A Comparative Analysis of Machine-Learning Algorithms for Automated International Classification of Diseases (ICD)-10 Coding in Malaysian Death Records.

objectiveThis study explores machine learning (ML) for automating unstructured textual data translation into structured International Classification of Diseases (ICD)-10 codes, aiming to identify algorithms that enhance mortality data accuracy and reliability for public health decisions.

methodsThis study analyzed death records from January 2017 to June 2022, sourced from Malaysia's Health Informatics Centre, coded into ICD-10. Data anonymization adhered to ethical standards, with 387,650 death registrations included after quality checks. The dataset, limited to three-digit ICD-10 codes, underwent cleaning and an 80:20 training-testing split. Preprocessing involved HTML tag removal and tokenization. ML approaches, including BERT (Bidirectional Encoder Representations from Transformers), Gzip+KNN (K-Nearest Neighbors), XGBoost (Extreme Gradient Boosting), TensorFlow, SVM (Support Vector Machine), and Naive Bayes, were evaluated for automated ICD-10 coding. Models were fine-tuned and assessed across accuracy, F1-score, precision, recall, specificity, and precision-recall curves using Amazon SageMaker (Amazon Web Services, Seattle, WA). Sensitivity analysis addressed unbalanced data scenarios, enhancing model robustness.

resultsIn assessing ICD-10 coding with ML, Gzip+KNN had the longest training time at 10 hours, with BERT leading in memory use. BERT performed best for the F1-score (0.71) and accuracy (0.82), closely followed by Gzip+KNN. TensorFlow excelled in recall, whereas SVM had the highest specificity but lower overall performance. XGBoost was notably less effective across metrics. Precision-recall analysis showed Gzip+KNN's superiority. On an unbalanced dataset, BERT and Gzip+KNN demonstrated consistent accuracy.

conclusionOur study highlights that BERT and Gzip+KNN optimize ICD-10 coding, balancing efficiency, resource use, and accuracy. BERT excels in precision with higher memory demands, while Gzip+KNN offers robust accuracy and recall. This suggests significant potential for improving healthcare analytics and decision-making through advanced ML models.