Predicting the outcome of patients with subarachnoid hemorrhage using machine learning techniques. de Toledo, P., Rios, P. M., Ledezma, A., Sanchis, A., Alen, J. F., & Lagares, A. IEEE transactions on information technology in biomedicine : a publication of the IEEE Engineering in Medicine and Biology Society, 13(5):794–801, September, 2009.
abstract   bibtex   
Outcome prediction for subarachnoid hemorrhage (SAH) helps guide care and compare global management strategies. Logistic regression models for outcome prediction may be cumbersome to apply in clinical practice. To use machine learning techniques to build a model of outcome prediction that makes the knowledge discovered from the data explicit and communicable to domain experts. A derivation cohort (n = 441) of nonselected SAH cases was analyzed using different classification algorithms to generate decision trees and decision rules. Algorithms used were C4.5, fast decision tree learner, partial decision trees, repeated incremental pruning to produce error reduction, nearest neighbor with generalization, and ripple down rule learner. Outcome was dichotomized in favorable [Glasgow outcome scale (GOS) = I-II] and poor (GOS = III-V). An independent cohort (n = 193) was used for validation. An exploratory questionnaire was given to potential users (specialist doctors) to gather their opinion on the classifier and its usability in clinical routine. The best classifier was obtained with the C4.5 algorithm. It uses only two attributes [World Federation of Neurological Surgeons (WFNS) and Fisher's scale] and leads to a simple decision tree. The accuracy of the classifier [area under the ROC curve (AUC) = 0.84; confidence interval (CI) = 0.80-0.88] is similar to that obtained by a logistic regression model (AUC = 0.86; CI = 0.83-0.89) derived from the same data and is considered better fit for clinical use.
@ARTICLE{deToledo-2009,
  author = {de Toledo, Paula and Rios, Pablo M. and Ledezma, Agapito and Sanchis,
	Araceli and Alen, Jose F. and Lagares, Alfonso},
  title = {Predicting the outcome of patients with subarachnoid hemorrhage using
	machine learning techniques.},
  journal = {IEEE transactions on information technology in biomedicine : a publication
	of the IEEE Engineering in Medicine and Biology Society},
  year = {2009},
  volume = {13},
  pages = {794--801},
  number = {5},
  month = sep,
  DI = {10.1109/TITB.2009.2020434},
  SN = {1558-0032},
  UT = {MEDLINE:19369161},
  Z9 = {1},
  abstract = {Outcome prediction for subarachnoid hemorrhage (SAH) helps guide care
	and compare global management strategies. Logistic regression models
	for outcome prediction may be cumbersome to apply in clinical practice.
	To use machine learning techniques to build a model of outcome prediction
	that makes the knowledge discovered from the data explicit and communicable
	to domain experts. A derivation cohort (n = 441) of nonselected SAH
	cases was analyzed using different classification algorithms to generate
	decision trees and decision rules. Algorithms used were C4.5, fast
	decision tree learner, partial decision trees, repeated incremental
	pruning to produce error reduction, nearest neighbor with generalization,
	and ripple down rule learner. Outcome was dichotomized in favorable
	[Glasgow outcome scale (GOS) = I-II] and poor (GOS = III-V). An independent
	cohort (n = 193) was used for validation. An exploratory questionnaire
	was given to potential users (specialist doctors) to gather their
	opinion on the classifier and its usability in clinical routine.
	The best classifier was obtained with the C4.5 algorithm. It uses
	only two attributes [World Federation of Neurological Surgeons (WFNS)
	and Fisher's scale] and leads to a simple decision tree. The accuracy
	of the classifier [area under the ROC curve (AUC) = 0.84; confidence
	interval (CI) = 0.80-0.88] is similar to that obtained by a logistic
	regression model (AUC = 0.86; CI = 0.83-0.89) derived from the same
	data and is considered better fit for clinical use.}
}

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