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Machine learning models for synthesizing actionable care decisions on lower extremity wounds.
Nguyen, Holly; Agu, Emmanuel; Tulu, Bengisu; Strong, Diane; Mombini, Haadi; Pedersen, Peder; Lindsay, Clifford; Dunn, Raymond; Loretz, Lorraine.
Afiliación
  • Nguyen H; Worcester Polytechnic Institute, 100 Institute Road, Worcester and 01609, United States.
  • Agu E; Worcester Polytechnic Institute, 100 Institute Road, Worcester and 01609, United States.
  • Tulu B; Worcester Polytechnic Institute, 100 Institute Road, Worcester and 01609, United States.
  • Strong D; Worcester Polytechnic Institute, 100 Institute Road, Worcester and 01609, United States.
  • Mombini H; Worcester Polytechnic Institute, 100 Institute Road, Worcester and 01609, United States.
  • Pedersen P; Worcester Polytechnic Institute, 100 Institute Road, Worcester and 01609, United States.
  • Lindsay C; University of Massachusetts Medical School/UMass Memorial Health Car, 55 N Lake Ave, Worcester and 01655, United States.
  • Dunn R; University of Massachusetts Medical School/UMass Memorial Health Car, 55 N Lake Ave, Worcester and 01655, United States.
  • Loretz L; University of Massachusetts Medical School/UMass Memorial Health Car, 55 N Lake Ave, Worcester and 01655, United States.
Smart Health (Amst) ; 182020 Nov.
Article en En | MEDLINE | ID: mdl-33299924
Lower extremity chronic wounds affect 4.5 million Americans annually. Due to inadequate access to wound experts in underserved areas, many patients receive non-uniform, non-standard wound care, resulting in increased costs and lower quality of life. We explored machine learning classifiers to generate actionable wound care decisions about four chronic wound types (diabetic foot, pressure, venous, and arterial ulcers). These decisions (target classes) were: (1) Continue current treatment, (2) Request non-urgent change in treatment from a wound specialist, (3) Refer patient to a wound specialist. We compare classification methods (single classifiers, bagged & boosted ensembles, and a deep learning network) to investigate (1) whether visual wound features are sufficient for generating a decision and (2) whether adding unstructured text from wound experts increases classifier accuracy. Using 205 wound images, the Gradient Boosted Machine (XGBoost) outperformed other methods when using both visual and textual wound features, achieving 81% accuracy. Using only visual features decreased the accuracy to 76%, achieved by a Support Vector Machine classifier. We conclude that machine learning classifiers can generate accurate wound care decisions on lower extremity chronic wounds, an important step toward objective, standardized wound care. Higher decision-making accuracy was achieved by leveraging clinical comments from wound experts.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Aspecto: Patient_preference Idioma: En Revista: Smart Health (Amst) Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Aspecto: Patient_preference Idioma: En Revista: Smart Health (Amst) Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos