Predicting intervention onset in the ICU with switching state space models

AMIA Jt Summits Transl Sci Proc. 2017 Jul 26;2017:82-91. eCollection 2017.


The impact of many intensive care unit interventions has not been fully quantified, especially in heterogeneous patient populations. We train unsupervised switching state autoregressive models on vital signs from the public MIMIC-III database to capture patient movement between physiological states. We compare our learned states to static demographics and raw vital signs in the prediction of five ICU treatments: ventilation, vasopressor administra tion, and three transfusions. We show that our learned states, when combined with demographics and raw vital signs, improve prediction for most interventions even 4 or 8 hours ahead of onset. Our results are competitive with existing work while using a substantially larger and more diverse cohort of 36,050 patients. While custom classifiers can only target a specific clinical event, our model learns physiological states which can help with many interventions. Our robust patient state representations provide a path towards evidence-driven administration of clinical interventions.