4.6 Article

Predict or draw blood: An integrated method to reduce lab tests

Journal

JOURNAL OF BIOMEDICAL INFORMATICS
Volume 104, Issue -, Pages -

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.jbi.2020.103394

Keywords

Time series data; Clinical informatics; Laboratory test reduction; Recurrent neural network; Combinatorial optimization

Funding

  1. UTHealth startup funding
  2. National Institute of General Medical Sciences [R01GM124111]
  3. CPRIT Rising Stars Award [RR180012]
  4. Center for Clinical and Translational Sciences (NCATS) [1 U54 TR002804-01, U01 TR002062]
  5. National Library of Medicine [R01LM011829]
  6. Christopher Sarofim Family Professorship
  7. PCORI [CDRN-130604608]
  8. Reynolds and Reynolds Professorship in Clinical Informatics
  9. Cancer Prevention Research Institute of Texas (CPRIT) Data Science and Informatics Core for Cancer Research [RP170668]
  10. Tsinghua Scholarship for Overseas Graduate Studies

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Serial laboratory testing is common, especially in Intensive Care Units (ICU). Such repeated testing is expensive and may even harm patients. However, identifying specific tests that can be omitted is challenging. The search space of different lab tests is large and the optimal reduction is hard to determine without modeling the time trajectory of decisions, which is a nontrivial optimization problem. In this paper, we propose a novel deep-learning method with a very concise architecture to jointly predict future lab test events to be omitted and the values of the omitted events based on observed testing values. Using our method, we were able to omit 15% of lab tests with <5% prediction accuracy loss. Although the application is specific to repeated lab tests, our proposed framework is highly generalizable and can be used to tackle a family of similar business decision making problems.

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