Human-machine collaboration for feature selection and integration to improve congestive Heart failure risk prediction

摘要

The issue of harnessing machine learning (ML) algorithms for the prediction of adverse medical events is important considering the prevalence of vast repositories of patient-level medical data, and the quest to reduce healthcare costs while elevating the quality of care. Of particular interest is identifying a set of features that can better predict the risk of unplanned readmissions of chronically ill patients within 30 days post discharge, among them patients with Congestive Heart Failure (CHF). While numerous studies have employed ML algorithms to identify sets of significant features, only a handful have compared features extracted by various methods, and even fewer have compared the predictive power of feature sets selected by human experts to those selected by ML. Hence, this research aimed to elicit a comprehensive feature set selected by four ML algorithms and compare its predictive performance to that of a feature set selected by experts. We then evaluated a merged list of the two feature sets, constructing a human-machine collaborative set to predict the likelihood of 30-day unplanned readmission of CHF patients using data on 10,763 CHF patients hospitalized during the years 2010-2017. Our models achieved Area under the ROC Curve (AUC) above 0.8 and an Accuracy of similar to 0.89, comparable to the best models in the extant literature. Moreover, the Human-Machine Collaborative model significantly outperformed (best AUC 0.836) other human-only selected models as well as the machine-selected set. This study contributes to a better understanding of the power of using ML for patient risk stratification with special attention to the benefits of human-machine collaboration, even when these two entities work separately or in parallel, for improved clinical decision making.