arXiv subjects

Abdulaziz Ahmed

Publications and source records attributed to Abdulaziz Ahmed.

15 recordsLinked to original sources

arXiv2026

Does Machine Learning Outperform Traditional Fibrosis Scores in Predicting Liver Cirrhosis Risk? A Longitudinal EHR-Based Study

Objective: Develop and evaluate machine learning (ML) models for predicting incident liver cirrhosis (LC) one and two years before diagnosis using routinely collected electronic health record (EHR) data and compare their performance with the FIB-4 and APRI clinical scores. Methods: We conducted a retrospective cohort study using de-identified EHR data from a large academic health system. Adult patients with diagnostic evidence of LC or LC-related risk conditions were identified using ICD-9/10 codes and classified into cirrhosis and non-cirrhosis cohorts. One- and two-year prediction scenarios were created using observation and prediction windows. Demographics, diagnoses, laboratory results, and vital signs from the observation window were used as predictors. XGBoost models were developed with feature selection and Bayesian hyperparameter tuning and evaluated on held-out test sets. The performance of XGBoost, FIB-4, and APRI were compared on the same test data using accuracy, precision, recall, F1 score, AUC, and PR AUC. Results: The final cohorts included 54,365 patients for the 1-year prediction and 43,743 for the 2-year prediction. XGBoost consistently outperformed FIB-4 and APRI across both prediction horizons. The ML models achieved AUCs of 0.834 and 0.811 versus 0.700 and 0.677 for FIB-4 and 0.744 and 0.719 for APRI. PR AUCs were 0.502 and 0.434 for XGBoost compared with 0.310 and 0.241 for FIB-4 and 0.372 and 0.306 for APRI. Conclusions: ML models using routine EHR data substantially outperform traditional clinical scores for early LC prediction, enabling more accurate risk stratification and supporting earlier clinical intervention through automated decision support.

cs.LG↗

arXiv2026

A Large Language Model Based Pipeline for Review of Systems Entity Recognition from Clinical Notes

Objective: Develop a cost-effective, large language model (LLM)-based pipeline for automatically extracting Review of Systems (ROS) entities from clinical notes. Materials and Methods: The pipeline extracts ROS section from the clinical note using SecTag header terminology, followed by few-shot LLMs to identify ROS entities such as diseases or symptoms, their positive/negative status and associated body systems. We implemented the pipeline using 4 open-source LLM models: llama3.1:8b, gemma3:27b, mistral3.1:24b and gpt-oss:20b. Additionally, we introduced a novel attribution algorithm that aligns LLM-identified ROS entities with their source text, addressing non-exact and synonymous matches. The evaluation was conducted on 24 general medicine notes containing 340 annotated ROS entities. Results: Open-source LLMs enable a local, cost-efficient pipeline while delivering promising performance. Larger models like Gemma, Mistral, and Gpt-oss demonstrate robust performance across three entity recognition tasks of the pipeline: ROS entity extraction, negation detection and body system classification (highest F1 score = 0.952). With the attribution algorithm, all models show improvements across key performance metrics, including higher F1 score and accuracy, along with lower error rate. Notably, the smaller Llama model also achieved promising results despite using only one-third the VRAM of larger models. Discussion and Conclusion: From an application perspective, our pipeline provides a scalable, locally deployable solution to easing the ROS documentation burden. Open-source LLMs offer a practical AI option for resource-limited healthcare settings. Methodologically, our newly developed algorithm facilitates accuracy improvements for zero- and few-shot LLMs in named entity recognition.

cs.CL↗

arXiv2026

An Integrated Forecasting Prototype for Emergency Department Boarding Time to Support Proactive Operational Decision Making

