Evidence map›Paper›PMID 41225138›Full record

ArticleNPJ digital medicine2025

Equipping mathematical models for hospital dynamics using information theory.

Jeremy A Balch, Jackson G Brandberg, Robert T Andris, Ian G Mesner, Daniel C Nametz, Murad Megjhani, Matthew M Ruppert, Die Hu, Matthew T Clark, Benjamin Shickel and 6 more

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

16 authors.

Jeremy A Balch *Department of Surgery, University of Florida, Gainesville, FL, USA. jeremy.balch@surgery.ufl.edu.
Jackson G Brandberg *University of Virginia Health System, Charlottesville, VA, USA.
Robert T Andris *University of Virginia Health System, Charlottesville, VA, USA.
Ian G Mesner *University of Virginia Health System, Charlottesville, VA, USA.
Daniel C NametzProgram for Hospital and Intensive Care Informatics, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA.
Murad MegjhaniProgram for Hospital and Intensive Care Informatics, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA.
Matthew M RuppertUniversity of Central Florida College of Medicine, Orlando, FL, USA.
Die HuDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Matthew T ClarkNihon Kohden Digital Health Solutions, Irvine, CA, USA.
Benjamin ShickelDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.
Benjamin L RanardProgram for Hospital and Intensive Care Informatics, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA.
John B DelosUniversity of Virginia Center for Advanced Medical Analytics, Charlottesville, VA, USA.
David J AlbersUniversity of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Tyler J LoftusDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Soojin ParkProgram for Hospital and Intensive Care Informatics, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA.
J Randall MoormanUniversity of Virginia Health System, Charlottesville, VA, USA. rm3h@virginia.edu.

Funding

Bridge2AI: Patient-Focused Collaborative Hospital Repository Uniting Standards (CHoRUS) for Equitable AIOT2OD032701 · OD · MASSACHUSETTS GENERAL HOSPITAL · PI BIHORAC, AZRA, CLERMONT, GILLES · 2022 to 2025
$24.6M
Integrating data, algorithms and clinical reasoning for surgical risk assessmentR01GM110240 · NIGMS · UNIVERSITY OF FLORIDA · PI BIHORAC, AZRA, RASHIDI, PARISA · 2016 to 2025
$5.1M
Molecular Biology in Burns and TraumaT32GM008721 · NIGMS · UNIVERSITY OF FLORIDA · PI Philip A Efron · 1999 to 2026
$5.0M
Machine Learning to Optimize Management of Acute HydrocephalusR01NS131606 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Soojin Park · 2023 to 2026
$2.6M
Aligning Patient Acuity with Resource Intensity after Major SurgeryR01GM149657 · NIGMS · UNIVERSITY OF FLORIDA · PI Tyler J Loftus · 2023 to 2026
$1.3M
AHRQ HHS T32 HS026121AHRQ HHS T32-HS026121NIGMS NIH HHS OT2 OD032701NIGMS NIH HHS R01 GM110240NIGMS NIH HHS R01 GM149657NIGMS NIH HHS R01 NS131606NIGMS NIH HHS T32 GM008721NIGMS NIH HHS T32 GM008721-24NIH HHS OT2 OD032701NINDS NIH HHS R01 NS131606
6 · The paper itself

Abstract

We propose metrics from information theory to characterize the clinical and operational dynamics of hospitals. Ergodicity, the equality of time- and space-averages within a dynamical system, ensures its stationarity. Surprisal, the log-inverse of probability, and entropy, the average surprisal, provide mathematical insights into the nature of dynamical systems. We applied these metrics to lab test order times from 15 units in three hospitals from 2018 to 2021. We found hospital units were ergodic in the sense that each bed is typical of the unit, while hospitals were not, and that external forces like the COVID-19 pandemic can perturb hospital dynamics. These information-theoretic metrics can indicate systemic shifts, inefficiencies, and anomalies in patient care, providing granular and interpretable signals of change. Monitoring these metrics can expose data drift, where evolving inputs and outputs hinder generalizability, and label leakage, where clinician actions inadvertently corrupt predictive monitoring systems.

Identifiers

PMID41225138
PMCPMC12612260

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.