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Machine learning methods for hospital readmission prediction: systematic analysis of literature

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Abstract

Hospital readmission is one of the challenges that force an extra pressure and financial burden on healthcare and causes a significant waste of medical resources. However, some of these readmissions could be predicted and preventable. For this prediction, identifying the patients with high readmission rates is necessary before discharge to make appropriate interference to impede the readmission. Using smart technologies, and their collected data help in preparing a large amount of medical data sets suitable for Artificial Intelligence and machine learning to extract data insights and trends. Recently, there has been a significant interest in predicting readmission using artificial intelligence including machine learning methods. However, most of these studies focus on specific aspects of the prediction process and very few provide a comprehensive machine learning process in readmission prediction. Therefore, the objective of this article is to provide a comprehensive review of the recent studies on machine learning algorithms. In addition to the systematic literature review, by integrating the contribution of previous studies we also present the findings in a framework to cover all stages of machine learning for predicting the chance of hospital readmission.

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References

  1. Artetxe A, Beristain A, Grana M (2018) Predictive models for hospital readmission risk: a systematic review of methods. Comput Methods Programs Biomed 164:49–64

    Article  Google Scholar 

  2. Baig MM, Hua N, Zhang E, Robinson R, Spyker A, Armstrong D, Whittaker R, Robinson T, Ullah E (2020) A machine learning model for predicting risk of hospital readmission within 30 days of discharge: validated with LACE index and patient at risk of hospital readmission (PARR) model. Med Biol Eng Comput 58(7):1459–1466. https://doi.org/10.1007/s11517-020-02165-1

    Article  Google Scholar 

  3. Basu Roy S, Teredesai A, Zolfaghar K, Liu R, Hazel D, Newman S, Marinez A (2015) Dynamic hierarchical classification for patient risk-of-readmission. In: Proceedings of the 21th ACM SIGKDD international conference on knowledge discovery and data mining. pp 1691–1700

  4. Center for Health Information and Analysis (2015) Performance of the Massachusetts Health Care System Series: a focus on provider quality. Boston, MA

  5. Blakely T, Atkinson J, Kvizhinadze G, Nghiem N, McLeod H, Davies A, Wilson N (2015) Updated New Zealand health system cost estimates from health events by sex, age and proximity to death: further improvements in the age of’big data’. N Zeal Med J (Online) 128(1422):13

    Google Scholar 

  6. Ali AM, Loeffler MD, Aylin P, Bottle A (2017) Factors associated with 30-day readmission after primary total hip arthroplasty: analysis of 514,455 procedures in the UK National Health Service. JAMA Surg 152(12):e173949–e173949. https://doi.org/10.1001/jamasurg.2017.4857

    Article  Google Scholar 

  7. Krumholz HM (2014) Big data and new knowledge in medicine: the thinking, training, and tools needed for a learning health system. Health Aff 33(7):1163–1170

    Article  Google Scholar 

  8. Zack CJ, Senecal C, Kinar Y, Metzger Y, Bar-Sinai Y, Widmer RJ, Lennon R, Singh M, Bell MR, Lerman A (2019) Leveraging machine learning techniques to forecast patient prognosis after percutaneous coronary intervention. JACC Cardiovasc Interv 12(14):1304–1311

    Article  Google Scholar 

  9. Rehm M (2010) Chapter 13—nonsymbolic gestural interaction for ambient intelligence. In: Aghajan H, Delgado RLC, Augusto JC (eds) Human-centric interfaces for ambient intelligence. Academic Press, Oxford, pp 327–345. https://doi.org/10.1016/B978-0-12-374708-2.00013-9

    Chapter  Google Scholar 

  10. Tun SY, Madanian S, Parry D (2020) Clinical perspective on internet of things applications for care of the elderly. Electronics. https://doi.org/10.3390/electronics9111925

    Article  Google Scholar 

  11. Madanian S, Nguyen HH, Mirza F (2019) Wearable technology. In: Gu D, Dupre ME (eds) Encyclopedia of gerontology and population aging. Springer International Publishing, Cham, pp 1–8. https://doi.org/10.1007/978-3-319-69892-2_459-1

