We declare no competing interests. This article is published as part of G20 Riyadh Global Digital Health Summit (Aug 11-12, 2020) activities. Saudi Arabia hosted this virtual summit to leverage the role of digital health in the fight against current and future pandemics.
Outpatients who fail to attend their appointments have a negative impact on the healthcare outcome. Thus, healthcare organizations facing new opportunities, one of them is to improve the quality of healthcare. The main challenges is predictive analysis using techniques capable of handle the huge data generated. We propose a big data framework for identifying subject outpatients’ no-show via feature engineering and machine learning (MLlib) in the Spark platform. This study evaluates the performance of five machine learning techniques, using the (2,011,813) outpatients’ visits data. Conducting several experiments and using different validation methods, the Gradient Boosting (GB) performed best, resulting in an increase of accuracy and ROC to 79% and 81%, respectively. In addition, we showed that exploring and evaluating the performance of the machine learning models using various evaluation methods is critical as the accuracy of prediction can significantly differ. The aim of this paper is exploring factors that affect no-show rate and can be used to formulate predictions using big data machine learning techniques.
Outpatients who fail to attend their appointments have a negative impact on the healthcare outcome. Thus, healthcare organizations facing new opportunities, one of them is to improve the quality of healthcare. The main challenges is predictive analysis using techniques capable of handle the huge data generated. We propose a big data framework for identifying subject outpatients’ no-show via feature engineering and machine learning (MLlib) in the Spark platform. This study evaluates the performance of five machine learning techniques, using the (2,011,813) outpatients’ visits data. Conducting several experiments and using different validation methods, the Gradient Boosting (GB) performed best, resulting in an increase of accuracy and ROC to 79% and 81%, respectively. In addition, we showed that exploring and evaluating the performance of the machine learning models using various evaluation methods is critical as the accuracy of prediction can significantly differ. The aim of this paper is exploring factors that affect no-show rate and can be used to formulate predictions using big data machine learning techniques.
Background
To evaluate the effect of screening for sepsis using an electronic sepsis alert vs. no alert in hospitalized ward patients on 90-day in-hospital mortality.
Methods
The SCREEN trial is designed as a stepped-wedge cluster randomized controlled trial. Hospital wards (total of 45 wards, constituting clusters in this design) are randomized to have active alert vs. masked alert, 5 wards at a time, with each 5 wards constituting a sequence. The study consists of ten 2-month periods with a phased introduction of the intervention. In the first period, all wards have a masked alert for 2 months. Afterwards the intervention (alert system) is implemented in a new sequence every 2-month period until the intervention is implemented in all sequences. The intervention includes the implementation of an electronic alert system developed in the hospital electronic medical records based on the quick sequential organ failure assessment (qSOFA). The alert system sends notifications of “possible sepsis alert” to the bedside nurse, charge nurse, and primary medical team and requires an acknowledgment in the health information system from the bedside nurse and physician. The calculated sample size is 65,250. The primary endpoint is in-hospital mortality by 90 days.
Discussion
The trial started on October 1, 2019, and is expected to complete patient follow-up by the end of October 2021.
Trial registration
ClinicalTrials.gov NCT04078594. Registered on September 6, 2019
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