A machine learning approach to triaging patients with chronic obstructive pulmonary disease

PLoS One. 2017 Nov 22;12(11):e0188532. doi: 10.1371/journal.pone.0188532. eCollection 2017.

Abstract

COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set. Our results show that algorithm accuracy and safety indicators surpass all individual pulmonologists in both identifying exacerbations and predicting the consensus triage in a 101 case validation set. The algorithm is also the top performer in sensitivity, specificity, and ppv when predicting a patient's need for emergency care.

MeSH terms

  • Algorithms
  • Clinical Decision-Making
  • Consensus
  • Disease Progression
  • Humans
  • Machine Learning*
  • Physicians
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Reproducibility of Results
  • Statistics as Topic
  • Triage*