    Chapter  Google Scholar 

  12. Tun SYY, Madanian S, Mirza F (2021) Internet of things (IoT) applications for elderly care: a reflective review. Aging Clin Exp Res 33(4):855–867. https://doi.org/10.1007/s40520-020-01545-9

    Article  Google Scholar 

  13. Khoshmanesh F, Thurgood P, Pirogova E, Nahavandi S, Baratchi S (2021) Wearable sensors: at the frontier of personalised health monitoring, smart prosthetics and assistive technologies. Biosens Bioelectron 176:112946. https://doi.org/10.1016/j.bios.2020.112946

    Article  Google Scholar 

  14. Sagl G, Resch B, Blaschke T (2015) Contextual sensing: integrating contextual information with human and technical geo-sensor information for smart cities. Sensors 15(7):17013–17035. https://doi.org/10.3390/s150717013

    Article  Google Scholar 

  15. Darwish A, Hassanien AE (2011) Wearable and implantable wireless sensor network solutions for healthcare monitoring. Sensors (Basel) 11(6):5561–5595. https://doi.org/10.3390/s110605561

    Article  Google Scholar 

  16. Banaee H, Ahmed MU, Loutfi A (2013) Data mining for wearable sensors in health monitoring systems: a review of recent trends and challenges. Sensors 13(12):17472–17500. https://doi.org/10.3390/s131217472

    Article  Google Scholar 

  17. BaHammam AS, Alassiri SS, Al-Adab AH, Alsadhan IM, Altheyab AM, Alrayes AH, Alkhawajah MM, Olaish AH (2015) Long-term compliance with continuous positive airway pressure in Saudi patients with obstructive sleep apnea: a prospective cohort study. Saudi Med J 36(8):911–919. https://doi.org/10.15537/smj.2015.8.11716

    Article  Google Scholar 

  18. Artetxe A, Beristain A, Graña M (2018) Predictive models for hospital readmission risk: a systematic review of methods. Comput Methods Programs Biomed 164:49–64. https://doi.org/10.1016/j.cmpb.2018.06.006

    Article  Google Scholar 

  19. Tang F, Xiao C, Wang F, Zhou J (2018) Predictive modeling in urgent care: a comparative study of machine learning approaches. Jamia Open 1(1):87–98

    Article  Google Scholar 

  20. Kwon JY, Karim ME, Topaz M, Currie LM (2019) Nurses “seeing forest for the trees” in the age of machine learning: using nursing knowledge to improve relevance and performance. Comput Inform Nurs 37(4):203–212. https://doi.org/10.1097/cin.0000000000000508

    Article  Google Scholar 

  21. Golas SB, Shibahara T, Agboola S, Otaki H, Sato J, Nakae T, Hisamitsu T, Kojima G, Felsted J, Kakarmath S, Kvedar J, Jethwani K (2018) A machine learning model to predict the risk of 30-day readmissions in patients with heart failure: a retrospective analysis of electronic medical records data. BMC Med Inform Decis Mak 18(1):44. https://doi.org/10.1186/s12911-018-0620-z

    Article  Google Scholar 

  22. Amato ACM, Dos Santos RV, Saucedo DZ, Amato S (2020) Machine learning in prediction of individual patient readmissions for elective carotid endarterectomy, aortofemoral bypass/aortic aneurysm repair, and femoral-distal arterial bypass. SAGE Open Med 8:2050312120909057. https://doi.org/10.1177/2050312120909057

    Article  Google Scholar 

  23. Ben-Assuli O, Padman R (2018) Analysing repeated hospital readmissions using data mining techniques. Health Syst (Basingstoke) 7(3):166–180. https://doi.org/10.1080/20476965.2018.1510040

    Article  Google Scholar 

  24. Cui S, Wang D, Wang Y, Yu PW, Jin Y (2018) An improved support vector machine-based diabetic readmission prediction. Comput Methods Programs Biomed 166:123–135. https://doi.org/10.1016/j.cmpb.2018.10.012

