Conditional anomaly detection methods for patient-management alert systems

Anomaly detection methods can be very useful in identifying unusual or interesting patterns in data. A recently proposed conditional anomaly detection framework extends anomaly detection to the problem of identifying anomalous patterns on a subset of attributes in the data. The anomaly always depends (is conditioned) on the value of remaining attributes. The work presented in this paper focuses on instance-based methods for detecting conditional anomalies. The methods rely on the distance metric to identify examples in the dataset that are most critical for detecting the anomaly. We investigate various metrics and metric learning methods to optimize the performance of the instance-based anomaly detection methods. We show the benefits of the instance-based methods on two real-world detection problems: detection of unusual admission decisions for patients with the community-acquired pneumonia and detection of unusual orders of an HPF4 test that is used to confirm Heparin induced thrombocytopenia - a life-threatening condition caused by the Heparin therapy.

Conditional outlier detection for clinical alerting

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates.

Evidence-based anomaly detection in clinical domains

Anomaly detection methods can be very useful in identifying interesting or concerning events. In this work, we develop and examine new probabilistic anomaly detection methods that let us evaluate management decisions for a specific patient and identify those decisions that are highly unusual with respect to patients with the same or similar condition. The statistics used in this detection are derived from probabilistic models such as Bayesian networks that are learned from a database of past patient cases. We apply our methods to the problem of identifying unusual patient-management decisions in post-surgical cardiac patients.

Learning Adjustment Sets from Observational and Limited Experimental Data

Estimating causal effects from observational data is not always possible due to confounding. Identifying a set of appropriate covariates (adjustment set) and adjusting for their influence can remove confounding bias; however, such a set is typically not identifiable from observational data alone. Experimental data do not have confounding bias, but are typically limited in sample size and can therefore yield imprecise estimates. Furthermore, experimental data often include a limited set of covariates, and therefore provide limited insight into the causal structure of the underlying system. In this work we introduce a method that combines large observational and limited experimental data to identify adjustment sets and improve the estimation of causal effects. The method identifies an adjustment set (if possible) by calculating the marginal likelihood for the experimental data given observationally-derived prior probabilities of potential adjustmen sets. In this way, the method can make inferences that are not possible using only the conditional dependencies and independencies in all the observational and experimental data. We show that the method successfully identifies adjustment sets and improves causal effect estimation in simulated data, and it can sometimes make additional inferences when compared to state-of-the-art methods for combining experimental and observational data.

Proceedings of the Fourteenth Conference on Uncertainty in Artificial Intelligence (1998)

This is the Proceedings of the Fourteenth Conference on Uncertainty in Artificial Intelligence, which was held in Madison, WI, July 24-26, 1998