A machine learning approach to identifying delirium from electronic health records

Author:

Kim Jae Hyun1,Hua May23,Whittington Robert A2,Lee Junghwan1,Liu Cong1ORCID,Ta Casey N1,Marcantonio Edward R456ORCID,Goldberg Terry E27,Weng Chunhua1

Affiliation:

1. Department of Biomedical Informatics, Columbia University, New York, New York, USA

2. Department of Anesthesiology, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York, USA

3. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA

4. Harvard Medical School, Boston, Massachusetts, USA

5. Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

6. Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

7. Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA

Abstract

Abstract The identification of delirium in electronic health records (EHRs) remains difficult due to inadequate assessment or under-documentation. The purpose of this research is to present a classification model that identifies delirium using retrospective EHR data. Delirium was confirmed with the Confusion Assessment Method for the Intensive Care Unit. Age, sex, Elixhauser comorbidity index, drug exposures, and diagnoses were used as features. The model was developed based on the Columbia University Irving Medical Center EHR data and further validated with the Medical Information Mart for Intensive Care III dataset. Seventy-six patients from Surgical/Cardiothoracic ICU were included in the model. The logistic regression model achieved the best performance in identifying delirium; mean AUC of 0.874 ± 0.033. The mean positive predictive value of the logistic regression model was 0.80. The model promises to identify delirium cases with EHR data, thereby enable a sustainable infrastructure to build a retrospective cohort of delirium.

Funder

National Library of Medicine

National Center for Advancing Clinical and Translational Science

Publisher

Oxford University Press (OUP)

Subject

Health Informatics

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