CREST - Risk Prediction for Clostridium Difficile Infection Using Multimodal Data Mining

Abstract

Clostridium difficile infection (CDI) is a common hospital acquired infection with a 1B annual price tag that resulted in 30,000 deaths in 2011. Studies have shown that early detection of CDI significantly improves the prognosis for the individual patient and reduces the overall mortality rates and associated medical costs. In this paper, we present CREST: CDI Risk Estimation, a data-driven framework for early and continuous detection of CDI in hospitalized patients. CREST uses a three-pronged approach for high accuracy risk prediction. First, CREST builds a rich set of highly predictive features from Electronic Health Records. These features include clinical and non-clinical phenotypes, key biomarkers from the patient’s laboratory tests, synopsis features processed from time series vital signs, and medical history mined from clinical notes. Given the inherent multimodality of clinical data, CREST bins these features into three sets: time-invariant, time-variant, and temporal synopsis features. CREST then learns classifiers for each set of features, evaluating their relative effectiveness. Lastly, CREST employs a second-order meta learning process to ensemble these classifiers for optimized estimation of the risk scores. We evaluate the CREST framework using publicly available critical care data collected for over 12 years from Beth Israel Deaconess Medical Center, Boston. Our results demonstrate that CREST predicts the probability of a patient acquiring CDI with an AUC of 0.76 five days prior to diagnosis. This value increases to 0.80 and even 0.82 for prediction two days and one day prior to diagnosis, respectively.