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Battling antibiotic resistance: can machine learning improve prescribing?

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  • Michael Allan Ribers
  • Hannes Ullrich

Abstract

Antibiotic resistance constitutes a major health threat. Predicting bacterial causes of infections is key to reducing antibiotic misuse, a leading driver of antibiotic resistance. We train a machine learning algorithm on administrative and microbiological laboratory data from Denmark to predict diagnostic test outcomes for urinary tract infections. Based on predictions, we develop policies to improve prescribing in primary care, highlighting the relevance of physician expertise and policy implementation when patient distributions vary over time. The proposed policies delay antibiotic prescriptions for some patients until test results are known and give them instantly to others. We find that machine learning can reduce antibiotic use by 7.42 percent without reducing the number of treated bacterial infections. As Denmark is one of the most conservative countries in terms of antibiotic use, this result is likely to be a lower bound of what can be achieved elsewhere.

Suggested Citation

  • Michael Allan Ribers & Hannes Ullrich, 2019. "Battling antibiotic resistance: can machine learning improve prescribing?," CESifo Working Paper Series 7654, CESifo.
  • Handle: RePEc:ces:ceswps:_7654
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    1. Jon Kleinberg & Jens Ludwig & Sendhil Mullainathan & Ziad Obermeyer, 2015. "Prediction Policy Problems," American Economic Review, American Economic Association, vol. 105(5), pages 491-495, May.
    2. Aaron Chalfin & Oren Danieli & Andrew Hillis & Zubin Jelveh & Michael Luca & Jens Ludwig & Sendhil Mullainathan, 2016. "Productivity and Selection of Human Capital with Machine Learning," American Economic Review, American Economic Association, vol. 106(5), pages 124-127, May.
    3. Kwon, Illoong & Jun, Daesung, 2015. "Information disclosure and peer effects in the use of antibiotics," Journal of Health Economics, Elsevier, vol. 42(C), pages 1-16.
    4. Schwandt, Hannes, 2017. "The Lasting Legacy of Seasonal Influenza: In-utero Exposure and Labor Market Outcomes," DaCHE discussion papers 2017:5, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    5. Anna, Petrenko, 2016. "Мaркування готової продукції як складова частина інформаційного забезпечення маркетингової діяльності підприємств овочепродуктового підкомплексу," Agricultural and Resource Economics: International Scientific E-Journal, Agricultural and Resource Economics: International Scientific E-Journal, vol. 2(1), March.
    6. Susan Athey, 2018. "The Impact of Machine Learning on Economics," NBER Chapters, in: The Economics of Artificial Intelligence: An Agenda, pages 507-547, National Bureau of Economic Research, Inc.
    7. Jon Kleinberg & Himabindu Lakkaraju & Jure Leskovec & Jens Ludwig & Sendhil Mullainathan, 2018. "Human Decisions and Machine Predictions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 133(1), pages 237-293.
    8. Schieve, L.A. & Handler, A. & Hershow, R. & Persky, V. & Davis, F., 1994. "Urinary tract infection during pregnancy: Its association with maternal morbidity and perinatal outcome," American Journal of Public Health, American Public Health Association, vol. 84(3), pages 405-410.
    9. Daniel Bennett & Che-Lun Hung & Tsai-Ling Lauderdale, 2015. "Health Care Competition and Antibiotic Use in Taiwan," Journal of Industrial Economics, Wiley Blackwell, vol. 63(2), pages 371-393, June.
    10. Janet Currie & W. Bentley MacLeod, 2017. "Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 1-43.
    11. Jean-Pierre Dubé & Sanjog Misra, 2017. "Personalized Pricing and Consumer Welfare," NBER Working Papers 23775, National Bureau of Economic Research, Inc.
    12. Andini, Monica & Ciani, Emanuele & de Blasio, Guido & D'Ignazio, Alessio & Salvestrini, Viola, 2018. "Targeting with machine learning: An application to a tax rebate program in Italy," Journal of Economic Behavior & Organization, Elsevier, vol. 156(C), pages 86-102.
    13. Justine S. Hastings & Mark Howison & Sarah E. Inman, 2020. "Predicting high-risk opioid prescriptions before they are given," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(4), pages 1917-1923, January.
    14. Jishnu Das & Alaka Holla & Aakash Mohpal & Karthik Muralidharan, 2016. "Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India," American Economic Review, American Economic Association, vol. 106(12), pages 3765-3799, December.
    15. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2014. "Addressing antibiotic abuse in China: An experimental audit study," Journal of Development Economics, Elsevier, vol. 110(C), pages 39-51.
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    Cited by:

    1. Michael Allan Ribers & Hannes Ullrich, 2020. "Machine Predictions and Human Decisions with Variation in Payoffs and Skill," CESifo Working Paper Series 8702, CESifo.
    2. Jason Abaluck & Leila Agha & David C. Chan Jr & Daniel Singer & Diana Zhu, 2020. "Fixing Misallocation with Guidelines: Awareness vs. Adherence," NBER Working Papers 27467, National Bureau of Economic Research, Inc.
    3. MARTENS Bertin, 2020. "An economic perspective on data and platform market power," JRC Working Papers on Digital Economy 2020-09, Joint Research Centre.
    4. Jeanine Miklós-Thal & Catherine Tucker, 2019. "Collusion by Algorithm: Does Better Demand Prediction Facilitate Coordination Between Sellers?," Management Science, INFORMS, vol. 65(4), pages 1552-1561, April.
    5. Christian Peukert & Imke Reimers, 2022. "Digitization, Prediction, and Market Efficiency: Evidence from Book Publishing Deals," Management Science, INFORMS, vol. 68(9), pages 6907-6924, September.
    6. Shan Huang & Michael Allan Ribers & Hannes Ullrich, 2021. "The Value of Data for Prediction Policy Problems: Evidence from Antibiotic Prescribing," Discussion Papers of DIW Berlin 1939, DIW Berlin, German Institute for Economic Research.

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    More about this item

    Keywords

    antibiotic prescribing; prediction policy; machine learning; expert decision-making;
    All these keywords.

    JEL classification:

    • C10 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - General
    • C55 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Large Data Sets: Modeling and Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L38 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Public Policy
    • O38 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Government Policy
    • Q28 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Renewable Resources and Conservation - - - Government Policy

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