Clinical Decision Support Systems for Predicting Patients Liable to Acquire Acute Myocardial Infarctions
Pages 622 - 634
Abstract
Acute myocardial infarction (AMI) is a major cause of death worldwide. There are around 0.8 million persons suffered from AMI annually in the US and the death rate reaches 27%. The risk factors of AMI were reported to include hypertension, family history, smoking habit, diabetes, serenity, obesity, cholesterol, alcoholism, coronary artery disease, etc. In this study, data acquired from a subset of the National Health Insurance Research Database (NHIRD) of Taiwan were used to develop the clinical decision support system (CDSS) for predicting AMI. Support vector machine integrated with genetic algorithm (IGS) was adopted to design the AMI prediction models. Data of 6087 AMI patients and 6087 non-AMI patients, each includes 50 features, were acquired for designing the predictive models. Tenfold cross validation and three objective functions were used for obtaining the optimal model with best prediction performance during training. The experimental results show that the CDSSs reach a prediction performance with accuracy, sensitivity, specificity, and area under ROC curve (AUC) of 81.47–84.11%, 75.46–80.94%, 86.48–88.21%, and 0.8602–0.8935, respectively. The IGS algorithm and comorbidity-related features are promising in designing strong CDSS models for predicting patients who may acquire AMI in the near future.
References
[1]
World Health Organization, https://www.who.int/cardiovascular_diseases/about_cvd/en/. Accessed 20 Nov 2019
[2]
Boateng S et al. Acute myocardial infarction Dis. Mon. 2013 59 3 83-96
[3]
Ministry of Health and Welfare of Taiwan, https://www.mohw.gov.tw/cp-16-48057-1.html. Accessed 20 Nov 2019
[4]
ICD 9, http://www.icd9data.com/2009/Volume1/390-459/410-414/410/default.htm. Accessed 20 Nov 2019
[5]
Lanas F et al. Risk factors for acute myocardial infarction in Latin America: The INTERHEART Latin American study Circulation 2007 115 9 1067-1074
[6]
Atiq M Recent Advances in Cardiovascular Risk Factors 2012 Croatia IntechOpen
[7]
Isiozor NM et al. Ideal cardiovascular health and risk of acute myocardial infarction among Finnish men Atherosclerosis 2019 289 126-131
[8]
Garg AX et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: A systematic review JAMA 2005 293 10 1223-1238
[9]
Porat T et al. Eliciting user decision requirements for designing computerized diagnostic support for family physicians J. Cognit. Eng. Decis. Mak. 2016 10 1 57-73
[10]
Horng S et al. Creating an automated trigger for sepsis clinical decision support at emergency department triage using machine learning PLoS ONE 2017 12 4 e0174708
[11]
Hsu J-C et al. Clinical verification of a clinical decision support system for ventilator weaning Biomed. Eng. Online 2013 12 1 S4
[12]
Luo G et al. A systematic review of predictive modeling for bronchiolitis Int. J. Med. Informatics 2014 83 10 691-714
[13]
Dunn Lopez, K., et al.: Integrative review of clinical decision support for registered nurses in acute care settings. J. Am. Med. Inform. Assoc. 24(2), 441–450 (2017)
[14]
Scheepers-Hoeks A-MJ et al. Physicians’ responses to clinical decision support on an intensive care unit—comparison of four different alerting methods Artif. Intell. Med. 2013 59 1 33-38
[15]
Otto AK et al. The development of a clinical decision support system for the management of pediatric food allergy Clin. Pediatr. 2017 56 6 571-578
[16]
Ammenwerth E et al. The effect of electronic prescribing on medication errors and adverse drug events: A systematic review J. Am. Med. Inform. Assoc. 2008 15 5 585-600
[17]
Baypinar F et al. Physicians’ compliance with a clinical decision support system alerting during the prescribing process J. Med. Syst. 2017 41 6 96
[18]
Chen Y-F et al. Semi-automatic segmentation and classification of pap smear cells IEEE J. Biomed. Health Inform. 2013 18 1 94-108
[19]
Chen Y-F et al. Design of a clinical decision support system for fracture prediction using imbalanced dataset J. Healthcare Eng. 2018 2018 9621640
[20]
Lai, H.-J., et al.: Designing a clinical decision support system to predict readmissions for patients admitted with all-cause conditions. J. Ambient Intell. Human. Comput. (2020). https://doi.org/10.1007/s12652-019-01579-6
[21]
Chen Y-F et al. Design of a Clinical Decision Support System for Predicting Erectile Dysfunction in Men Using NHIRD Dataset IEEE J. Biomed. Health Inform. 2018 23 5 2127-2137
[22]
Chang C-C et al. Perioperative medicine and Taiwan National Health Insurance Research Database Acta Anaesthesiologica Taiwanica 2016 54 3 93-96
[23]
Decoste D et al. Training invariant support vector machines Mach. Learn. 2002 46 1–3 161-190
[24]
