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Observational Study
. 2023 Dec 13;24(1):311.
doi: 10.1186/s12931-023-02628-7.

Deep learning prediction of hospital readmissions for asthma and COPD

Kevin Lopez #  1   2 , Huan Li #  1   2 , Zachary Lipkin-Moore  1   3 , Shannon Kay  1   2 , Haseena Rajeevan  4 , J Lucian Davis  1   5 , F Perry Wilson  6 , Carolyn L Rochester  1   7 , Jose L Gomez  8   9
Affiliations
Observational Study

Deep learning prediction of hospital readmissions for asthma and COPD

Kevin Lopez et al. Respir Res. .

Abstract

Question: Severe asthma and COPD exacerbations requiring hospitalization are linked to increased disease morbidity and healthcare costs. We sought to identify Electronic Health Record (EHR) features of severe asthma and COPD exacerbations and evaluate the performance of four machine learning (ML) and one deep learning (DL) model in predicting readmissions using EHR data.

Study design and methods: Observational study between September 30, 2012, and December 31, 2017, of patients hospitalized with asthma and COPD exacerbations.

Results: This study included 5,794 patients, 1,893 with asthma and 3,901 with COPD. Patients with asthma were predominantly female (n = 1288 [68%]), 35% were Black (n = 669), and 25% (n = 479) were Hispanic. Black (44 vs. 33%, p = 0.01) and Hispanic patients (30 vs. 24%, p = 0.02) were more likely to be readmitted for asthma. Similarly, patients with COPD readmissions included a large percentage of Blacks (18 vs. 10%, p < 0.01) and Hispanics (8 vs. 5%, p < 0.01). To identify patients at high risk of readmission index hospitalization data of a subset of 2,682 patients, 777 with asthma and 1,905 with COPD, was analyzed with four ML models, and one DL model. We found that multilayer perceptron, the DL method, had the best sensitivity and specificity compared to the four ML methods implemented in the same dataset.

Interpretation: Multilayer perceptron, a deep learning method, had the best performance in predicting asthma and COPD readmissions, demonstrating that EHR and deep learning integration can improve high-risk patient detection.

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Conflict of interest statement

Dr. Gomez is a former associate editor of Respiratory Research.

Figures

Fig. 1
Fig. 1
A Receiver operating characteristic (ROC) curves of four machine learning models and a deep learning model to predict readmissions in the combined cohort (n = 2682) of asthma (n = 777) and COPD (n = 1905). B Precision-recall (PR) curves of five machine learning models implemented in the combined cohort. C SHapley Additive exPlanation (SHAP) values of the top 10 predictive features of the multilayer perceptron (MLP) model implemented in the combined cohort
Fig. 2
Fig. 2
A ROC curves of four machine learning models and a deep learning model to predict readmissions in the asthma cohort (n = 777). B PR curves of five machine learning models implemented in the asthma cohort. C. SHAP values of the top 10 predictive features of the MLP model implemented in the asthma cohort
Fig. 3
Fig. 3
A ROC curves of four machine learning models and a deep learning model to predict readmissions in the COPD cohort (n = 1905). B PR curves of five machine learning models implemented in the COPD cohort. C SHAP values of the top 10 predictive features of the MLP model implemented in the COPD cohort
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