Abstract
Remote Patient Monitoring (RPM) in cardiac surgery can become valuable for clinicians to follow patients post-discharge closely. However, these services require additional and frequently limited human and technical resources. We present the CardioFollow.AI Framework, a decision support system to assist doctors in selecting patients to be monitored remotely. Currently supporting a clinical trial, it leverages a Machine Learning model to predict the risk of post-discharge complications. Interpretable assessments are included so that clinicians can evaluate individual predictions. Additionally, the user-friendly interface of the CardioFollow.AI Framework enhances the follow-up of discharged patients by granting access to centralised information. This paper outlines the design and implementation of the CardioFollow.AI Framework and its potential impact on improving personalised patient careq.
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References
Allyn, J., et al.: A comparison of a machine learning model with euroscore ii in predicting mortality after elective cardiac surgery: a decision curve analysis. PLoS ONE 12 (2017). https://doi.org/10.1371/journal.pone.0169772
Azevedo, S., et al.: Scaling-up digital follow-up care services: collaborative development and implementation of remote patient monitoring pilot initiatives to increase access to follow-up care. Front. Digit. Health 4 (2022)
Breiman, L.: Random forests. Mach. Learn. 45, 5–32 (2001). https://doi.org/10.1023/a:1010933404324
Caruso, E., Zadra, A.R.: The trade-off between costs and outcome after cardiac surgery. Evidence from an Italian administrative registry. Health Policy 124(12), 1345–1353 (2020). https://doi.org/10.1016/j.healthpol.2020.09.005
Django Software Foundation: Django. https://djangoproject.com
Efthymiou, C.A., O’regan, D.J.: Postdischarge complications: what exactly happens when the patient goes home? Interact. Cardiovasc. Thorac. Surg. 12(2), 130–134 (2011). https://doi.org/10.1510/icvts.2010.249474
Fan, Y., et al. Development of machine learning models for mortality risk prediction after cardiac surgery. Cardiovasc. Diagnosis Therapy 12(1), 12–23 (2022). https://doi.org/10.21037/cdt-21-648
Farias, F.A.C.d., Dagostini, C.M., Bicca, Y.d.A., Falavigna, V.F., Falavigna, A.: Remote patient monitoring: a systematic review. Telemedicine e-Health 26(5), 576–583 (2020). https://doi.org/10.1089/tmj.2019.0066
Hart, S.: Shapley Value, pp. 210–216. Palgrave Macmillan UK, London (1989). https://doi.org/10.1007/978-1-349-20181-5_25
Khoury, H., et al.: Readmission following surgical aortic valve replacement in the United States. Ann. Thorac. Surg. 110(3), 849–855 (2020). https://doi.org/10.1016/j.athoracsur.2019.11.058
Lundberg, S.M., et al.: From local explanations to global understanding with explainable AI for trees. Nat. Mach. Intell. 2(1), 2522–5839 (2020). https://doi.org/10.1038/s42256-019-0138-9
Lundberg, S.M., Lee, S.I.: A unified approach to interpreting model predictions. In: Guyon, I., et al. (eds.) Advances in Neural Information Processing Systems, vol. 30, pp. 4765–4774. Curran Associates, Inc. (2017)
Mortazavi, B., et al.: Prediction of adverse events in patients undergoing major cardiovascular procedures. IEEE J. Biomed. Health Inform. 21, 1719–1729 (2017). https://doi.org/10.1109/JBHI.2017.2675340
Nashef, S.A.M., et al.: Euroscore ii. Eur. J. Cardio-thoracic Surg. Off. J. Eur. Assoc. Cardio-thoracic Surg. 41(4), 734–44 (2012). https://doi.org/10.1093/ejcts/ezs043
Pahwa, S., et al.: Impact of postoperative complications after cardiac surgery on long-term survival. J. Card. Surg. 36, 2045–2052 (2021). https://doi.org/10.1111/jocs.15471
Park, D.K., et al.: Telecare system for cardiac surgery patients: implementation and effectiveness. Healthc. Inform. Res. 17, 93–100 (2011). https://doi.org/10.4258/hir.2011.17.2.93
Sanchez, C.E., et al.: Predictors and risk calculator of early unplanned hospital readmission following contemporary self-expanding transcatheter aortic valve replacement from the STS/ACC TVT-registry. Cardiovasc. Revascularization Med. Including Mol. Interventions 21(3), 263–270 (2020). https://doi.org/10.1016/j.carrev.2019.05.032
Seese, L.M., et al.: The impact of major postoperative complications on long-term survival after cardiac surgery. Ann. Thorac. Surg. 110(1), 128–135 (2019). https://doi.org/10.1016/j.athoracsur.2019.09.100
Shahian, D.M., et al.: The society of thoracic surgeons 2018 adult cardiac surgery risk models: part 1-background, design considerations, and model development. Ann. Thorac. Surg. 105(5), 1411–1418 (2018). https://doi.org/10.1016/j.athoracsur.2018.03.002
Sullivan, P., Wallach, J.D., Ioannidis, J.P.A.: Meta-analysis comparing established risk prediction models (euroscore ii, STS score, and ACEF score) for perioperative mortality during cardiac surgery. Am. J. Cardiol. 118(10), 1574–1582 (2016). https://doi.org/10.1016/j.amjcard.2016.08.024
Zhao, H.: Instance weighting versus threshold adjusting for cost-sensitive classification. Knowl. Inf. Syst. 15, 321–334 (2008). https://doi.org/10.1007/s10115-007-0079-1
Acknowledgements
This work refers to the project “CardioFollow.AI: An intelligent system to improve patients’ safety and remote surveillance in follow-up for cardiothoracic surgery”, and is supported by ‘FCT - Portuguese Foundation for Science and Technology, I.P.’, with the reference DSAIPA/AI/0094/2020.
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Santos, R. et al. (2023). A Risk Prediction Framework to Optimize Remote Patient Monitoring Following Cardiothoracic Surgery. In: De Francisci Morales, G., Perlich, C., Ruchansky, N., Kourtellis, N., Baralis, E., Bonchi, F. (eds) Machine Learning and Knowledge Discovery in Databases: Applied Data Science and Demo Track. ECML PKDD 2023. Lecture Notes in Computer Science(), vol 14175. Springer, Cham. https://doi.org/10.1007/978-3-031-43430-3_32
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