Graduated: June 12, 2021
Acute Care Sepsis Prediction: Analyzing the Predictive Influence of Social and Behavioral Determinants
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 established guidelines to help improve patient safety and efficacy by laying the framework for electronic healthcare record (EHR) adoption in the United States through financial incentives. Through the HITECH Act, basic EHR adoption skyrocketed domestically and large databases of clinical information were created. Currently, many institutions have large quantities of data, that have been under-analyzed, ripe for biomedical exploration and discovery. Within the hospital setting, sepsis is a leading cause of mortality, affecting more than 1.7 million adults annually. It is also present in about 30 to 50 percent of hospitalizations that end with death. Despite the high occurrence and prevalence, detection and diagnosis of sepsis remain a challenge due to its non-specific early-onset symptoms. However, as it can quickly progress to a life-threatening stage, it is important to detect sepsis patients earlier to increase outcomes. With the recently increased adoption of EHRs, many institutions now have large amounts of patient data being collected and have created their own customized sepsis detection and mortality tools using various modeling or machine learning (ML) techniques. Additionally, those who experience more socioeconomic challenges are more susceptible to chronic illnesses, including sepsis. However, structured coding of social or behavioral features is often underutilized and unreliable. First, in order to understand the current environment of predictive analytics solutions for sepsis, we systematically identified various studies that utilize different models or ML techniques and analyzed their approach and results. Second, we developed a framework that utilizes natural language processing text classification from clinical notes to extract social and behavioral determinants of health (SBDH). Third, we assessed classification methods that utilize currently established sepsis definitions or clinical scores to establish a baseline and integrated the SBDH data extracted from clinical notes in Aim Two, and determined if SBDH features can help enhance predictive performance for sepsis detection in the acute care setting.
Drs. Adam Wilcox-Chair, David Carlbom, Anne Turner, Basia Belza