Developing an ICU scoring system with interaction terms using a genetic algorithm

ICU mortality scoring systems attempt to predict patient mortality using predictive models with various clinical predictors. Examples of such systems are APACHE, SAPS and MPM. However, most such scoring systems do not actively look for and include interaction terms, despite physicians intuitively taking such interactions into account when making a diagnosis. One barrier to including such terms in predictive models is the difficulty of using most variable selection methods in high-dimensional datasets. A genetic algorithm framework for variable selection with logistic regression models is used to search for two-way interaction terms in a clinical dataset of adult ICU patients, with separate models being built for each category of diagnosis upon admittance to the ICU. The models had good discrimination across all categories, with a weighted average AUC of 0.84 (>0.90 for several categories) and the genetic algorithm was able to find several significant interaction terms, which may be able to provide greater insight into mortality prediction for health practitioners. The GA selected models had improved performance against stepwise selection and random forest models, and provides greater flexibility in terms of variable selection by being able to optimize over any modeler-defined model performance metric instead of a specific variable importance metric.

An improved chromosome formulation for genetic algorithms applied to variable selection with the inclusion of interaction terms

Genetic algorithms are a well-known method for tackling the problem of variable selection. As they are non-parametric and can use a large variety of fitness functions, they are well-suited as a variable selection wrapper that can be applied to many different models. In almost all cases, the chromosome formulation used in these genetic algorithms consists of a binary vector of length n for n potential variables indicating the presence or absence of the corresponding variables. While the aforementioned chromosome formulation has exhibited good performance for relatively small n, there are potential problems when the size of n grows very large, especially when interaction terms are considered. We introduce a modification to the standard chromosome formulation that allows for better scalability and model sparsity when interaction terms are included in the predictor search space. Experimental results show that the indexed chromosome formulation demonstrates improved computational efficiency and sparsity on high-dimensional datasets with interaction terms compared to the standard chromosome formulation.