Accuracy of the Epic Sepsis Prediction Model in a Regional Health System

Interest in an electronic health record-based computational model that can accurately predict a patient's risk of sepsis at a given point in time has grown rapidly in the last several years. Like other EHR vendors, the Epic Systems Corporation has developed a proprietary sepsis prediction model (ESPM). Epic developed the model using data from three health systems and penalized logistic regression. Demographic, comorbidity, vital sign, laboratory, medication, and procedural variables contribute to the model. The objective of this project was to compare the predictive performance of the ESPM with a regional health system's current Early Warning Score-based sepsis detection program.

Equivalence of Kernel Machine Regression and Kernel Distance Covariance for Multidimensional Trait Association Studies

Associating genetic markers with a multidimensional phenotype is an important yet challenging problem. In this work, we establish the equivalence between two popular methods: kernel-machine regression (KMR), and kernel distance covariance (KDC). KMR is a semiparametric regression frameworks that models the covariate effects parametrically, while the genetic markers are considered non-parametrically. KDC represents a class of methods that includes distance covariance (DC) and Hilbert-Schmidt Independence Criterion (HSIC), which are nonparametric tests of independence. We show the equivalence between the score test of KMR and the KDC statistic under certain conditions. This result leads to a novel generalization of the KDC test that incorporates the covariates. Our contributions are three-fold: (1) establishing the equivalence between KMR and KDC; (2) showing that the principles of kernel machine regression can be applied to the interpretation of KDC; (3) the development of a broader class of KDC statistics, that the members are the quantities of different kernels. We demonstrate the proposals using simulation studies. Data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) is used to explore the association between the genetic variants on gene \emph{FLJ16124} and phenotypes represented in 3D structural brain MR images adjusting for age and gender. The results suggest that SNPs of \emph{FLJ16124} exhibit strong pairwise interaction effects that are correlated to the changes of brain region volumes.