arXiv subjects

Lasith Adhikari

Publications and source records attributed to Lasith Adhikari.

5 recordsLinked to original sources

arXiv2019

Added Value of Intraoperative Data for Predicting Postoperative Complications: Development and Validation of a MySurgeryRisk Extension

To test the hypothesis that accuracy, discrimination, and precision in predicting postoperative complications improve when using both preoperative and intraoperative data input features versus preoperative data alone. Models that predict postoperative complications often ignore important intraoperative physiological changes. Incorporation of intraoperative physiological data may improve model performance. This retrospective cohort analysis included 52,529 inpatient surgeries at a single institution during a 5 year period. Random forest machine learning models in the validated MySurgeryRisk platform made patient-level predictions for three postoperative complications and mortality during hospital admission using electronic health record data and patient neighborhood characteristics. For each outcome, one model trained with preoperative data alone and one model trained with both preoperative and intraoperative data. Models were compared by accuracy, discrimination (expressed as AUROC), precision (expressed as AUPRC), and reclassification indices (NRI). Machine learning models incorporating both preoperative and intraoperative data had greater accuracy, discrimination, and precision than models using preoperative data alone for predicting all three postoperative complications (intensive care unit length of stay >48 hours, mechanical ventilation >48 hours, and neurological complications including delirium) and in-hospital mortality (accuracy: 88% vs. 77%, AUROC: 0.93 vs. 0.87, AUPRC: 0.21 vs. 0.15). Overall reclassification improvement was 2.9-10.0% for complications and 11.2% for in-hospital mortality. Incorporating both preoperative and intraoperative data significantly increased accuracy, discrimination, and precision for machine learning models predicting postoperative complications.

cs.CY↗

arXiv2019

DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning

Traditional methods for assessing illness severity and predicting in-hospital mortality among critically ill patients require time-consuming, error-prone calculations using static variable thresholds. These methods do not capitalize on the emerging availability of streaming electronic health record data or capture time-sensitive individual physiological patterns, a critical task in the intensive care unit. We propose a novel acuity score framework (DeepSOFA) that leverages temporal measurements and interpretable deep learning models to assess illness severity at any point during an ICU stay. We compare DeepSOFA with SOFA (Sequential Organ Failure Assessment) baseline models using the same model inputs and find that at any point during an ICU admission, DeepSOFA yields significantly more accurate predictions of in-hospital mortality. A DeepSOFA model developed in a public database and validated in a single institutional cohort had a mean AUC for the entire ICU stay of 0.90 (95% CI 0.90-0.91) compared with baseline SOFA models with mean AUC 0.79 (95% CI 0.79-0.80) and 0.85 (95% CI 0.85-0.86). Deep models are well-suited to identify ICU patients in need of life-saving interventions prior to the occurrence of an unexpected adverse event and inform shared decision-making processes among patients, providers, and families regarding goals of care and optimal resource utilization.

cs.LG↗

arXiv2018

Improved Predictive Models for Acute Kidney Injury with IDEAs: Intraoperative Data Embedded Analytics

Acute kidney injury (AKI) is a common and serious complication after a surgery which is associated with morbidity and mortality. The majority of existing perioperative AKI risk score prediction models are limited in their generalizability and do not fully utilize the physiological intraoperative time-series data. Thus, there is a need for intelligent, accurate, and robust systems, able to leverage information from large-scale data to predict patient's risk of developing postoperative AKI. A retrospective single-center cohort of 2,911 adult patients who underwent surgery at the University of Florida Health has been used for this study. We used machine learning and statistical analysis techniques to develop perioperative models to predict the risk of AKI (risk during the first 3 days, 7 days, and until the discharge day) before and after the surgery. In particular, we examined the improvement in risk prediction by incorporating three intraoperative physiologic time series data, i.e., mean arterial blood pressure, minimum alveolar concentration, and heart rate. For an individual patient, the preoperative model produces a probabilistic AKI risk score, which will be enriched by integrating intraoperative statistical features through a machine learning stacking approach inside a random forest classifier. We compared the performance of our model based on the area under the receiver operating characteristics curve (AUROC), accuracy and net reclassification improvement (NRI). The predictive performance of the proposed model is better than the preoperative data only model. For AKI-7day outcome: The AUC was 0.86 (accuracy was 0.78) in the proposed model, while the preoperative AUC was 0.84 (accuracy 0.76). Furthermore, with the integration of intraoperative features, we were able to classify patients who were misclassified in the preoperative model.

cs.CY↗

arXiv2017

Nonconvex Regularization Based Sparse Recovery and Demixing with Application to Color Image Inpainting

This work addresses the recovery and demixing problem of signals that are sparse in some general dictionary. Involved applications include source separation, image inpainting, super-resolution, and restoration of signals corrupted by clipping, saturation, impulsive noise, or narrowband interference. We employ the $\ell_q$-norm ($0 \le q < 1$) for sparsity inducing and propose a constrained $\ell_q$-minimization formulation for the recovery and demixing problem. This nonconvex formulation is approximately solved by two efficient first-order algorithms based on proximal coordinate descent and alternative direction method of multipliers (ADMM), respectively. The new algorithms are convergent in the nonconvex case under some mild conditions and scale well for high-dimensional problems. A convergence condition of the new ADMM algorithm has been derived. Furthermore, extension of the two algorithms for multi-channels joint recovery has been presented, which can further exploit the joint sparsity pattern among multi-channel signals. Various numerical experiments showed that the new algorithms can achieve considerable performance gain over the $\ell_1$-regularized algorithms.

cs.IT↗

arXiv2016

Trust-Region Methods for Sparse Relaxation

In this paper, we solve the l2-l1 sparse recovery problem by transforming the objective function of this problem into an unconstrained differentiable function and apply a limited-memory trust-region method. Unlike gradient projection-type methods, which uses only the current gradient, our approach uses gradients from previous iterations to obtain a more accurate Hessian approximation. Numerical experiments show that our proposed approach eliminates spurious solutions more effectively while improving the computational time to converge.

math.NA↗