Using data-driven rules to predict mortality in severe community acquired pneumonia

PLoS One. 2014 Apr 3;9(4):e89053. doi: 10.1371/journal.pone.0089053. eCollection 2014.

Abstract

Prediction of patient-centered outcomes in hospitals is useful for performance benchmarking, resource allocation, and guidance regarding active treatment and withdrawal of care. Yet, their use by clinicians is limited by the complexity of available tools and amount of data required. We propose to use Disjunctive Normal Forms as a novel approach to predict hospital and 90-day mortality from instance-based patient data, comprising demographic, genetic, and physiologic information in a large cohort of patients admitted with severe community acquired pneumonia. We develop two algorithms to efficiently learn Disjunctive Normal Forms, which yield easy-to-interpret rules that explicitly map data to the outcome of interest. Disjunctive Normal Forms achieve higher prediction performance quality compared to a set of state-of-the-art machine learning models, and unveils insights unavailable with standard methods. Disjunctive Normal Forms constitute an intuitive set of prediction rules that could be easily implemented to predict outcomes and guide criteria-based clinical decision making and clinical trial execution, and thus of greater practical usefulness than currently available prediction tools. The Java implementation of the tool JavaDNF will be publicly available.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Artificial Intelligence
  • Cohort Studies
  • Community-Acquired Infections / classification
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality*
  • Databases, Factual*
  • Decision Making
  • Hospitalization
  • Humans
  • Models, Statistical*
  • Outcome Assessment, Health Care
  • Pneumonia / classification
  • Pneumonia / microbiology
  • Pneumonia / mortality*
  • ROC Curve
  • Severity of Illness Index
  • Survival Rate