Overcrowding in emergency departments (ED) remains a persistent operational challenge worldwide, causing delays in care delivery and downstream congestion. ED boarding time, defined as the duration admitted patients remain in the ED while awaiting inpatient bed placement, is a key indicator of this congestion. Predicting ED boarding time in advance enables proactive operational decision making before congestion escalates. We developed and evaluated a multi-horizon time series forecasting framework to predict ED boarding time at 6, 8, 10, 12, and 24-hour horizons. Real-world data from a university-affiliated urban hospital in the United States were utilized and integrated with external contextual data sources, including weather, holidays, and major local events. Decomposition-based Linear (DLinear) and Normalization-based Linear (NLinear) time series forecasting deep learning models showed superior performance across multiple horizons. Models were also evaluated under extreme congestion scenarios characterized by elevated boarding times. In addition, a Machine Learning Operations (MLOps) web application prototype was developed to support translation of the forecasting framework into practice through integrated data ingestion, forecast visualization, experimentation, and retraining.

cs.LG↗

arXiv2025

Deep Learning-Based Forecasting of Boarding Patient Counts to Address ED Overcrowding

This study presents a deep learning-based framework for predicting emergency department (ED) boarding counts six hours in advance using only operational and contextual data, without patient-level information. Data from ED tracking systems, inpatient census, weather, holidays, and local events were aggregated hourly and processed with comprehensive feature engineering. The mean ED boarding count was 28.7 (standard deviation = 11.2). Multiple deep learning models, including ResNetPlus, TSTPlus, and TSiTPlus, were trained and optimized using Optuna, with TSTPlus achieving the best results (mean absolute error = 4.30, mean squared error = 29.47, R2 = 0.79). The framework accurately forecasted boarding counts, including during extreme periods, and demonstrated that broader input features improve predictive accuracy. This approach supports proactive hospital management and offers a practical method for mitigating ED overcrowding.

cs.LG↗

arXiv2025

Explainable AI for Mental Health Emergency Returns: Integrating LLMs with Predictive Modeling

Importance: Emergency department (ED) returns for mental health conditions pose a major healthcare burden, with 24-27% of patients returning within 30 days. Traditional machine learning models for predicting these returns often lack interpretability for clinical use. Objective: To assess whether integrating large language models (LLMs) with machine learning improves predictive accuracy and clinical interpretability of ED mental health return risk models. Methods: This retrospective cohort study analyzed 42,464 ED visits for 27,904 unique mental health patients at an academic medical center in the Deep South from January 2018 to December 2022. Main Outcomes and Measures: Two primary outcomes were evaluated: (1) 30-day ED return prediction accuracy and (2) model interpretability using a novel LLM-enhanced framework integrating SHAP (SHapley Additive exPlanations) values with clinical knowledge. Results: For chief complaint classification, LLaMA 3 (8B) with 10-shot learning outperformed traditional models (accuracy: 0.882, F1-score: 0.86). In SDoH classification, LLM-based models achieved 0.95 accuracy and 0.96 F1-score, with Alcohol, Tobacco, and Substance Abuse performing best (F1: 0.96-0.89), while Exercise and Home Environment showed lower performance (F1: 0.70-0.67). The LLM-based interpretability framework achieved 99% accuracy in translating model predictions into clinically relevant explanations. LLM-extracted features improved XGBoost AUC from 0.74 to 0.76 and AUC-PR from 0.58 to 0.61. Conclusions and Relevance: Integrating LLMs with machine learning models yielded modest but consistent accuracy gains while significantly enhancing interpretability through automated, clinically relevant explanations. This approach provides a framework for translating predictive analytics into actionable clinical insights.

cs.LG↗

arXiv2025

Assessing the Impact of External and Internal Factors on Emergency Department Overcrowding

Study Objective: To analyze the factors influencing Emergency Department (ED) overcrowding by examining the impacts of operational, environmental, and external variables, including weather conditions and football games. Methods: This study integrates ED tracking and hospital census data from a southeastern U.S. academic medical center (2019-2023) with data from external sources, including weather, football events, and federal holidays. The dependent variable is the hourly waiting count in the ED. Seven regression models were developed to assess the effects of different predictors such as weather conditions, hospital census, federal holidays, and football games across different timestamps. Results: Some weather conditions significantly increased ED crowding in the Baseline Model, while federal holidays and weekends consistently reduced waiting counts. Boarding count positively correlated with ED crowding when they are concurrent, but earlier boarding count (3-6 hours before) showed significant negative associations, reducing subsequent waiting counts. Hospital census exhibited a negative association in the Baseline Model but shifted to a positive effect in other models, reflecting its time-dependent influence on ED operations. Football games 12 hours before significantly increased waiting counts, while games 12 and 24 hours after had no significant effects. Conclusion: This study highlights the importance of incorporating both operational and non-operational factors (e.g., weather) to understand ED patient flow. Identifying robust predictors such as weather, federal holidays, boarding count, and hospital census can inform dynamic resource allocation strategies to mitigate ED overcrowding effectively.