    Article  Google Scholar 

  25. Zhao P, Yoo IA (2017) Self-adaptive 30-day diabetic readmission prediction model based on incremental learning. In: 2017 IEEE International Conference on Bioinformatics and Biomedicine (BIBM). IEEE, pp 895–898

  26. Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 26(2):91–108

    Article  Google Scholar 

  27. QSR International Pty Ltd (2019) Nvivo. https://www.qsrinternational.com/nvivo/home. Accessed 19 Nov 2019

  28. Yi E (2018) Themes don’t just emerge-coding the qualitative data. Medium data science

  29. Kalagara S, Eltorai AEM, Durand WM, DePasse JM, Daniels AH (2018) Machine learning modeling for predicting hospital readmission following lumbar laminectomy. J Neurosurg Spine 30(3):344–352. https://doi.org/10.3171/2018.8.Spine1869

    Article  Google Scholar 

  30. Burdick H, Pino E, Gabel-Comeau D, McCoy A, Gu C, Roberts J, Le S, Slote J, Pellegrini E, Green-Saxena A, Hoffman J, Das R (2020) Effect of a sepsis prediction algorithm on patient mortality, length of stay and readmission: a prospective multicentre clinical outcomes evaluation of real-world patient data from US hospitals. BMJ Health Care Inform. https://doi.org/10.1136/bmjhci-2019-100109

    Article  Google Scholar 

  31. Gupta S, Ko DT, Azizi P, Bouadjenek MR, Koh M, Chong A, Austin PC, Sanner S (2020) Evaluation of machine learning algorithms for predicting readmission after acute myocardial infarction using routinely collected clinical data. Can J Cardiol 36(6):878–885. https://doi.org/10.1016/j.cjca.2019.10.023

    Article  Google Scholar 

  32. Jain D, Durand W, Burch S, Daniels A, Berven S (2020) Machine learning for predictive modeling of 90-day readmission, major medical complication, and discharge to a facility in patients undergoing long segment posterior lumbar spine fusion. Spine 45(16):1151–1160

    Article  Google Scholar 

  33. Reddy BK, Delen D (2018) Predicting hospital readmission for lupus patients: an RNN-LSTM-based deep-learning methodology. Comput Biol Med 101:199–209. https://doi.org/10.1016/j.compbiomed.2018.08.029

    Article  Google Scholar 

  34. Landicho JA, Esichaikul V, Sasil RM (2020) Comparison of predictive models for hospital readmission of heart failure patients with cost-sensitive approach. Int J Healthc Manag. https://doi.org/10.1080/20479700.2020.1797334

    Article  Google Scholar 

  35. Awan SE, Bennamoun M, Sohel F, Sanfilippo FM, Chow BJ, Dwivedi G (2019) Feature selection and transformation by machine learning reduce variable numbers and improve prediction for heart failure readmission or death. PLoS ONE 14(6):e0218760. https://doi.org/10.1371/journal.pone.0218760

    Article  Google Scholar 

  36. McKinley D, Moye-Dickerson P, Davis S, Akil A (2019) Impact of a pharmacist-led intervention on 30-day readmission and assessment of factors predictive of readmission in african american men with heart failure. Am J Mens Health 13(1):1557988318814295. https://doi.org/10.1177/1557988318814295

    Article  Google Scholar 

  37. Mahajan SM, Mahajan AS, King R, Negahban S (2018) Predicting risk of 30-day readmissions using two emerging machine learning methods. Stud Health Technol Inform 250:250–255

    Google Scholar 

  38. Ena J, Gómez-Huelgas R, Gracia-Tello BC, Vázquez-Rodríguez P, Alcalá-Pedrajas JN, Carrasco-Sánchez FJ, Murcia-Casas B, Romero-Sánchez M, Segura-Heras JV, Carretero J (2018) Derivation and validation of a predictive model for the readmission of patients with diabetes mellitus treated in internal medicine departments. Revista Clínica Española (English Edition) 218(6):271–278. https://doi.org/10.1016/j.rceng.2018.03.018

