Abstract
Chronic obstructive pulmonary disease (COPD) is a global burden, which is estimated to be the third leading cause of death worldwide by 2030. The economic burden of COPD grows continuously because it is not a curable disease. These conditions make COPD an important research field of artificial intelligence (AI) techniques in medicine. In this study, an integrated approach of the statistical-based fuzzy cognitive maps (SBFCM) and artificial neural networks (ANN) is proposed for predicting length of hospital stay of patients with COPD, who admitted to the hospital with an acute exacerbation. The SBFCM method is developed to determine the input variables of the ANN model. The SBFCM conducts statistical analysis to prepare preliminary information for the experts and then collects expert opinions accordingly, to define a conceptual map of the system. The integration of SBFCM and ANN methods provides both statistical data and expert opinion in the prediction model. In the numerical application, the proposed approach outperformed the conventional approach and other machine learning algorithms with 79.95% accuracy, revealing the power of expert opinion involvement in medical decisions. A medical decision support framework is constructed for better prediction of length of hospital stay and more effective hospital management.
Graphical abstract
Similar content being viewed by others
References
Mundt M, Thomsen W, Witter T, Koeppe A, David S, Bamer F, Potthast W, Markert B (2020) Prediction of lower limb joint angles and moments during gait using artificial neural networks. Med Biol Eng Comput 58(1):211–225. https://doi.org/10.1007/s11517-019-02061-3
Yavuz E, Eyupoglu C (2020) An effective approach for breast cancer diagnosis based on routine blood analysis features. Med Biol Eng Comput 58(7):1583–1601. https://doi.org/10.1007/s11517-020-02187-9
WHO (2007) Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. World Health Organization
Adeyemi S, Demir E, Chaussalet T (2013) Towards an evidence-based decision making healthcare system management: modelling patient pathways to improve clinical outcomes. Decis Support Syst 55(1):117–125. https://doi.org/10.1016/j.dss.2012.12.039
Nava R, Escalante-Ramirez B, Cristobal G, Estepar RS (2014) Extended Gabor approach applied to classification of emphysematous patterns in computed tomography. Med Biol Eng Comput 52(4):393–403. https://doi.org/10.1007/s11517-014-1139-9
Sanchez-Morillo D, Fernandez-Granero MA, Jimenez AL (2015) Detecting COPD exacerbations early using daily telemonitoring of symptoms and k-means clustering: a pilot study. Med Biol Eng Comput 53(5):441–451. https://doi.org/10.1007/s11517-015-1252-4
Agarwal A, Baechle C, Behara R, Zhu X (2018) A natural language processing framework for assessing hospital readmissions for patients with COPD. IEEE J Biomed Health 22(2):588–596. https://doi.org/10.1109/JBHI.2017.2684121
Laskar MR, Chatterjee S, Das A (2018) Design of an integrated system for modeling of functional air quality index integrated with health-GIS using Bayesian neural network. J Indian Soc Remote Sens:1–11. https://doi.org/10.1007/s12524-017-0724-4
Andrés-Blanco AM, Álvarez D, Crespo A, Arroyo CA, Cerezo-Hernández A, Gutiérrez-Tobal GC, Hornero R, Del Campo F (2017) Assessment of automated analysis of portable oximetry as a screening test for moderate-to-severe sleep apnea in patients with chronic obstructive pulmonary disease. PLoS One 12(11). https://doi.org/10.1371/journal.pone.0188094
Filho PPR, Barros ACDS, Ramalho GLB, Pereira CR, Papa JP, de Albuquerque VHC, Tavares JMRS (2017) Automated recognition of lung diseases in CT images based on the optimum-path forest classifier. Neural Comput & Applic:1–14. https://doi.org/10.1007/s00521-017-3048-y
Raja BS, Babu TR (2017) A novel feature selection based parallel ensemble classification model for COPD detection. Int J Pure Appl Math 117(19 Special Issue):283–291
Moretz C, Zhou Y, Dhamane AD, Burslem K, Saverno K, Jain G, Devercelli G, Kaila S, Ellis JJ, Hernandez G, Renda A (2015) Development and validation of a predictive model to identify individuals likely to have undiagnosed chronic obstructive pulmonary disease using an administrative claims database. J Manag Care Pharm 21(12):1149–1159
Badnjevic A, Cifrek M, Koruga D, Osmankovic D (2015) Neuro-fuzzy classification of asthma and chronic obstructive pulmonary disease. BMC Med Inform Decis Mak 15(3). https://doi.org/10.1186/1472-6947-15-S3-S1
Dias A, Gorzelniak L, Schultz K, Wittmann M, Rudnik J, Jörres R, Horsch A (2014) Classification of exacerbation episodes in chronic obstructive pulmonary disease patients. Methods Inf Med 53(2):108–114. https://doi.org/10.3414/ME12-01-0108
Mohktar MS, Redmond SJ, Antoniades NC, Rochford PD, Pretto JJ, Basilakis J, Lovell NH, McDonald CF (2015) Predicting the risk of exacerbation in patients with chronic obstructive pulmonary disease using home telehealth measurement data. Artif Intell Med 63(1):51–59. https://doi.org/10.1016/j.artmed.2014.12.003
van der Heijden M, Lucas PJF (2013) Describing disease processes using a probabilistic logic of qualitative time. Artif Intell Med 59(3):143–155. https://doi.org/10.1016/j.artmed.2013.09.003
Mobley BA, Leasure R, Davidson L (1995) Artificial neural network predictions of lengths of stay on a post-coronary care unit. Heart Lung 24(3):251–256
