Relational regularized risk prediction of acute coronary syndrome using electronic health records

Abstract In this paper, we attempt to utilize the information that is inherent in electronic health records (EHR) to predict clinical risks of acute coronary syndrome (ACS) patients. Because EHR data are typically highly-dimensional and non-linear, we propose a novel relational regularization-based feature selection method to identify informative risk factors from EHR data, on which a sparse ACS risk prediction model can be built. Specifically, we formulate our objective function by imposing two types of correlational characteristics, i.e., feature-feature relations and sample-sample relations, along with an l2-norm regularization term, to extract significant risk factors from EHR data. With the dimension-reduced EHR data, we train a Softmax Regression model to predict clinical risks of ACS patients. To validate the effectiveness of the proposed method, a case study was conducted on a real ACS clinical data-set that was collected from a Chinese hospital. The experimental results demonstrate the efficacy of the proposed method for improving the performance of ACS risk prediction via relational regularized risk factor selection by a comparison with state-of-the-art methods.

[1]  Jyotishman Pathak,et al.  Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function , 2016, J. Biomed. Informatics.

[2]  A. Jaffe,et al.  A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines , 2015 .

[3]  Huilong Duan,et al.  Utilizing Chinese Admission Records for MACE Prediction of Acute Coronary Syndrome , 2016, International journal of environmental research and public health.

[4]  Nasser M. Nasrabadi,et al.  Pattern Recognition and Machine Learning , 2006, Technometrics.

[5]  Fei Wang,et al.  Towards actionable risk stratification: A bilinear approach , 2015, J. Biomed. Informatics.

[6]  A. Ng Feature selection, L1 vs. L2 regularization, and rotational invariance , 2004, Twenty-first international conference on Machine learning - ICML '04.

[7]  Halil Kilicoglu,et al.  The role of fine-grained annotations in supervised recognition of risk factors for heart disease from EHRs , 2015, J. Biomed. Informatics.

[8]  David A Morrow,et al.  Risk Prediction in Cardiovascular Medicine Cardiovascular Risk Prediction in Patients With Stable and Unstable Coronary Heart Disease , 2010 .

[9]  Yan Li,et al.  A distributed ensemble approach for mining healthcare data under privacy constraints , 2016, Inf. Sci..

[10]  Ahmad Samiei,et al.  Generating a robust statistical causal structure over 13 cardiovascular disease risk factors using genomics data , 2016, J. Biomed. Informatics.

[11]  Mikhail Belkin,et al.  Manifold Regularization: A Geometric Framework for Learning from Labeled and Unlabeled Examples , 2006, J. Mach. Learn. Res..

[12]  Nan Liu,et al.  Risk Scoring for Prediction of Acute Cardiac Complications from Imbalanced Clinical Data , 2014, IEEE Journal of Biomedical and Health Informatics.

[13]  Constantinos S. Pattichis,et al.  Assessment of the Risk Factors of Coronary Heart Events Based on Data Mining With Decision Trees , 2010, IEEE Transactions on Information Technology in Biomedicine.

[14]  Paul Burton,et al.  Rivaroxaban in patients with a recent acute coronary syndrome. , 2012, The New England journal of medicine.

[15]  Nigam H. Shah,et al.  Implications of non-stationarity on predictive modeling using EHRs , 2015, J. Biomed. Informatics.

[16]  Á. Avezum,et al.  Predictors of hospital mortality in the global registry of acute coronary events. , 2003, Archives of internal medicine.

[17]  E. Antman,et al.  The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. , 2000, JAMA.

[18]  R. Tibshirani Regression Shrinkage and Selection via the Lasso , 1996 .

[19]  Nancy M. Lorenzi,et al.  Machine Learning for Risk Prediction of Acute Coronary Syndrome , 2014, AMIA.

[20]  Huilong Duan,et al.  A Regularized Deep Learning Approach for Clinical Risk Prediction of Acute Coronary Syndrome Using Electronic Health Records , 2018, IEEE Transactions on Biomedical Engineering.

[21]  Stefan Schulz,et al.  Secondary use of electronic health records for building cohort studies through top-down information extraction , 2015, J. Biomed. Informatics.

[22]  Gil Alterovitz,et al.  Classification of hospital acquired complications using temporal clinical information from a large electronic health record , 2016, J. Biomed. Informatics.

[23]  Hung T. Nguyen,et al.  Hypotension Risk Prediction via Sequential Contrast Patterns of ICU Blood Pressure , 2016, IEEE Journal of Biomedical and Health Informatics.

[24]  Huilong Duan,et al.  On mining latent treatment patterns from electronic medical records , 2015, Data Mining and Knowledge Discovery.

[25]  Carl J Pepine,et al.  ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction--summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients , 2002, Journal of the American College of Cardiology.

[26]  Adler J. Perotte,et al.  Learning probabilistic phenotypes from heterogeneous EHR data , 2015, J. Biomed. Informatics.

[27]  Huilong Duan,et al.  A probabilistic topic model for clinical risk stratification from electronic health records , 2015, J. Biomed. Informatics.

[28]  Girish N. Nadkarni,et al.  Incorporating temporal EHR data in predictive models for risk stratification of renal function deterioration , 2014, J. Biomed. Informatics.

[29]  Wei Luo,et al.  Stabilized sparse ordinal regression for medical risk stratification , 2014, Knowledge and Information Systems.

[30]  Zhongfei Zhang,et al.  Manifold regularized cross-modal embedding for zero-shot learning , 2017, Inf. Sci..

[31]  Dinggang Shen,et al.  A novel relational regularization feature selection method for joint regression and classification in AD diagnosis , 2017, Medical Image Anal..