cs.CY↗

arXiv2025

An Artificial Intelligence-Based Framework for Predicting Emergency Department Overcrowding: Development and Evaluation Study

Background: Emergency department (ED) overcrowding remains a major challenge, causing delays in care and increased operational strain. Hospital management often reacts to congestion after it occurs. Machine learning predictive modeling offers a proactive approach by forecasting patient flow metrics, such as waiting count, to improve resource planning and hospital efficiency. Objective: This study develops machine learning models to predict ED waiting room occupancy at two time scales. The hourly model forecasts the waiting count six hours ahead (e.g., a 1 PM prediction for 7 PM), while the daily model estimates the average waiting count for the next 24 hours (e.g., a 5 PM prediction for the following day's average). These tools support staffing decisions and enable earlier interventions to reduce overcrowding. Methods: Data from a partner hospital's ED in the southeastern United States were used, integrating internal metrics and external features. Eleven machine learning algorithms, including traditional and deep learning models, were trained and evaluated. Feature combinations were optimized, and performance was assessed across varying patient volumes and hours. Results: TSiTPlus achieved the best hourly prediction (MAE: 4.19, MSE: 29.32). The mean hourly waiting count was 18.11, with a standard deviation of 9.77. Accuracy varied by hour, with MAEs ranging from 2.45 (11 PM) to 5.45 (8 PM). Extreme case analysis at one, two, and three standard deviations above the mean showed MAEs of 6.16, 10.16, and 15.59, respectively. For daily predictions, XCMPlus performed best (MAE: 2.00, MSE: 6.64), with a daily mean of 18.11 and standard deviation of 4.51. Conclusions: These models accurately forecast ED waiting room occupancy and support proactive resource allocation. Their implementation has the potential to improve patient flow and reduce overcrowding in emergency care settings.

cs.LG↗

arXiv2025

Large Language Models in Healthcare

Large language models (LLMs) hold promise for transforming healthcare, from streamlining administrative and clinical workflows to enriching patient engagement and advancing clinical decision-making. However, their successful integration requires rigorous development, adaptation, and evaluation strategies tailored to clinical needs. In this Review, we highlight recent advancements, explore emerging opportunities for LLM-driven innovation, and propose a framework for their responsible implementation in healthcare settings. We examine strategies for adapting LLMs to domain-specific healthcare tasks, such as fine-tuning, prompt engineering, and multimodal integration with electronic health records. We also summarize various evaluation metrics tailored to healthcare, addressing clinical accuracy, fairness, robustness, and patient outcomes. Furthermore, we discuss the challenges associated with deploying LLMs in healthcare--including data privacy, bias mitigation, regulatory compliance, and computational sustainability--and underscore the need for interdisciplinary collaboration. Finally, these challenges present promising future research directions for advancing LLM implementation in clinical settings and healthcare.

cs.CY↗

arXiv2025

A stochastic programming approach for the scheduling of medical interpreting service under uncertainty

