The health outcomes of high-need patients can be substantially influenced by the degree of patient engagement in their own care. The role of care managers includes that of enrolling patients into care programs and keeping them sufficiently engaged in the program, so that patients can attain various goals. The attainmen…
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48 results for “managed care”
This paper provides a ML framework for diabetes prediction and care management.
problem Diabetes prediction and care management challenges in real-world healthcare.
method Illustrates a Machine Learning framework for T2DM prediction and risk stratification.
result ML models align with physician's disease management steps.
Estimates causal effect of managed care plans on NYC Medicaid spending.
problem Generalizing causal estimates to a target population not well-represented by randomized studies.
method Conditional cross-design synthesis estimators combining randomized and observational data.
result Estimates causal effect of managed care plans on health care spending.
New AI model optimizes personalized care for elderly residents.
problem Limited care workforce impacts health outcomes and quality of life.
method Bandit algorithms for personalized care planning.
result Improves care quality and health outcomes through personalized care planning.
Study predicts high-cost patients using insurance claims data.
problem Accurately identifying high-cost patients to manage costs.
method Applied machine learning to health insurance claims data.
result Developed a high-performance algorithm with 91.2% AUC.
A Self-Attention Network for Hierarchical Data Structures with an Application to Claims Managementcs.LG
Insurance companies must manage millions of claims per year. While most of these claims are non-fraudulent, fraud detection is core for insurance companies. The ultimate goal is a predictive model to single out the fraudulent claims and pay out the non-fraudulent ones immediately. Modern machine learning methods are we…
Study shows racial bias in health data, which can be reduced with simple techniques.
problem Racial bias in health indicators measured by the Medical Expenditure Panel Survey (MEPS).
method Used publicly available and nationally representative MEPS data to show bias in predictive models for care management.
result Racial bias can be significantly reduced using simple mitigation techniques.
Predicting Length of Stay in the Intensive Care Unit with Temporal Pointwise Convolutional Networkscs.LG
New model predicts ICU patients' stay duration efficiently.
problem Efficient ICU bed allocation under resource constraints.
method Temporal Pointwise Convolution (TPC) model combining temporal and pointwise convolutions.
result Significant performance improvements over LSTM and Transformer models.
LMM predicts healthcare costs and risks with improved accuracy.
problem Wasteful healthcare spending and inefficiencies in risk prediction.
method Generative pre-trained transformer trained on patient event sequences.
result Improves cost prediction by 14.1% and chronic conditions prediction by 1.9%.
Modelo de maturidade em gerenciamento de riscos em projetos (Project Risk Management Model Maturity)q-fin.RM
The globalization feeded by the technology explosion that begans in the end of the last century, started the world to change faster every day. The only today's certain is the tomorrow's uncertain. Risk is defined as uncertain where one or many causes composed of ocurrence probality can generate an impact or consequence…
The study develops a logic reasoner to verify MS case management specifications.
problem Ensuring correctness and solvability of abstract clinical work products.
method Developed a logic reasoner using UML class and state diagrams, SPIN, and ODM.
result Formal representations of UML diagrams proved consistent for MS case management.
Enhances patient failure prediction using dynamic survival models.
problem Lack of precise individual level prediction in conventional models.
method Developed counterfactual dynamic survival model (CDSM).
result Inflection point of estimated survival curves predicts patient failure time.
Temporal Pointwise Convolutional Networks for Length of Stay Prediction in the Intensive Care Unitcs.LG
New model predicts ICU patient stays more accurately.
problem Efficient ICU bed allocation under resource constraints.
method Temporal Pointwise Convolutional Networks (TPC) combining temporal and pointwise convolutions.
result Significant performance improvements over LSTM and Transformer models.
Large Language Models-Enabled Digital Twins for Precision Medicine in Rare Gynecological Tumorscs.CL
Study uses LLMs to create personalized treatment plans for rare gynecological tumors.
problem Suboptimal management and poor prognosis due to low incidence and heterogeneity of rare gynecological tumors.
method Developed a digital twin system using LLMs to integrate clinical and biomarker data.
result LLM-enabled digital twins efficiently model individual patient trajectories and identify potential treatment options.
This paper develops explainable treatment policies for RPM using clinical knowledge.
problem Barriers to adoption of DHIs and lack of interpretability in purely black-box algorithms.
method Developed a pipeline for learning explainable treatment policies using clinician-informed representations.
result Policies learned from clinician-informed representations are more efficacious and efficient than black-box policies.
