Random survival forests constitute a robust approach to survival modeling, i.e., predicting the probability that an event will occur before or on a given point in time. Similar to most standard predictive models, no guarantee for the prediction error is provided for this model, which instead typically is empirically evaluated. Conformal prediction is a rather recent framework, which allows the error of a model to be determined by a user specified confidence level, something which is achieved by considering set rather than point predictions. The framework, which has been applied to some of the most popular classification and regression techniques, is here for the first time applied to survival modeling, through random survival forests. An empirical investigation is presented where the technique is evaluated on datasets from two real-world applications; predicting component failure in trucks using operational data and predicting survival and treatment of heart failure patients from administrative healthcare data. The experimental results show that the error levels indeed are very close to the provided confidence levels, as guaranteed by the conformal prediction framework, and that the error for predicting each outcome, i.e., event or no-event, can be controlled separately. The latter may, however, lead to less informative predictions, i.e., larger prediction sets, in case the class distribution is heavily imbalanced.

Electronic health records contain large amounts of longitudinal data that are valuable for biomedical informatics research. The application of machine learning is a promising alternative to manual analysis of such data. However, the complex structure of the data, which includes clinical events that are unevenly distributed over time, poses a challenge for standard learning algorithms. Some approaches to modeling temporal data rely on extracting single values from time series; however, this leads to the loss of potentially valuable sequential information. How to better account for the temporality of clinical data, hence, remains an important research question. In this study, novel representations of temporal data in electronic health records are explored. These representations retain the sequential information, and are directly compatible with standard machine learning algorithms. The explored methods are based on symbolic sequence representations of time series data, which are utilized in a number of different ways. An empirical investigation, using 19 datasets comprising clinical measurements observed over time from a real database of electronic health records, shows that using a distance measure to random subsequences leads to substantial improvements in predictive performance compared to using the original sequences or clustering the sequences. Evidence is moreover provided on the quality of the symbolic sequence representation by comparing it to sequences that are generated using domain knowledge by clinical experts. The proposed method creates representations that better account for the temporality of clinical events, which is often key to prediction tasks in the biomedical domain.

An administrative health register containing health care data for over 2 million patients will be used to search for factors that can affect the treatment of heart failure. In the study, we will measure the effects of employed treatment for various groups of heart failure patients, using different measures of effectiveness. Significant deviations in effectiveness of treatments of the various patient groups will be reported and factors that may help explaining the effect of treatment will be analyzed. Identification of the most important factors that may help explain the observed deviations between the different groups will be derived through generation of predictive models, for which variable importance can be calculated. The findings may affect recommended treatments as well as highlighting deviations from national guidelines.

Adverse drug events (ADEs) are grossly under-reported in electronic health records (EHRs). This could be mitigated by methods that are able to detect ADEs in EHRs, thereby allowing for missing ADE-specific diagnosis codes to be identified and added. A crucial aspect of constructing such systems is to find proper representations of the data in order to allow the predictive modeling to be as accurate as possible. One category of EHR data that can be used as indicators of ADEs are clinical measurements. However, using clinical measurements as features is not unproblematic due to the high rate of missing values and they can be repeated a variable number of times in each patient health record. In this study, five basic representations of clinical measurements are proposed and evaluated to handle these two problems. An empirical investigation using random forest on 27 datasets from a real EHR database with different ADE targets is presented, demonstrating that the predictive performance, in terms of accuracy and area under ROC curve, is higher when representing clinical measurements crudely as whether they were taken or how many times they were taken by a patient. Furthermore, a sixth alternative, combining all five basic representations, significantly outperforms using any of the basic representation except for one. A subsequent analysis of variable importance is also conducted with this fused feature set, showing that when clinical measurements have a high missing rate, the number of times they were taken by one patient is ranked as more informative than looking at their actual values. The observation from random forest is also confirmed empirically using other commonly employed classifiers. This study demonstrates that the way in which clinical measurements from EHRs are presented has a high impact for ADE detection, and that using multiple representations outperforms using a basic representation.

We describe how machine learning and decision theory is combined in an application that supports control room operators of a combined heating and power plant to cope with the overwhelming complexity of situations when severe plant disturbances occur. The application is designed as an assistant, rather than as an automatic system that intervenes directly in the operator/plant loop. The application is required to handle vague and numerically imprecise background information in the construction of classifier committees. A classifier committee (or ensemble) is a classifier created by combining the predictions of multiple sub-classifiers. The presented method combines classifiers into a committee by using computational methods for decision analysis that are designed to work when the information at hand is imprecise. The application evaluates and make priorities between classified alarms according to credibilities that depend on the current context. Machine learning techniques are used to construct classifiers that recognize various malfunctions in a process, determine whether a situation is normal or not, and make priorities among alarms.