Limited English Proficiency (LEP) patients face higher risks of adverse health outcomes due to communication barriers, making timely medical interpreting services essential for mitigating those risks. This paper addresses the scheduling of medical interpreting services under uncertainty. The problem is formulated as a two-stage stochastic programming model that accounts for uncertainties in emergency patients' arrival and service time. The model handles the hiring decisions of part-time interpreters and the assignment of full-time and hired part-time interpreters. The objective is to minimize the total cost, which encompasses full-time interpreters' overtime cost, the fixed and variable costs of part-time interpreters, and the penalty cost for not serving LEP patients on time. The model is solved using the Sample Average Approximation (SAA) algorithm. To overcome the computational burden of the SAA algorithm, a Tabu Search (TS) algorithm was used to solve the model. A real-life case study is used to validate and evaluate the proposed solution algorithms. The results demonstrate the effectiveness of the proposed stochastic programming-based solutions in concurrently reducing both the total cost and the waiting time. Further, sensitivity analysis reveals how the increase in some key parameters, such as the arrival rate of emergency patients with LEP, impacts scheduling outcomes.

cs.DM↗

arXiv2023

Machine Learning Applications in Studying Mental Health Among Immigrants and Racial and Ethnic Minorities: A Systematic Review

Background: The use of machine learning (ML) in mental health (MH) research is increasing, especially as new, more complex data types become available to analyze. By systematically examining the published literature, this review aims to uncover potential gaps in the current use of ML to study MH in vulnerable populations of immigrants, refugees, migrants, and racial and ethnic minorities. Methods: In this systematic review, we queried Google Scholar for ML-related terms, MH-related terms, and a population of a focus search term strung together with Boolean operators. Backward reference searching was also conducted. Included peer-reviewed studies reported using a method or application of ML in an MH context and focused on the populations of interest. We did not have date cutoffs. Publications were excluded if they were narrative or did not exclusively focus on a minority population from the respective country. Data including study context, the focus of mental healthcare, sample, data type, type of ML algorithm used, and algorithm performance was extracted from each. Results: Our search strategies resulted in 67,410 listed articles from Google Scholar. Ultimately, 12 were included. All the articles were published within the last 6 years, and half of them studied populations within the US. Most reviewed studies used supervised learning to explain or predict MH outcomes. Some publications used up to 16 models to determine the best predictive power. Almost half of the included publications did not discuss their cross-validation method. Conclusions: The included studies provide proof-of-concept for the potential use of ML algorithms to address MH concerns in these special populations, few as they may be. Our systematic review finds that the clinical application of these models for classifying and predicting MH disorders is still under development.

cs.LG↗

arXiv2022

A Study of Left Before Treatment Complete Emergency Department Patients: An Optimized Explanatory Machine Learning Framework

The issue of left before treatment complete (LBTC) patients is common in emergency departments (EDs). This issue represents a medico-legal risk and may cause a revenue loss. Thus, understanding the factors that cause patients to leave before treatment is complete is vital to mitigate and potentially eliminate these adverse effects. This paper proposes a framework for studying the factors that affect LBTC outcomes in EDs. The framework integrates machine learning, metaheuristic optimization, and model interpretation techniques. Metaheuristic optimization is used for hyperparameter optimization--one of the main challenges of machine learning model development. Three metaheuristic optimization algorithms are employed for optimizing the parameters of extreme gradient boosting (XGB), which are simulated annealing (SA), adaptive simulated annealing (ASA), and adaptive tabu simulated annealing (ATSA). The optimized XGB models are used to predict the LBTC outcomes for the patients under treatment in ED. The designed algorithms are trained and tested using four data groups resulting from the feature selection phase. The model with the best predictive performance is interpreted using SHaply Additive exPlanations (SHAP) method. The findings show that ATSA-XGB outperformed other mode configurations with an accuracy, area under the curve (AUC), sensitivity, specificity, and F1-score of 86.61%, 87.50%, 85.71%, 87.51%, and 86.60%, respectively. The degree and the direction of effects of each feature were determined and explained using the SHAP method.

cs.AI↗

arXiv2022

An Adaptive Simulated Annealing-Based Machine Learning Approach for Developing an E-Triage Tool for Hospital Emergency Operations

