Evidence map›Paper›PMID 28466088›Full record

ArticleApplied clinical informatics2017

Combining Contrast Mining with Logistic Regression To Predict Healthcare Utilization in a Managed Care Population.

Lincoln Sheets, Gregory F Petroski, Yan Zhuang, Michael A Phinney, Bin Ge, Jerry C Parker, Chi-Ren Shyu

Abstract read
In one paragraph

Article in Applied clinical informatics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lincoln SheetsLincoln Sheets, MD, PhD, University of Missouri, Columbia, Missouri, telephone: 417-860-1197, fax: 573-884-4808, Email: SheetsLR@health.missouri.edu.
Gregory F Petroski
Yan Zhuang
Michael A Phinney
Bin Ge
Jerry C Parker
Chi-Ren Shyu

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBecause 5% of patients incur 50% of healthcare expenses, population health managers need to be able to focus preventive and longitudinal care on those patients who are at highest risk of increased utilization. Predictive analytics can be used to identify these patients and to better manage their care. Data mining permits the development of models that surpass the size restrictions of traditional statistical methods and take advantage of the rich data available in the electronic health record (EHR), without limiting predictions to specific chronic conditions.

objectiveThe objective was to demonstrate the usefulness of unrestricted EHR data for predictive analytics in managed healthcare.

methodsIn a population of 9,568 Medicare and Medicaid beneficiaries, patients in the highest 5% of charges were compared to equal numbers of patients with the lowest charges. Contrast mining was used to discover the combinations of clinical attributes frequently associated with high utilization and infrequently associated with low utilization. The attributes found in these combinations were then tested by multiple logistic regression, and the discrimination of the model was evaluated by the c-statistic.

resultsOf 19,014 potential EHR patient attributes, 67 were found in combinations frequently associated with high utilization, but not with low utilization (support>20%). Eleven of these attributes were significantly associated with high utilization (p<0.05). A prediction model composed of these eleven attributes had a discrimination of 84%.

conclusionsEHR mining reduced an unusably high number of patient attributes to a manageable set of potential healthcare utilization predictors, without conjecturing on which attributes would be useful. Treating these results as hypotheses to be tested by conventional methods yielded a highly accurate predictive model. This novel, two-step methodology can assist population health managers to focus preventive and longitudinal care on those patients who are at highest risk for increased utilization.

Indexed as

Data MiningDelivery of Health CareElectronic Health RecordsHumansLogistic ModelsManaged Care Programsclinical decision supportData miningdata reusepractice managementprediction models

Identifiers

PMID28466088
PMCPMC6241738

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.