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A machine learning framework for interpretable predictions in patient pathways: The case of predicting ICU admission for patients with symptoms of sepsis

Author

Listed:
  • Sandra Zilker

    (Professorship for Business Analytics
    Friedrich-Alexander-Universität Erlangen-Nürnberg, Chair of Digital Industrial Service Systems)

  • Sven Weinzierl

    (Friedrich-Alexander-Universität Erlangen-Nürnberg, Chair of Digital Industrial Service Systems)

  • Mathias Kraus

    (University of Regensburg, Chair for Explainable AI in Business Value Creation)

  • Patrick Zschech

    (Leipzig University, Professorship for Intelligent Information Systems and Processes)

  • Martin Matzner

    (Friedrich-Alexander-Universität Erlangen-Nürnberg, Chair of Digital Industrial Service Systems)

Abstract

Proactive analysis of patient pathways helps healthcare providers anticipate treatment-related risks, identify outcomes, and allocate resources. Machine learning (ML) can leverage a patient’s complete health history to make informed decisions about future events. However, previous work has mostly relied on so-called black-box models, which are unintelligible to humans, making it difficult for clinicians to apply such models. Our work introduces PatWay-Net, an ML framework designed for interpretable predictions of admission to the intensive care unit (ICU) for patients with symptoms of sepsis. We propose a novel type of recurrent neural network and combine it with multi-layer perceptrons to process the patient pathways and produce predictive yet interpretable results. We demonstrate its utility through a comprehensive dashboard that visualizes patient health trajectories, predictive outcomes, and associated risks. Our evaluation includes both predictive performance – where PatWay-Net outperforms standard models such as decision trees, random forests, and gradient-boosted decision trees – and clinical utility, validated through structured interviews with clinicians. By providing improved predictive accuracy along with interpretable and actionable insights, PatWay-Net serves as a valuable tool for healthcare decision support in the critical case of patients with symptoms of sepsis.

Suggested Citation

  • Sandra Zilker & Sven Weinzierl & Mathias Kraus & Patrick Zschech & Martin Matzner, 2024. "A machine learning framework for interpretable predictions in patient pathways: The case of predicting ICU admission for patients with symptoms of sepsis," Health Care Management Science, Springer, vol. 27(2), pages 136-167, June.
  • Handle: RePEc:kap:hcarem:v:27:y:2024:i:2:d:10.1007_s10729-024-09673-8
    DOI: 10.1007/s10729-024-09673-8
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    References listed on IDEAS

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    1. Ramy Elitzur & Dmitry Krass & Eyal Zimlichman, 2023. "Machine learning for optimal test admission in the presence of resource constraints," Health Care Management Science, Springer, vol. 26(2), pages 279-300, June.
    2. Seung-Yup Lee & Ratna Babu Chinnam & Evrim Dalkiran & Seth Krupp & Michael Nauss, 2020. "Prediction of emergency department patient disposition decision for proactive resource allocation for admission," Health Care Management Science, Springer, vol. 23(3), pages 339-359, September.
    3. Christian Janiesch & Patrick Zschech & Kai Heinrich, 2021. "Machine learning and deep learning," Electronic Markets, Springer;IIM University of St. Gallen, vol. 31(3), pages 685-695, September.
    4. Arun Rai, 2020. "Explainable AI: from black box to glass box," Journal of the Academy of Marketing Science, Springer, vol. 48(1), pages 137-141, January.
    5. Julian Senoner & Torbjørn Netland & Stefan Feuerriegel, 2022. "Using Explainable Artificial Intelligence to Improve Process Quality: Evidence from Semiconductor Manufacturing," Management Science, INFORMS, vol. 68(8), pages 5704-5723, August.
    6. Jonas Krämer & Jonas Schreyögg & Reinhard Busse, 2019. "Classification of hospital admissions into emergency and elective care: a machine learning approach," Health Care Management Science, Springer, vol. 22(1), pages 85-105, March.
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