Neural Networks for Clinical Order Decision Support. 2019

Jonathan X Wang, and Delaney K Sullivan, and Adam J Wells, and Alex C Wells, and Jonathan H Chen
Biomedical Informatics, Stanford University School of Medicine, Stanford, CA, USA.

Consistent and high quality medical decisions are difficult as the amount of literature, data, and treatment options grow. We developed a model to provide automated physician order decision support suggestions for inpatient care through a feed-forward neural network. Given a patient's current status based on information data-mined and extracted from the Electronic Health Record (EHR), our model predicts clinical orders a physician enters for a patient within 24 hours. As a reference benchmark of real-world standard-of-care clinical decision support, existing manually-curated order sets implemented in the hospital demonstrate precision: 0.21, recall: 0.48, AUROC: 0.75 relative to what clinicians actually order within 24 hours. Our feed-forward model provides an automated, scalable, and robust system that achieves precision: 0.41, recall: 0.61, AUROC: 0.80.

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