An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors

Background: This study aimed to identify the most impactful set of intrinsic and extrinsic fall risk factors and develop a data-driven inpatient fall risk assessment tool (FRAT). Methods: The dataset used for the study comprised in-hospital fall records from 2012 to 2017. Four machine learning (ML) ...

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Main Authors: Sonia Jahangiri, Masoud Abdollahi, Rasika Patil, Ehsan Rashedi, Nasibeh Azadeh-Fard
Format: Article
Language:English
Published: Elsevier 2024-03-01
Series:Machine Learning with Applications
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666827023000725
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author Sonia Jahangiri
Masoud Abdollahi
Rasika Patil
Ehsan Rashedi
Nasibeh Azadeh-Fard
author_facet Sonia Jahangiri
Masoud Abdollahi
Rasika Patil
Ehsan Rashedi
Nasibeh Azadeh-Fard
author_sort Sonia Jahangiri
collection DOAJ
description Background: This study aimed to identify the most impactful set of intrinsic and extrinsic fall risk factors and develop a data-driven inpatient fall risk assessment tool (FRAT). Methods: The dataset used for the study comprised in-hospital fall records from 2012 to 2017. Four machine learning (ML) algorithms, Support Vector Machine (SVM), Random Forest (RF), Gradient Boosting (Gboost), and Deep Neural Network (DNN) were utilized to predict the inpatient fall risk level. To enhance the performance of the prediction models, two approaches were implemented, including (1) feature selection to identify the optimal feature set and (2) the development of three distinct shift-wise models. Furthermore, the optimal feature sets in the shift-wise models were extracted. Results: According to the results, DNN outperformed other methods by reaching an accuracy, sensitivity, specificity, and AUC of 0.71, 0.8, 0.6, and 0.7, respectively, considering the full set of features. The performance of the models was further improved (by 3-5 %) by conducting a feature selection process for all models. Specifically, the DNN model achieved an accuracy of 0.74 while considering the optimal set of predictors. Moreover, the shift-wise RF models demonstrated higher accuracies (by 4-10 %) compared to the same model using a full feature set. Conclusions: This study's outcome confirms ML models' compelling capability in developing an inpatient FRAT while considering intrinsic and extrinsic factors. The insight from such models could form a foundation to (1) monitor the inpatients’ fall risk, (2) identify the major factors involved in inpatient falls, and (3) create subject-specific self-care plans.
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spelling doaj.art-96edfc89321d4a5f88e0ff8e5ac5d54b2023-12-14T05:24:05ZengElsevierMachine Learning with Applications2666-82702024-03-0115100519An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factorsSonia Jahangiri0Masoud Abdollahi1Rasika Patil2Ehsan Rashedi3Nasibeh Azadeh-Fard4Corresponding author.; Industrial and Systems Engineering Department, Rochester Institute of Technology, 81 Lomb Memorial Dr. Rochester, NY 14623, United StatesIndustrial and Systems Engineering Department, Rochester Institute of Technology, 81 Lomb Memorial Dr. Rochester, NY 14623, United StatesIndustrial and Systems Engineering Department, Rochester Institute of Technology, 81 Lomb Memorial Dr. Rochester, NY 14623, United StatesIndustrial and Systems Engineering Department, Rochester Institute of Technology, 81 Lomb Memorial Dr. Rochester, NY 14623, United StatesIndustrial and Systems Engineering Department, Rochester Institute of Technology, 81 Lomb Memorial Dr. Rochester, NY 14623, United StatesBackground: This study aimed to identify the most impactful set of intrinsic and extrinsic fall risk factors and develop a data-driven inpatient fall risk assessment tool (FRAT). Methods: The dataset used for the study comprised in-hospital fall records from 2012 to 2017. Four machine learning (ML) algorithms, Support Vector Machine (SVM), Random Forest (RF), Gradient Boosting (Gboost), and Deep Neural Network (DNN) were utilized to predict the inpatient fall risk level. To enhance the performance of the prediction models, two approaches were implemented, including (1) feature selection to identify the optimal feature set and (2) the development of three distinct shift-wise models. Furthermore, the optimal feature sets in the shift-wise models were extracted. Results: According to the results, DNN outperformed other methods by reaching an accuracy, sensitivity, specificity, and AUC of 0.71, 0.8, 0.6, and 0.7, respectively, considering the full set of features. The performance of the models was further improved (by 3-5 %) by conducting a feature selection process for all models. Specifically, the DNN model achieved an accuracy of 0.74 while considering the optimal set of predictors. Moreover, the shift-wise RF models demonstrated higher accuracies (by 4-10 %) compared to the same model using a full feature set. Conclusions: This study's outcome confirms ML models' compelling capability in developing an inpatient FRAT while considering intrinsic and extrinsic factors. The insight from such models could form a foundation to (1) monitor the inpatients’ fall risk, (2) identify the major factors involved in inpatient falls, and (3) create subject-specific self-care plans.http://www.sciencedirect.com/science/article/pii/S2666827023000725Inpatient fallRisk assessmentMachine learningIntrinsic risk factorsExtrinsic risk factors
spellingShingle Sonia Jahangiri
Masoud Abdollahi
Rasika Patil
Ehsan Rashedi
Nasibeh Azadeh-Fard
An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors
Machine Learning with Applications
Inpatient fall
Risk assessment
Machine learning
Intrinsic risk factors
Extrinsic risk factors
title An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors
title_full An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors
title_fullStr An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors
title_full_unstemmed An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors
title_short An inpatient fall risk assessment tool: Application of machine learning models on intrinsic and extrinsic risk factors
title_sort inpatient fall risk assessment tool application of machine learning models on intrinsic and extrinsic risk factors
topic Inpatient fall
Risk assessment
Machine learning
Intrinsic risk factors
Extrinsic risk factors
url http://www.sciencedirect.com/science/article/pii/S2666827023000725
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