Автор |
Somoza, Eugene |
Автор |
Somoza, John, R. |
Дата выпуска |
1993 |
dc.description |
Clinical decision making is based on recognizing complex patterns of patients' signs and symptoms. Neural networks have been shown to be very effective at this type of pattern recognition, and in this study a neural-network approach was used to predict which patients seen in a psychiatric emergency room required admission and which did not. Data from all walk-in patients (N = 658) evaluated during normal working hours in a psychiatric emergency room during a one-year period were used either to train a neural network or to test its performance. The network had 53 input nodes, one hidden layer, and an output layer with a single node. The back-propagation method was used to train the network. The neural network's admitting decisions were in substantial agreement with those of the clinicians (kappa coefficient = 0.63). When used as a diagnostic test for admission it had a specificity of 94%, a sensitivity of 70%, and an overall accuracy of 91%. The information gain was 35% of that of a perfect diagnostic test. These results show that a neural network can be trained to make clinical decisions that are in substantial agreement with those of experienced cli nicians. Key words: neural networks; admission decisions; pattern recognition; psychiatric emergency room. (Med Decis Making 1993;13:273-280) |
Издатель |
Sage Publications |
Название |
A Neural-network Approach to Predicting Admission Decisions in a Psychiatric Emergency Room |
Тип |
Journal Article |
DOI |
10.1177/0272989X9301300402 |
Print ISSN |
0272-989X |
Журнал |
Medical Decision Making |
Том |
13 |
Первая страница |
273 |
Последняя страница |
280 |
Выпуск |
4 |
Библиографическая ссылка |
Feigelson EB , Davis EB, Mackinnon R., Shands HC, Schwartz CC The decision to hospitalize. Am J Psychiat. 1978;135;354-7. 2. Mezzich JE, Evanczuk KJ, Mathias RJ, Coffman GA Symptoms and hospital decisions. Am J Psychiat. 1984A;141:764-9. |
Библиографическая ссылка |
Tischler GLDecision-making process in the emergency room. Arch Gen Psychiat.1966;14:69-78. |
Библиографическая ссылка |
Baxter S., Chodorkoff B., Underhill R.Psychiatric emergencies: dispositional determinants and the validity of the decision to admit. Am J Psychiat.1968;124:1542-8. |
Библиографическая ссылка |
Mendel WM, Rapport S.Determinants of the decision for psychiatric hospitalization. Arch Gen Psychiat.1969;20:321-8. |
Библиографическая ссылка |
Streiner DL, Goodman JT, Woodard CACorrelates of the hospitalization decision: a replicative study. Can J Public Health.1975;66:411-5. |
Библиографическая ссылка |
Evenson R., Waite J., Holland R.Admission decisions in the psychiatric emergency room. Comp Psychiat.1983;24:90-3. |
Библиографическая ссылка |
Mezzich JE, Evanczuk KJ, Mathias RJ, Coffman GAAdmission decisions and multiaxial diagnosis. Arch Gen Psychiat.1948B;41:1001-4. |
Библиографическая ссылка |
Amit DJ, Modeling Brain Function: The World of Attractor Neural Networks. New York: Cambridge University Press, 1989. |
Библиографическая ссылка |
Qian N., Sejnowski, TJPredicting the secondary structure of globular proteins using neural network models. J Molec Biol.1988;202:865-84. |
Библиографическая ссылка |
Fukushima K. , Miyake S., Takayuki I. Neocognition: a neural network model for a mechanism of visual pattern recognition. IEEE Trans Systems Manual Cybernetics. 1983;13:826-34. |
Библиографическая ссылка |
Rhoades HM, Overall JEThe semistructured BPRS interview and rating guide. Psychopharmacol Bull.1988;24:101-4. |
Библиографическая ссылка |
