Key result
Using the icuARM clinical decision support system, coagulopathy was identified as the comorbidity with the highest probability (54.1%) of leading to a prolonged ICU stay.
Observational (n=30,000)
No
The icuARM system demonstrates the feasibility of using association rule mining on large ICU databases to provide real-time, personalized clinical decision support and identify risk factors for prolonged ICU stays.
Hypothesis-generating for ICU risk stratification; leaves open prospective validation of association rule mining before clinical adoption.
The rapid development of biomedical monitoring technologies has enabled modern intensive care units (ICUs) to gather vast amounts of multimodal measurement data about their patients. However, processing large volumes of complex data in real-time has become a big challenge. Together with ICU physicians, we have designed and developed an ICU clinical decision support system icuARM based on associate rule mining (ARM), and a publicly available research database MIMIC-II (Multi-parameter Intelligent Monitoring in Intensive Care II) that contains more than 40,000 ICU records for 30,000+patients. icuARM is constructed with multiple association rules and an easy-to-use graphical user interface (GUI) for care providers to perform real-time data and information mining in the ICU setting. To validate icuARM, we have investigated the associations between patients' conditions such as comorbidities, demographics, and medications and their ICU outcomes such as ICU length of stay. Coagulopathy surfaced as the most dangerous co-morbidity that leads to the highest possibility (54.1%) of prolonged ICU stay. In addition, women who are older than 50 years have the highest possibility (38.8%) of prolonged ICU stay. For clinical conditions treatable with multiple drugs, icuARM suggests that medication choice can be optimized based on patient-specific characteristics. Overall, icuARM can provide valuable insights for ICU physicians to tailor a patient's treatment based on his or her clinical status in real time.
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Cheng et al. (2013) conducted an observational in Intensive care unit patients (n=30,000). icuARM (Clinical Decision Support System) was evaluated on Prolonged ICU stay (>3 days). Using the icuARM clinical decision support system, coagulopathy was identified as the comorbidity with the highest probability (54.1%) of leading to a prolonged ICU stay.
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