Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
Predicting Mechanical Restraint of Psychiatric Inpatients by Applying Machine Learning on Electronic Health Data. / Danielsen, Andreas A; Fenger, Morten H J; Østergaard, Søren D; Nielbo, Kristoffer L; Mors, Ole.
In: Acta Psychiatrica Scandinavica, Vol. 140, No. 2, 08.2019, p. 147-157.Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
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TY - JOUR
T1 - Predicting Mechanical Restraint of Psychiatric Inpatients by Applying Machine Learning on Electronic Health Data
AU - Danielsen, Andreas A
AU - Fenger, Morten H J
AU - Østergaard, Søren D
AU - Nielbo, Kristoffer L
AU - Mors, Ole
N1 - This article is protected by copyright. All rights reserved.
PY - 2019/8
Y1 - 2019/8
N2 - OBJECTIVE: Mechanical restraint (MR) is used to prevent patients from harming themselves or others during inpatient treatment. The objective of this study was to investigate whether incident MR occurring in the first three days following admission could be predicted based on analysis of electronic health data available after the first hour of admission.METHODS: The dataset consisted of clinical notes from Electronic Health Records from the Central Denmark Region and data from the Danish Health Registers from patients admitted to a psychiatric department in the period from 2011 to 2015. Supervised machine learning algorithms were trained on a randomly selected subset of the data and validated using an independent test dataset.RESULTS: A total of 5,050 patients with 8,869 admissions were included in the study. One-hundred patients were mechanically restrained in the period between one hour and three days after the admission. A Random Forest algorithm predicted MR with an area under the curve of 0.87 (95% CI 0.79-0.93). At 94% specificity, the sensitivity was 56%. Among the ten strongest predictors, nine were derived from the clinical notes.CONCLUSIONS: These findings open for the development of an early warning system that may guide interventions to reduce the use of MR. This article is protected by copyright. All rights reserved.
AB - OBJECTIVE: Mechanical restraint (MR) is used to prevent patients from harming themselves or others during inpatient treatment. The objective of this study was to investigate whether incident MR occurring in the first three days following admission could be predicted based on analysis of electronic health data available after the first hour of admission.METHODS: The dataset consisted of clinical notes from Electronic Health Records from the Central Denmark Region and data from the Danish Health Registers from patients admitted to a psychiatric department in the period from 2011 to 2015. Supervised machine learning algorithms were trained on a randomly selected subset of the data and validated using an independent test dataset.RESULTS: A total of 5,050 patients with 8,869 admissions were included in the study. One-hundred patients were mechanically restrained in the period between one hour and three days after the admission. A Random Forest algorithm predicted MR with an area under the curve of 0.87 (95% CI 0.79-0.93). At 94% specificity, the sensitivity was 56%. Among the ten strongest predictors, nine were derived from the clinical notes.CONCLUSIONS: These findings open for the development of an early warning system that may guide interventions to reduce the use of MR. This article is protected by copyright. All rights reserved.
KW - coercion
KW - electronic medical records
KW - mental disorders
KW - natural language processing
KW - supervised machine learning
U2 - 10.1111/acps.13061
DO - 10.1111/acps.13061
M3 - Journal article
C2 - 31209866
VL - 140
SP - 147
EP - 157
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
SN - 0001-690X
IS - 2
ER -