JMIR Publications

ABSTRACT

Background:

Asthma and chronic obstructive pulmonary disease (COPD) both put a heavy burden on healthcare. About 1/4 of asthma and COPD patients are prone to exacerbations, which can be greatly reduced by preventive care via integrated disease management that has a limited service capacity. To do this well requires a predictive model for exacerbation-proneness, but no such model exists. It would be suboptimal to build such models using the current model building approach for asthma and COPD, which has 2 gaps due to rarely factoring in temporal features showing early health changes and general directions. 1) Existing models for other asthma and COPD outcomes rarely use more advanced temporal features, such as the slope of the number of days to albuterol refill, and are inaccurate. 2) Existing models seldom show the reason a patient is deemed high-risk and potential interventions to cut the risk, making already occupied clinicians expend more time on chart review and overlook suitable interventions. Regular automatic explanation methods cannot deal with temporal data and well address this issue.

Objective:

To let more asthma and COPD patients obtain suitable and timely care to avert exacerbations, we will implement comprehensible computational methods to accurately predict exacerbation-proneness and recommend customized interventions.

Methods:

We will: a) use temporal features to accurately predict exacerbation-proneness; b) automatically find modifiable temporal risk factors for every high-risk patient; c) assess actionable warning’s impact on clinicians’ decisions of using integrated disease management to prevent exacerbation-proneness.

Results:

We have obtained most of the clinical and administrative data of asthma patients from 3 prominent American healthcare systems. We are retrieving the other clinical and administrative data, mostly of COPD patients, needed for the study. We intend to complete the study in 6 years.

Conclusions:

Our results will help make asthma and COPD care more proactive, effective, and efficient, improving outcomes and saving resources.