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A Tree-Based Decision Model to Support Prediction of the Severity of Asthma Exacerbations in Children

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Abstract

This paper describes the development of a tree-based decision model to predict the severity of pediatric asthma exacerbations in the emergency department (ED) at 2 h following triage. The model was constructed from retrospective patient data abstracted from the ED charts. The original data was preprocessed to eliminate questionable patient records and to normalize values of age-dependent clinical attributes. The model uses attributes routinely collected in the ED and provides predictions even for incomplete observations. Its performance was verified on independent validating data (split-sample validation) where it demonstrated AUC (area under ROC curve) of 0.83, sensitivity of 84%, specificity of 71% and the Brier score of 0.18. The model is intended to supplement an asthma clinical practice guideline, however, it can be also used as a stand-alone decision tool.

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Acknowledgements

The authors would like to thank William Klement and Morvarid Sehatkar from the School of Information Technology and Engineering, University of Ottawa for help with data analysis and Chris Drummond and Peter Turney from the National Research Council of Canada for advice about contextual normalization. The authors also would like to thank anonymous reviewers for helpful comments and suggestions. Research reported here was supported by NSERC-CIHR grant from the CHRP program.

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Authors and Affiliations

  1. Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON, Canada

    Ken Farion

  2. Telfer School of Management, University of Ottawa, 55 Laurier Ave East, Ottawa, ON, Canada, K1N 6N5

    Wojtek Michalowski, Szymon Wilk & Dympna O’Sullivan

  3. School of Information Technology and Engineering, University of Ottawa, Ottawa, ON, Canada

    Stan Matwin

  4. Institute of Computer Science, Polish Academy of Sciences, Warsaw, Poland

    Stan Matwin

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  1. Ken Farion
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Correspondence to Szymon Wilk.

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Farion, K., Michalowski, W., Wilk, S. et al. A Tree-Based Decision Model to Support Prediction of the Severity of Asthma Exacerbations in Children. J Med Syst 34, 551–562 (2010). https://doi.org/10.1007/s10916-009-9268-7

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