Prediction of medical concepts in electronic health records: Similar patient analysis

Abstract

Background: Medicine 2.0-the adoption of Web 2.0 technologies such as social networks in health care-creates the need for apps that can find other patients with similar experiences and health conditions based on a patient's electronic health record (EHR). Concurrently, there is an increasing number of longitudinal EHR data sets with rich information, which are essential to fulfill this need. Objective: This study aimed to evaluate the hypothesis that we can leverage similar EHRs to predict possible future medical concepts (eg, disorders) from a patient's EHR. Methods: We represented patients'EHRs using time-based prefixes and suffixes, where each prefix or suffix is a set of medical concepts from a medical ontology. We compared the prefixes of other patients in the collection with the state of the current patient using various interpatient distance measures. The set of similar prefixes yields a set of suffixes, which we used to determine probable future concepts for the current patient's EHR. Results: We evaluated our methods on the Multiparameter Intelligent Monitoring in Intensive Care II data set of patients, where we achieved precision up to 56.1% and recall up to 69.5%. For a limited set of clinically interesting concepts, specifically a set of procedures, we found that 86.9% (353/406) of the true-positives are clinically useful, that is, these procedures were actually performed later on the patient, and only 4.7% (19/406) of true-positives were completely irrelevant. Conclusions: These initial results indicate that predicting patients' future medical concepts is feasible. Effectively predicting medical concepts can have several applications, such as managing resources in a hospital.