    Article  Google Scholar 

  39. Loreto M, Lisboa T, Moreira VP (2020) Early prediction of ICU readmissions using classification algorithms. Comput Biol Med 118:103636. https://doi.org/10.1016/j.compbiomed.2020.103636

    Article  Google Scholar 

  40. Pakbin A, Rafi P, Hurley N, Schulz W, Harlan Krumholz M, Bobak Mortazavi J (2018) Prediction of ICU readmissions using data at patient discharge. Conf Proc IEEE Eng Med Biol Soc 2018:4932–4935. https://doi.org/10.1109/embc.2018.8513181

    Article  Google Scholar 

  41. Thoral PJ, Fornasa M, de Bruin DP, Hovenkamp H, Driessen RH, Girbes AR, Hoogendoorn M, Elbers PW (2020) Developing a machine learning prediction model for bedside decision support by predicting readmission or death following discharge from the intensive care unit. Res Sq. https://doi.org/10.21203/rs.2.21940/v1

    Article  Google Scholar 

  42. Rojas JC, Carey KA, Edelson DP, Venable LR, Howell MD, Churpek MM (2018) Predicting intensive care unit readmission with machine learning using electronic health record data. Ann Am Thorac Soc 15(7):846–853. https://doi.org/10.1513/AnnalsATS.201710-787OC

    Article  Google Scholar 

  43. Deschepper M, Eeckloo K, Vogelaers D, Waegeman W (2019) A hospital wide predictive model for unplanned readmission using hierarchical ICD data. Comput Methods Programs Biomed 173:177–183. https://doi.org/10.1016/j.cmpb.2019.02.007

    Article  Google Scholar 

  44. Ta WA, Goh HL, Tan CS, Sun Y, Aung KCY, Teoh ZW, Tan KB, Lau ZY, Abisheganaden JA, Lee KH (2018) Development and implementation of nationwide predictive model for admission prevention: System architecture and machine learning. In: IEEE EMBS International Conference on Biomedical and Health Informatics (BHI). IEEE, pp 303–306

  45. Ko M, Chen E, Rajpurkar P, Agrawal A, Avati A, Ng A, Basu S, Shah N (2020) Improving hospital readmission prediction using individualized utility analysis. medRxiv

  46. Jamei M, Nisnevich A, Wetchler E, Sudat S, Liu E (2017) Predicting all-cause risk of 30-day hospital readmission using artificial neural networks. PLoS ONE 12(7):e0181173. https://doi.org/10.1371/journal.pone.0181173

    Article  Google Scholar 

  47. Schiltz NK, Dolansky MA, Warner DF, Stange KC, Gravenstein S, Koroukian SM (2020) Impact of instrumental activities of daily living limitations on hospital readmission: an observational study using machine learning. J Gen Intern Med 35:1–8

    Article  Google Scholar 

  48. Jones CD, Falvey J, Hess E, Levy CR, Nuccio E, Barón AE, Masoudi FA, Stevens-Lapsley J (2019) Predicting Hospital Readmissions from Home Healthcare in Medicare Beneficiaries. J Am Geriatr Soc 67(12):2505–2510. https://doi.org/10.1111/jgs.16153

    Article  Google Scholar 

  49. Eckert C, Nieves-Robbins N, Spieker E, Louwers T, Hazel D, Marquardt J, Solveson K, Zahid A, Ahmad M, Barnhill R, McKelvey TG, Marshall R, Shry E, Teredesai A (2019) Development and prospective validation of a machine learning-based risk of readmission model in a large military hospital. Appl Clin Inform 10(2):316–325. https://doi.org/10.1055/s-0039-1688553

    Article  Google Scholar 

  50. Baig MM, Hua N, Zhang E, Robinson R, Armstrong D, Whittaker R, Robinson T, Mirza F, Ullah E (2019) Machine learning-based risk of hospital readmissions: predicting acute readmissions within 30 days of discharge. Conf Proc IEEE Eng Med Biol Soc 2019:2178–2181. https://doi.org/10.1109/embc.2019.8856646