Neural system optimizes glucose levels in diabetics.
problem Limited research on continuous glucose maintenance devices.
method Differential predictive control with neural policy and differentiable modeling.
result Improves glucose level optimization in real-time.
Model predicts wound and episode-level readmission risk and time to re-admit.
problem Identify patients at high risk of re-admission to prevent wound recurrences and reduce healthcare costs.
method Data-driven analysis of wound care and episode-level patient data.
result Model achieves high recall and precision for predicting re-admission risk and time.
Develops a personalized reinforcement learning algorithm for dyadic health interventions.
problem Personalizing health interventions for dyadic relationships in mobile health.
method Dyadic Reinforcement Learning (dyadic RL), a Bayesian and hierarchical online algorithm.
result Established a regret bound and demonstrated empirical performance through simulations and real data.
Monitoring patients in ICU is a challenging and high-cost task. Hence, predicting the condition of patients during their ICU stay can help provide better acute care and plan the hospital's resources. There has been continuous progress in machine learning research for ICU management, and most of this work has focused on…
We introduce a novel apprenticeship learning algorithm to learn an expert's underlying reward structure in off-policy model-free \emph{batch} settings. Unlike existing methods that require a dynamics model or additional data acquisition for on-policy evaluation, our algorithm requires only the batch data of observed ex…
Study proposes managing COVID-19 without economy shutdowns.
problem Avoiding lockdowns while maintaining healthcare system capacity.
method Detailed heterogeneous epidemiological model, calibrated to data.
result Countries can avoid lockdowns if ICU beds per million > 100.
Improved TF-IDF for word relevance in health-care social media documents.
problem Determining word relevance in informal documents.
method Semantic Sensitive TF-IDF (STF-IDF) method.
result Decreased TF-IDF mean error rate by 50% to 13.7%.
This paper describes the Pressure Ulcers Online Website, which is a first step solution towards a new and innovative platform for helping people to detect, understand and manage pressure ulcers. It outlines the reasons why the project has been developed and provides a central point of contact for pressure ulcer analysi…
Prediction of Dilatory Behavior in eLearning: A Comparison of Multiple Machine Learning Modelsstat.ML
Study predicts online procrastination using machine learning.
problem Predicting procrastination in eLearning to prevent drop-outs.
method Comparison of multiple machine learning models with subjective and objective predictors.
result Models with objective predictors outperform those with subjective predictors.
Simplified proof for asset pricing theory.
problem Complexity in asset pricing theory.
method Accessible proof without real-world measure.
result No need for real-world measure for derivative securities.
In the Black-Scholes context we consider the probability distribution function (PDF) of financial returns implied by volatility smile and we study the relation between the decay of its tails and the fitting parameters of the smile. We show that, considering a scaling law derived from data, it is possible to get a new f…
Ability for accurate hospital case cost modelling and prediction is critical for efficient health care financial management and budgetary planning. A variety of regression machine learning algorithms are known to be effective for health care cost predictions. The purpose of this experiment was to build an Azure Machine…
Deep learning's success is puzzling from a statistical perspective.
problem Deep learning's success is puzzling from a statistical perspective.
method Physics-informed investigation of deep learning features and surprises.
result Neural scaling laws and their interplay with inductive biases.
Analyzes COVID-19 data to predict mortality, forecast spread, and optimize resource allocation.
problem Challenges in patient triage, treatment, and care management during the pandemic.
method Integrated four-step approach combining descriptive, predictive, and prescriptive analytics.
result Optimized resource allocation and informed policy decisions.
It is not clear how to target patients who are most likely to benefit from digital care management programs ex-ante, a shortcoming of current risk score based approaches. This study focuses on defining impactability by identifying those patients most likely to benefit from technology enabled care management, delivered …
Machine learning algorithms can misrepresent training data, study finds.
problem Misrepresentation of training data in machine learning algorithms.
method Demonstrated through underestimation of training data due to irreducible error, regularization, and class imbalance.
result Careful management of synthetic counterfactuals can mitigate underestimation bias.
