predict mortality and also suffer from reduced performance when available patient data is less. In this paper, a Genetic Algorithm based Wrapper Feature Selection technique is proposed for determining most-optimal lab events that contribute predominantly to mortality, even for large-scale patient cohorts. Using this, an Extreme Learning Machine (ELM) based neural network is designed for predicting patient-specific ICU mortality. The proposed GA-ELM model was benchmarked against four popular traditional mortality scores and also state-of-the-art machine learning models for experimental validation. The GA-ELM model achieved promising results as it outperformed the traditional scoring systems by 11%–29% and state-of-the-art models by up to 14%, in terms of AUROC.

[1]  Amparo Alonso-Betanzos,et al.  Filter Methods for Feature Selection - A Comparative Study , 2007, IDEAL.

[2]  G. Clermont,et al.  Predicting hospital mortality for patients in the intensive care unit: A comparison of artificial neural networks with logistic regression models , 2001, Critical care medicine.

[3]  Aram Galstyan,et al.  Multitask learning and benchmarking with clinical time series data , 2017, Scientific Data.

[4]  Duncan Fyfe Gillies,et al.  A Review of Feature Selection and Feature Extraction Methods Applied on Microarray Data , 2015, Adv. Bioinformatics.

[5]  Miguel A. Vega-Rodríguez,et al.  A Hybrid Multiobjective Memetic Metaheuristic for Multiple Sequence Alignment , 2016, IEEE Transactions on Evolutionary Computation.

[6]  Rajkumar Buyya,et al.  A Hybrid Bio-Inspired Algorithm for Scheduling and Resource Management in Cloud Environment , 2020, IEEE Transactions on Services Computing.

[7]  W. Knaus,et al.  The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. , 1991, Chest.

[8]  L. S. S. Wong,et al.  A comparison of ICU mortality prediction using the APACHE II scoring system and artificial neural networks , 1999 .

[9]  Yan Liu,et al.  Recurrent Neural Networks for Multivariate Time Series with Missing Values , 2016, Scientific Reports.

[10]  R. Dybowski,et al.  Prediction of outcome in critically ill patients using artificial neural network synthesised by genetic algorithm , 1996, The Lancet.

[11]  Guang-Bin Huang,et al.  Extreme learning machine: a new learning scheme of feedforward neural networks , 2004, 2004 IEEE International Joint Conference on Neural Networks (IEEE Cat. No.04CH37541).

[12]  Leo Anthony Celi,et al.  A Database-driven Decision Support System: Customized Mortality Prediction , 2012, Journal of personalized medicine.

[13]  Reda Alhajj,et al.  Multiple sequence alignment with affine gap by using multi-objective genetic algorithm , 2014, Comput. Methods Programs Biomed..

[14]  Mohamed Bader-El-Den,et al.  Patient length of stay and mortality prediction: A survey , 2017, Health services management research.

[15]  Peter Szolovits,et al.  MIMIC-III, a freely accessible critical care database , 2016, Scientific Data.

[16]  B. Walker I. Introduction , 2020 .

[17]  B. Grant,et al.  Application of mortality prediction systems to individual intensive care units , 1999, Intensive Care Medicine.

[18]  B. Efron Student's t-Test under Symmetry Conditions , 1969 .

[19]  P. Shekelle,et al.  Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care , 2006, Annals of Internal Medicine.

[20]  Christopher Barton,et al.  A computational approach to mortality prediction of alcohol use disorder inpatients , 2016, Comput. Biol. Medicine.

[21]  Gari D. Clifford,et al.  A New Severity of Illness Scale Using a Subset of Acute Physiology and Chronic Health Evaluation Data Elements Shows Comparable Predictive Accuracy* , 2013, Critical care medicine.

[22]  J. Zimmerman,et al.  Acute Physiology and Chronic Health Evaluation (APACHE) IV: Hospital mortality assessment for today’s critically ill patients* , 2006, Critical care medicine.

[23]  Ruhul A. Sarker,et al.  Progressive Alignment Method Using Genetic Algorithm for Multiple Sequence Alignment , 2012, IEEE Transactions on Evolutionary Computation.

[24]  M. J. van der Laan,et al.  Mortality prediction in intensive care units with the Super ICU Learner Algorithm (SICULA): a population-based study. , 2015, The Lancet. Respiratory medicine.

[25]  J. L. Gall,et al.  A simplified acute physiology score for ICU patients , 1984, Critical care medicine.

[26]  Isabelle Guyon,et al.  An Introduction to Variable and Feature Selection , 2003, J. Mach. Learn. Res..

[27]  J. Vincent,et al.  The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure , 1996, Intensive Care Medicine.

[28]  W. Knaus,et al.  APACHE II: a severity of disease classification system. , 1985 .

[29]  Guang-Bin Huang,et al.  Trends in extreme learning machines: A review , 2015, Neural Networks.

[30]  Florian Schmidt,et al.  Neural Document Embeddings for Intensive Care Patient Mortality Prediction , 2016, NIPS 2016.

[31]  Lucila Ohno-Machado,et al.  Prediction of mortality in an Indian intensive care unit , 2004, Intensive Care Medicine.

[32]  George Forman,et al.  An Extensive Empirical Study of Feature Selection Metrics for Text Classification , 2003, J. Mach. Learn. Res..

[33]  Hamid Mohamadlou,et al.  Using electronic health record collected clinical variables to predict medical intensive care unit mortality , 2016, Annals of medicine and surgery.

[34]  Ron Kohavi,et al.  Wrappers for Feature Subset Selection , 1997, Artif. Intell..

[35]  S. Lemeshow,et al.  A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study , 1993 .

[36]  Peter Bauer,et al.  SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission , 2005, Intensive Care Medicine.

[37]  Divya Chaudhary,et al.  Cloudy GSA for load scheduling in cloud computing , 2018, Appl. Soft Comput..

[38]  Leo A. Celi,et al.  The MIMIC Code Repository: enabling reproducibility in critical care research , 2017, J. Am. Medical Informatics Assoc..