    Article  Google Scholar 

  51. Dhalluin T, Bannay A, Lemordant P, Sylvestre E, Chazard E, Cuggia M, Bouzille G (2020) Comparison of Unplanned 30-Day Readmission Prediction Models, Based on Hospital Warehouse and Demographic Data. Stud Health Technol Inform 270:547–551. https://doi.org/10.3233/shti200220

    Article  Google Scholar 

  52. Merrill RK, Ferrandino RM, Hoffman R, Shaffer GW, Ndu A (2019) Machine learning accurately predicts short-term outcomes following open reduction and internal fixation of ankle fractures. J Foot Ankle Surg 58(3):410–416. https://doi.org/10.1053/j.jfas.2018.09.004

    Article  Google Scholar 

  53. Hain PD, Gay JC, Berutti TW, Whitney GM, Wang W, Saville BR (2013) Preventability of early readmissions at a children’s hospital. Pediatrics 131(1):e171–e181

    Article  Google Scholar 

  54. Xu Y, Yang X, Huang H, Peng C, Ge Y, Wu H, Wang J, Xiong G, Yi Y (2019) Extreme gradient boosting model has a better performance in predicting the risk of 90-day readmissions in patients with ischaemic stroke. J Stroke Cerebrovasc Dis 28(12):104441. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104441

    Article  Google Scholar 

  55. Goto T, Jo T, Matsui H, Fushimi K, Hayashi H, Yasunaga H (2019) Machine learning-based prediction models for 30-day readmission after hospitalization for chronic obstructive pulmonary disease. COPD 16(5–6):338–343. https://doi.org/10.1080/15412555.2019.1688278

    Article  Google Scholar 

  56. Nakamura MM, Toomey SL, Zaslavsky AM, Petty CR, Lin C, Savova GK, Rose S, Brittan MS, Lin JL, Bryant MC (2019) Potential impact of initial clinical data on adjustment of pediatric readmission rates. Acad Pediatr 19(5):589–598

    Article  Google Scholar 

  57. Mingle D (2017) Predicting diabetic readmission rates: moving beyond Hba1c. Curr Trends Biomed Eng Biosci 7(3):555707

    Article  Google Scholar 

  58. Hammoudeh A, Al-Naymat G, Ghannam I, Obied N (2018) Predicting hospital readmission among diabetics using deep learning. Procedia Comput Sci 141:484–489. https://doi.org/10.1016/j.procs.2018.10.138

    Article  Google Scholar 

  59. Madrid-García A, Font-Urgelles J, Vega-Barbas M, León-Mateos L, Freites DD, Lajas CJ, Pato E, Jover JA, Fernández-Gutiérrez B, Abásolo-Alcazar L (2019) Outpatient readmission in rheumatology: a machine learning predictive model of patient’s return to the clinic. J Clin Med 8(8):1156

    Article  Google Scholar 

  60. Coussement K, Lessmann S, Verstraeten G (2017) A comparative analysis of data preparation algorithms for customer churn prediction: a case study in the telecommunication industry. Decis Support Syst 95:27–36. https://doi.org/10.1016/j.dss.2016.11.007

    Article  Google Scholar 

  61. Xu X, Cui L, Liu S, Li H, Liu L, Zheng Y (2017) Predicting hospital readmission from longitudinal healthcare data using graph pattern mining based temporal phenotypes. In: 2017 IEEE International Conference on Bioinformatics and Biomedicine (BIBM). IEEE, pp 824–829

  62. Cearns M, Opel N, Clark S, Kaehler C, Thalamuthu A, Heindel W, Winter T, Teismann H, Minnerup H, Dannlowski U, Berger K, Baune BT (2019) Predicting rehospitalization within 2 years of initial patient admission for a major depressive episode: a multimodal machine learning approach. Transl Psychiatry 9(1):285. https://doi.org/10.1038/s41398-019-0615-2