Identifying patients who will be discharged within 24 hours can improve hospital resource management and quality of care. We studied this problem using eight years of Electronic Health Records (EHR) data from Stanford Hospital. We fit models to predict 24 hour discharge across the entire inpatient population. The best …
Models for predicting the risk of cardiovascular events based on individual patient characteristics are important tools for managing patient care. Most current and commonly used risk prediction models have been built from carefully selected epidemiological cohorts. However, the homogeneity and limited size of such coho…
Machine learning improves CAD management outcomes.
problem Current CAD guidelines do not account for patient-specific characteristics.
method Developed binary classifiers and regression models using patient data.
result Improved health outcomes by 24.11% compared to standard care.
The occurrence of drug-drug-interactions (DDI) from multiple drug dispensations is a serious problem, both for individuals and health-care systems, since patients with complications due to DDI are likely to reenter the system at a costlier level. We present a large-scale longitudinal study (18 months) of the DDI phenom…
As reinforcement learning (RL) achieves more success in solving complex tasks, more care is needed to ensure that RL research is reproducible and that algorithms herein can be compared easily and fairly with minimal bias. RL results are, however, notoriously hard to reproduce due to the algorithms' intrinsic variance, …
Approximate dynamic programming (ADP) has proven itself in a wide range of applications spanning large-scale transportation problems, health care, revenue management, and energy systems. The design of effective ADP algorithms has many dimensions, but one crucial factor is the stepsize rule used to update a value functi…
Bayesian method estimates dynamics from near-optimal trajectories.
problem Estimating dynamics from near-optimal expert trajectories in reinforcement learning.
method Constraint-based Bayesian approach integrating expert near-optimality.
result Significant improvements in decision-making and transfer success.
Artificial Intelligence for Diabetes Case Management: The Intersection of Physical and Mental Healthq-bio.QM
Diabetes is a major public health problem in the United States, affecting roughly 30 million people. Diabetes complications, along with the mental health comorbidities that often co-occur with them, are major drivers of high healthcare costs, poor outcomes, and reduced treatment adherence in diabetes. Here, we evaluate…
Model predicts COVID-19 growth in Senegal, highlighting health care capacity importance.
problem Impact of health care capacity on COVID-19 growth in Senegal.
method Compartmental model with logistic growth health care capacity, machine learning projection.
result Condition to avoid overwhelming health care system provided.
Study examines European banks' digital transformation strategies.
problem Lack of a common framework for open banking innovation in banking sector.
method Qualitative analysis of partnerships and API development.
result European banks are diversifying and boosting customer relationship management.
CPAS uses machine learning to plan hospital resources for COVID-19.
problem Forecasting hospital resource demands during the COVID-19 pandemic.
method Combining machine learning algorithms with diverse data sources.
result CPAS successfully managed hospital resource planning in the UK.
Improving the quality of end-of-life care for hospitalized patients is a priority for healthcare organizations. Studies have shown that physicians tend to over-estimate prognoses, which in combination with treatment inertia results in a mismatch between patients wishes and actual care at the end of life. We describe a …
CARE improves LLM aggregation by accounting for shared confounders.
problem LLM judges' correlated errors due to shared latent confounders.
method CARE explicitly models judges' scores as true quality and confounders.
result CARE reduces aggregation error by up to 26.8% across various benchmarks.
Public benchmark for machine learning models in critical care.
problem Lack of public benchmarks for machine learning in critical care.
method Defined four tasks (mortality prediction, length of stay, phenotyping, decompensation risk) and compared clinical and deep learning models on eICU dataset.
result First public benchmark on multi-centre critical care dataset, comparing clinical models with predictive models.
RL platform enhances user journeys in healthcare apps.
problem Improving user experience and personalization in healthcare apps.
method Reinforcement learning framework for adaptive interventions.
result Significant increase in basket size through personalized recommendations.
VisRuler: Visual Analytics for Extracting Decision Rules from Bagged and Boosted Decision Treescs.LG
VisRuler simplifies decision extraction from bagged and boosted trees.
problem Complexity and lack of interpretability in ensemble models.
method Visual analytics tool for selecting robust models, important features, and essential decisions.
result Users successfully extracted and explained decisions from ensemble models.
Study on privacy-preserving health care models that sacrifice accuracy for data protection.
problem Privacy-preserving models in health care neglect data from the tails, reducing accuracy for small groups.
method Used state-of-the-art differentially private learning methods for clinical prediction tasks.
result Privacy-preserving models in health care exhibit steep tradeoffs between privacy and utility, and disproportionately influence large demographic groups.