Kim WO, Kil HK, Kang JW, Park HH (2000) Prediction on lengths of stay in the postanesthesia care unit following general anesthesiai preliminary study of the neural. J Korean Med Sci 15:25–30
Launay C, Rivière H, Kabeshova A, Beauchet O (2015) Predicting prolonged length of hospital stay in older emergency department users: use of a novel analysis method, the Artificial Neural Network. Eur J Intern Med 26(7):478–482
LaFaro RJ, Pothula S, Kubal KP, Inchiosa ME, Pothula VM, Yuan SC, Maerz DA, Montes L, Oleszkiewicz SM, Yusupov A (2015) Neural network prediction of ICU length of stay following cardiac surgery based on pre-incision variables. PLoS One 10(12):e0145395
Tsai P-FJ, Chen P-C, Chen Y-Y, Song H-Y, Lin H-M, Lin F-M, Huang Q-P (2016) Length of hospital stay prediction at the admission stage for cardiology patients using artificial neural network. J Healthc Eng 2016
Rowan M, Ryan T, Hegarty F, O’Hare N (2007) The use of artificial neural networks to stratify the length of stay of cardiac patients based on preoperative and initial postoperative factors. Artif Intell Med 40(3):211–221. https://doi.org/10.1016/j.artmed.2007.04.005
Corizzo R, Pio G, Ceci M, Malerba D (2019) DENCAST: Distributed density-based clustering for multi-target regression. Journal of Big Data 6(1):43
Georga EI, Protopappas VC, Ardigò D, Marina M, Zavaroni I, Polyzos D, Fotiadis DI (2012) Multivariate prediction of subcutaneous glucose concentration in type 1 diabetes patients based on support vector regression. IEEE J Biomed Health Inform 17(1):71–81
Apte C, Damerau F, Weiss S (1998) Text mining with decision rules and decision trees. Citeseer,
Corizzo R, Ceci M, Fanaee-T H, Gama J (2020) Multi-aspect renewable energy forecasting. Inf Sci 546:701–722
Yuan H, Paskov I, Paskov H, González AJ, Leslie CS (2016) Multitask learning improves prediction of cancer drug sensitivity. Sci Rep 6:31619
Pio G, Ceci M, Prisciandaro F, Malerba D (2020) Exploiting causality in gene network reconstruction based on graph embedding. Mach Learn 109(6):1231–1279
Barracchia EP, Pio G, D’Elia D, Ceci M (2020) Prediction of new associations between ncRNAs and diseases exploiting multi-type hierarchical clustering. BMC bioinformatics 21(1):1–24
Jiang X, Zhao J, Qian W, Song W, Lin GN (2020) A generative adversarial network model for disease gene prediction with RNA-seq data. IEEE Access 8:37352–37360
Karan B, Sahu SS, Mahto K (2020) Parkinson disease prediction using intrinsic mode function based features from speech signal. Biocybern Biomed Eng 40(1):249–264
Li Z, Zhu J, Xu X, Yao Y (2019) RDense: a protein-RNA binding prediction model based on bidirectional recurrent neural network and densely connected convolutional networks. IEEE Access 8:14588–14605
Goker N, Dursun M, Cedolin M (2020) A novel IFCM integrated distance based hierarchical intuitionistic decision making procedure for agile supplier selection. J Intell Fuzzy Syst 38(1):653–662. https://doi.org/10.3233/jifs-179438
Ross TJ (2010) Fuzzy logic with engineering applications, 3rd edn. John Wiley, Chichester, U.K.
Panchal G, Panchal M (2014) Review on methods of selecting number of hidden nodes in artificial neural network. International Journal of Computer Science and Mobile. Computing 3(11):455–464
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383. https://doi.org/10.1016/0021-9681(87)90171-8
Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, Chen R, Decramer M, Fabbri LM, Frith P, Halpin DMG, Varela MVL, Nishimura M, Roche N, Rodriguez-Roisin R, Sin DD, Singh D, Stockley R, Vestbo J, Wedzicha JA, Agustí A (2017) Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary American. Am J Respir Crit Care Med 195(5):557–582. https://doi.org/10.1164/rccm.201701-0218PP
Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J (1999) Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 54(7):581–586
Buyukavcu A, Albayrak YE, Goker N (2016) A fuzzy information-based approach for breast cancer risk factors assessment. Appl Soft Comput 38:437–452. https://doi.org/10.1016/j.asoc.2015.09.026
Walczak S, Cerpa N (1999) Heuristic principles for the design of artificial neural networks. Inf Softw Technol 41(2):107–117. https://doi.org/10.1016/s0950-5849(98)00116-5
Karsoliya S (2012) Approximating number of hidden layer neurons in multiple hidden layer BPNN architecture. Int J Eng Technol 3(6):714–717
Acknowledgments
The authors are grateful to chest disease specialists Assoc. Prof. Gülfidan Aras MD and Zehra Dilek Kanmaz MD, who contributed with their valuable insight and expertise. The authors also thank to Özlem Yılmaz Ünlü MD for her contribution in collecting patient data.
Funding
This study is supported by the Galatasaray University Research Fund.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval and consent to participate
Informed consent for participation and publication was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Dogu, E., Albayrak, Y.E. & Tuncay, E. Length of hospital stay prediction with an integrated approach of statistical-based fuzzy cognitive maps and artificial neural networks. Med Biol Eng Comput 59, 483–496 (2021). https://doi.org/10.1007/s11517-021-02327-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11517-021-02327-9