    Article  Google Scholar 

  63. Sharma A, Agrawal P, Madaan V, Goyal S (2019) Prediction on diabetes patient's hospital readmission rates. In: Proceedings of the Third International Conference on Advanced Informatics for Computing Research. pp 1–5

  64. Tang F, Ishwaran H (2017) Random forest missing data algorithms. Stat Anal Data Min ASA Data Sci J 10(6):363–377

    Article  MathSciNet  Google Scholar 

  65. Ioffe S, Szegedy C (2015) Batch normalization: accelerating deep network training by reducing internal covariate shift. arXiv preprint https://arXiv.org/150203167

  66. Joel G (2015) Data science from scratch. O’Reilly Media Inc, Sebastopol

    Google Scholar 

  67. Chopra C, Sinha S, Jaroli S, Shukla A, Maheshwari S (2017) Recurrent neural networks with non-sequential data to predict hospital readmission of diabetic patients. In: Proceedings of the 2017 International Conference on Computational Biology and Bioinformatics. pp 18–23

  68. Yu K, Xie X (2019) Predicting hospital readmission: a joint ensemble-learning model. IEEE J Biomed Health Inform 24(2):447–456

    Article  Google Scholar 

  69. Anguita D, Ghelardoni L, Ghio A, Oneto L, Ridella S (2012) The 'K' in K-fold cross validation. In: ESANN

  70. Pedregosa F, Varoquaux G, Gramfort A, Vincent M, Thirion B, Grisel O, Blondel M, Prettenhofer P, Weiss R, Dubourg V, Vanderplas J, Passos A, Cournapeau D, Brucher M, Perrot M, Duchesnay É (2011) Scikit-learn: machine learning in Python

  71. Du G, Zhang J, Luo Z, Ma F, Ma L, Li S (2020) Joint imbalanced classification and feature selection for hospital readmissions. Knowl-Based Syst 200:106020. https://doi.org/10.1016/j.knosys.2020.106020

    Article  Google Scholar 

  72. Garcia-Arce A, Rico F, Zayas-Castro JL (2018) Comparison of machine learning algorithms for the prediction of preventable hospital readmissions. J Healthc Qual 40(3):129–138. https://doi.org/10.1097/jhq.0000000000000080

    Article  Google Scholar 

  73. Artetxe A, Ayerdi B, Graña M, Rios S (2017) Using anticipative hybrid extreme rotation forest to predict emergency service readmission risk. J Comput Sci 20:154–161

    Article  Google Scholar 

  74. Wolpert DH, Macready WG (1997) No free lunch theorems for optimization. IEEE Trans Evol Comput 1(1):67–82

    Article  Google Scholar 

  75. Huang J, Ling CX (2005) Using AUC and accuracy in evaluating learning algorithms. IEEE Trans Knowl Data Eng 17(3):299–310

    Article  Google Scholar 

  76. Échevin D, Li Q, Morin M-A (2017) Hospital readmission is highly predictable from deep learning. Chaire de recherche Industrielle Alliance sur les enjeux économiques des changements démographiques

  77. Liu X, Chen Y, Bae J, Li H, Johnston J, Sanger T (2019) Predicting heart failure readmission from clinical notes using deep learning. In: 2019 IEEE International Conference on Bioinformatics and Biomedicine (BIBM). IEEE, pp 2642–2648

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TC was responsible for data collection, and data analysis, all these tasks undertook under SM supervision. SM was responsible for project ideation and formulation of the research questions and objectives. SM contributed to the research method, reflection on research results and data interpretation. TC prepared the first draft of the research report which was commented on and enhanced by SM. DA and MC contributed to the preparation of the manuscript. DA contributed to the IoT section. All authors agreed on the final revision.

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Correspondence to Samaneh Madanian.

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Chen, T., Madanian, S., Airehrour, D. et al. Machine learning methods for hospital readmission prediction: systematic analysis of literature. J Reliable Intell Environ 8, 49–66 (2022). https://doi.org/10.1007/s40860-021-00165-y

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