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R. Washington, D.C.: American Psychiatric Association , 1984. |
Библиографическая ссылка |
Hopfield JJNeural networks and physical systems with emergent collective computational abilities. Proc Natl Acad Sci USA.1982;79:2554-8. |
Библиографическая ссылка |
Hertz J., Krogh A., Palmer RGIntroduction to the Theory of Neural Computation. Redwood City, CA: Addison-Wesley, 1991. |
Библиографическая ссылка |
Rumelhart DE, McClelland JLParallel Distributed Processing— Explorations in the Microstructure of Cognition. Volume 1. Cambridge, MA: MIT Press, 1988. |
Библиографическая ссылка |
Lippman RPAn introduction to computing with neural nets. IEEE ASSP Magazine , 1987, pp. 4-22. |
Библиографическая ссылка |
Dayhoff JENeural Network Architectures. New York: Van Nor-strand Reinhold, 1991. |
Библиографическая ссылка |
Freeman JA, Skapura DMNeural Networks: Algorithms, Applications, and Programming Techniques. Reading, MA: Addison-Wesley, 1991 ;89-125. |
Библиографическая ссылка |
Klimasauskas CCNeuralWare Inc., Pittsburgh, PA 15143, 1990. 21. Rosner B. Fundamentals of Biostatistics. 2nd edition. Boston: Duxbury Press, 1986;424-9. |
Библиографическая ссылка |
Kraemer HCRamifications of a population model for k as a coefficient of reliability . Psychometrika. 1979;44:461-72. |
Библиографическая ссылка |
Somoza E., Mossman D.Optimizing REM latency as a diagnostic test for depression using receiver operating characteristic analysis and information theory. Biol Psychiat.1990;27:990-1006. |
Библиографическая ссылка |
Somoza E., Soutullo-Esperon L., Mossman D.Evaluation and optimization of diagnostic tests using receiver operating characteristic analysis and information theory. Int J Biomed Comput, 1989;24:153-89. |
Библиографическая ссылка |
McNeil BJ, Keeler E., Adelstein SJPrimer on certain elements of medical decision making. N Engl J Med.1975;293:211-5. |
Библиографическая ссылка |
Somoza E., Mossman D.Introduction to neuropsychiatric decision making: binary diagnostic tests . J Neuropsychiat. 1990;2:297-300. |
Библиографическая ссылка |
Mossman D., Somoza E.Neuropsychiatric decision making: the role of disorder prevalence in diagnostic testing. J Neuropsychiat.1991;3:84-8. |
Библиографическая ссылка |
Landis JR, Koch GGThe measurement of observer agreement for categorical data. Biometrics.1977;33:159-74. |
Библиографическая ссылка |
Schwartz WB , Patil RS, Szolovits P. Artificial intelligence in medicine : where do we stand? N Engl J Med. 1987;316:685-8. |
Библиографическая ссылка |
Mulsant BHA neural network as an approach to clinical diagnosis. MD Comput.1990;7:25-36. |
Библиографическая ссылка |
Meistrell MLEvaluation of neural network performance by receiver operating characteristic analysis: examples from the biotechnology domain. Comp Meth Progr Biomed.1990;32:73-80. |
Библиографическая ссылка |
Somoza E., Mossman D.Comparing diagnostic tests using information theory: the INFO-ROC technique . J Neuropsychiat Clin Neurosci. 1992;4:214-9. |
Библиографическая ссылка |
Somoza E., Mossman D.Comparing and optimizing diagnostic tests: an information-theoretical approach . Med Decis Making. 1992;12:179-88. |
Библиографическая ссылка |
Somoza E., Mossman D. "Biological markers" and psychiatric diagnosis: risk-benefit balancing using ROC analysis. Biol Psychiat. 1991;29:811-26. |
Библиографическая ссылка |
Mossman D., Somoza E.Balancing risks and benefits: another approach to optimizing diagnostic tests . J Neuropsychiat Clin Neurosci. 1992;4:331-5. |
Библиографическая ссылка |
Localio AR, Lawthers AG, Bengtson JM, et al. Relationship between malpractice claims and cesarean delivery . JAMA. 1993; 843-8. |