LeCun, Y., et al.: Comparison of learning algorithms for handwritten digit recognition. In: International Conference on Artificial Neural Networks, pp. 53–60. Perth, Australia (1995)
[25]
Lillywhite K et al. Self-tuned evolution-constructed features for general object recognition Pattern Recogn. 2012 45 1 241-251
[26]
Tao P et al. An improved intrusion detection algorithm based on GA and SVM IEEE Access 2018 6 13624-13631
[27]
Tao Z et al. GA-SVM based feature selection and parameter optimization in hospitalization expense modeling Appl. Soft Comput. 2019 75 323-332
[28]
Bradley AP The use of the area under the ROC curve in the evaluation of machine learning algorithms Pattern Recogn. 1997 30 7 1145-1159
[29]
Cortes, C., et al.: AUC optimization vs. error rate minimization. In: Advances in Neural Information Processing Systems, pp. 313–320 (2004)
[30]
Lin HH et al. Increased risk of erectile dysfunction among patients with sleep disorders: A nationwide population-based cohort study Int. J. Clin. Pract. 2015 69 8 846-852
[31]
Chen Y-F et al. Gout and a subsequent increased risk of erectile dysfunction in men aged 64 and under: a nationwide cohort study in Taiwan J. Rheumatol. 2015 42 10 1898-1905
[32]
Thompson IM et al. Erectile dysfunction and subsequent cardiovascular disease JAMA 2005 294 23 2996-3002
[33]
Speel T et al. The risk of coronary heart disease in men with erectile dysfunction Eur. Urol. 2003 44 3 366-371
[34]
Shen B-J et al. Anxiety characteristics independently and prospectively predict myocardial infarction in men: the unique contribution of anxiety among psychologic factors J. Am. Coll. Cardiol. 2008 51 2 113-119
[35]
Seftel, A. D., et al.: The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J. Urology 171(6 Part 1), 2341–2345 (2004)
[36]
Andersen, Y. M., et al.: Risk of myocardial infarction, ischemic stroke, and cardiovascular death in patients with atopic dermatitis. J. Allergy Clin. Immunol. 138(1), 310–312, e3 (2016)
[37]
Silverberg JI Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies Allergy 2015 70 10 1300-1308
[38]
Su VY-F et al. Atopic dermatitis and risk of ischemic stroke: A nationwide population-based study Ann. Med. 2014 46 2 84-89
[39]
Paalasmaa J et al. Adaptive heartbeat modeling for beat-to-beat heart rate measurement in ballistocardiograms IEEE J. Biomed. Health Inform. 2014 19 6 1945-1952
[40]
Sadek, I.: Ballistocardiogram signal processing: A literature review. arXiv:1807.00951 (2018)
[41]
Alivar A et al. Motion artifact detection and reduction in bed-based ballistocardiogram IEEE Access 2019 7 13693-13703
[42]
Javaid AQ et al. Quantifying and reducing posture-dependent distortion in ballistocardiogram measurements IEEE J. Biomed. Health Inform. 2015 19 5 1549-1556
[43]
Kim C-S et al. Ballistocardiogram: Mechanism and potential for unobtrusive cardiovascular health monitoring Sci. Rep. 2016 6 31297
[44]
Rabbani MS et al. Accurate remote vital sign monitoring with 10 GHz ultra-wide patch antenna array AEU-Int. J. Electron. Commun. 2017 77 36-42
[45]
Cai, W., et al.: Low power SI class E power amplifier and Rf switch for health care. arXiv:1701.01771 (2017)
[46]
Adib, F., et al.: Smart homes that monitor breathing and heart rate. In: Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems, pp. 837–846. (2015)
[47]
Staderini EM UWB radars in medicine IEEE Aerosp. Electron. Syst. Mag. 2002 17 1 13-18
Recommendations
Predictive models for detecting patients more likely to develop acute myocardial infarctions
AbstractAcute myocardial infarction (AMI) is a major cause of death worldwide. In the USA, there are approximately 0.8 million persons suffering from AMI annually with a death rate of 27%. The risk factors of AMI include hypertension, family history, ...
A prediction model to identify acute myocardial infarction (AMI) patients at risk for 30-day readmission
SCSC '16: Proceedings of the Summer Computer Simulation ConferenceReductions in hospital readmissions have been identified by Congress and President Obama as a source for reducing Medicare spending. We aimed to build a prediction model for identifying acute myocardial infarction (AMI) patients who are at risk for ...
Comments
Please enable JavaScript to view thecomments powered by Disqus.Information & Contributors
Information
Published In

Oct 2020
751 pages
ISBN:978-3-030-59829-7
DOI:10.1007/978-3-030-59830-3
© Springer Nature Switzerland AG 2020.
Publisher
Springer-Verlag
Berlin, Heidelberg
Publication History
Published: 19 October 2020
Author Tags
Qualifiers
- Article
Contributors
Other Metrics
Bibliometrics & Citations
Bibliometrics
Article Metrics
- 0Total Citations
- 0Total Downloads
- Downloads (Last 12 months)0
- Downloads (Last 6 weeks)0
Reflects downloads up to 18 Feb 2025