Patient triage at emergency departments (EDs) is necessary to prioritize care for patients with critical and time-sensitive conditions. Different tools are used for patient triage and one of the most common ones is the emergency severity index (ESI), which has a scale of five levels, where level 1 is the most urgent and level 5 is the least urgent. This paper proposes a framework for utilizing machine learning to develop an e-triage tool that can be used at EDs. A large retrospective dataset of ED patient visits is obtained from the electronic health record of a healthcare provider in the Midwest of the US for three years. However, the main challenge of using machine learning algorithms is that most of them have many parameters and without optimizing these parameters, developing a high-performance model is not possible. This paper proposes an approach to optimize the hyperparameters of machine learning. The metaheuristic optimization algorithms simulated annealing (SA) and adaptive simulated annealing (ASA) are proposed to optimize the parameters of extreme gradient boosting (XGB) and categorical boosting (CaB). The newly proposed algorithms are SA-XGB, ASA-XGB, SA-CaB, ASA-CaB. Grid search (GS), which is a traditional approach used for machine learning fine-tunning is also used to fine-tune the parameters of XGB and CaB, which are named GS-XGB and GS-CaB. The six algorithms are trained and tested using eight data groups obtained from the feature selection phase. The results show ASA-CaB outperformed all the proposed algorithms with accuracy, precision, recall, and f1 of 83.3%, 83.2%, 83.3%, 83.2%, respectively.

cs.AI↗

arXiv2022

An Integrated Optimization and Machine Learning Models to Predict the Admission Status of Emergency Patients

This work proposes a framework for optimizing machine learning algorithms. The practicality of the framework is illustrated using an important case study from the healthcare domain, which is predicting the admission status of emergency department (ED) patients (e.g., admitted vs. discharged) using patient data at the time of triage. The proposed framework can mitigate the crowding problem by proactively planning the patient boarding process. A large retrospective dataset of patient records is obtained from the electronic health record database of all ED visits over three years from three major locations of a healthcare provider in the Midwest of the US. Three machine learning algorithms are proposed: T-XGB, T-ADAB, and T-MLP. T-XGB integrates extreme gradient boosting (XGB) and Tabu Search (TS), T-ADAB integrates Adaboost and TS, and T-MLP integrates multi-layer perceptron (MLP) and TS. The proposed algorithms are compared with the traditional algorithms: XGB, ADAB, and MLP, in which their parameters are tunned using grid search. The three proposed algorithms and the original ones are trained and tested using nine data groups that are obtained from different feature selection methods. In other words, 54 models are developed. Performance was evaluated using five measures: Area under the curve (AUC), sensitivity, specificity, F1, and accuracy. The results show that the newly proposed algorithms resulted in high AUC and outperformed the traditional algorithms. The T-ADAB performs the best among the newly developed algorithms. The AUC, sensitivity, specificity, F1, and accuracy of the best model are 95.4%, 99.3%, 91.4%, 95.2%, 97.2%, respectively.

cs.LG↗

arXiv2021

An Integrated Vaccination Site Selection and Dose Allocation Problem with Fairness Concerns

Fairness in vaccination is not only important from a social justice point of view, but experience has shown that a fair distribution of vaccine proves more effective in public immunization by preventing highly-concentrated infected areas to form among the population. In this paper, we address fairness from two simultaneous points of view: equity and accessibility. Equity in our setting means that as far as possible, each demand zone should receive a fair-share of the total doses available. On the other hand, accessibility means that as far as possible, each demand zone should have equal travel distance to access their assigned vaccination site.

math.OC↗

arXiv2021

Dynamics of Equity, Efficiency, and Efficacy in Home Health Care with Patient and Caregiver Preferences

There are three main entities in an HHC setting: the firm, the caregivers, and the patients. Often times the interests of each group of entities conflict with the other two. Whether a non-profit or a for-profit HHC, the firm generally seeks efficiency in terms of maximum utilization of the resources and highest level of care provided to the patients. Caregivers, seek a fair utilization across the network in order to increase job satisfaction. Finally, the patients seek maximum satisfaction level and a fair share of the care provided by the firm. Therefore, looking at HHCs from either one of these lenses by themselves leads to decisions that may neglect the interests of the others. The goal of this paper is to integrate the objectives of these three groups into one place and study their dynamics.

math.OC↗