Personalized treatment for coronary artery disease patients: a machine learning approach

AbstractCurrent clinical practice guidelines for managing Coronary Artery Disease (CAD) account for general cardiovascular risk factors. However, they do not present a framework that considers personalized patient-specific characteristics. Using the electronic health records of 21,460 patients, we created data-driven models for personalized CAD management that significantly improve health outcomes relative to the standard of care. We develop binary classifiers to detect whether a patient will experience an adverse event due to CAD within a 10-year time frame. Combining the patients ’ medical history and clinical examination results, we achieve 81.5% AUC. For each treatment, we also create a series of regression models that are based on different supervised machine learning algorithms. We are able to estimate with averageR2 = 0.801 the outcome of interest; the time from diagnosis to a potential adverse event (TAE). Leveraging combinations of these models, we presentML4CAD, a novel personalized prescriptive algorithm. Considering the recommendations of multiple predictive models at once, the goal ofML4CAD is to identify for every patient the therapy with the best expected TAE using a voting mechanism. We evaluate its performance by measuring the prescription effectiveness and robustness under alternative ground truths. We show that our methodology improves the expected TAE upon the current baseline by 24.11%, increasing it from 4.56 to 5.66 years. The algorithm performs parti...

Source: Health Care Management Science - October 10, 2020 Category: Hospital Management Source Type: research