论文标题
使用现实世界的医疗保健数据构建大型尺度筛查工具,以造成严重精神疾病的风险
Construction of extra-large scale screening tools for risks of severe mental illnesses using real world healthcare data
论文作者
论文摘要
重要性:美国严重精神疾病(SMI)的患病率约占整个人口的3%。大规模进行SMI的风险筛查的能力可以为早期的预防和治疗提供依据。 目的:开发了一种基于机器的基于机器学习的工具,以对SMIS进行人口水平的风险筛查,包括精神分裂症,精神分裂性疾病,精神病和双相情感障碍,使用1)医疗保险索赔和2)电子健康记录(EHRS)。 设计,设置和参与者:来自全国性商业医疗保险公司的受益人的数据,拥有7740万成员,以及来自美国八家学术医院的EHR的患者的数据。首先,使用保险索赔或EHR数据中的案例对照组中的数据构建和测试了预测模型。其次,分析了跨数据源的预测模型的性能。第三,作为说明性应用,对这些模型进行了进一步的培训,以预测18岁的年轻人和具有与物质相关条件的个人中SMI的风险。 主要成果和措施:基于机器学习的SMI的基于机器学习的预测模型是根据保险索赔和EHR建立的。
Importance: The prevalence of severe mental illnesses (SMIs) in the United States is approximately 3% of the whole population. The ability to conduct risk screening of SMIs at large scale could inform early prevention and treatment. Objective: A scalable machine learning based tool was developed to conduct population-level risk screening for SMIs, including schizophrenia, schizoaffective disorders, psychosis, and bipolar disorders,using 1) healthcare insurance claims and 2) electronic health records (EHRs). Design, setting and participants: Data from beneficiaries from a nationwide commercial healthcare insurer with 77.4 million members and data from patients from EHRs from eight academic hospitals based in the U.S. were used. First, the predictive models were constructed and tested using data in case-control cohorts from insurance claims or EHR data. Second, performance of the predictive models across data sources were analyzed. Third, as an illustrative application, the models were further trained to predict risks of SMIs among 18-year old young adults and individuals with substance associated conditions. Main outcomes and measures: Machine learning-based predictive models for SMIs in the general population were built based on insurance claims and EHR.