학술논문

Predicting opioid dependence from electronic health records with machine learning
Document Type
article
Source
BioData Mining, Vol 12, Iss 1, Pp 1-19 (2019)
Subject
Opioid epidemic
Opioid dependence
Electronic health records
Electronic medical records
Machine learning
Artificial intelligence
Computer applications to medicine. Medical informatics
R858-859.7
Analysis
QA299.6-433
Language
English
ISSN
1756-0381
Abstract
Abstract Background The opioid epidemic in the United States is averaging over 100 deaths per day due to overdose. The effectiveness of opioids as pain treatments, and the drug-seeking behavior of opioid addicts, leads physicians in the United States to issue over 200 million opioid prescriptions every year. To better understand the biomedical profile of opioid-dependent patients, we analyzed information from electronic health records (EHR) including lab tests, vital signs, medical procedures, prescriptions, and other data from millions of patients to predict opioid substance dependence. Results We trained a machine learning model to classify patients by likelihood of having a diagnosis of substance dependence using EHR data from patients diagnosed with substance dependence, along with control patients with no history of substance-related conditions, matched by age, gender, and status of HIV, hepatitis C, and sickle cell disease. The top machine learning classifier using all features achieved a mean area under the receiver operating characteristic (AUROC) curve of ~ 92%, and analysis of the model uncovered associations between basic clinical factors and substance dependence. Additionally, diagnoses, prescriptions, and procedures prior to the diagnoses of substance dependence were analyzed to elucidate the clinical profile of substance-dependent patients, relative to controls. Conclusions The predictive model may hold utility for identifying patients at risk of developing dependence, risk of overdose, and opioid-seeking patients that report other symptoms in their visits to the emergency room.