JMIR Publications

ABSTRACT

Background:

Accurate classification of patient safety event (PSE) reports is crucial for patient safety monitoring. However, this process faces challenges due to inconsistencies in classifications and the sheer volume of reports. Recent advancements in text representation, particularly contextual text representation derived from transformer-based language models, offer a promising solution for more precise PSE report classification. Integrating the ML classifier necessitates a balance between human expertise and artificial intelligence. Central to this integration is the concept of explainability which is crucial for building trust and ensuring effective human-AI collaboration.

Objective:

This study aims to investigate the efficacy of machine learning (ML) classifiers trained using contextual text representation in automatically classifying PSE reports. Furthermore, the study presents an interface that integrates the ML classifier with the explainability technique to facilitate human-AI collaboration for PSE report classification.

Methods:

This study utilized a dataset of 861 PSE reports from a large academic hospital's maternity units in the southeastern United States. Various ML classifiers were trained with both static and contextual text representations of PSE reports. The trained ML classifiers were evaluated with multi-class classification metrics and the confusion matrix. The Local Interpretable Model-Agnostic Explanations (LIME) technique was utilized to provide the rationale for the ML classifier’s predictions. An interface that integrates the ML classifier with the LIME technique was designed for incident reporting systems.

Results:

The top-performing classifier using contextual representation was able to obtain an accuracy of 75.40% compared to an accuracy of 66.67% by the top-performing classifier trained using static text representation. The confusion matrix showed the omission event types were frequently misclassified. A PSE reporting interface has been designed to facilitate human-AI collaboration in PSE report classification. In this design, the ML classifier recommends the top two most probable event types, along with the explanations for the prediction, enabling PSE reporters and patient safety analysts to choose the most suitable one. The LIME technique showed the classifier occasionally relies on arbitrary words for classification, emphasizing the necessity of human oversight.

Conclusions:

This study demonstrates that training ML classifiers with contextual text representations can significantly enhance the accuracy of PSE report classification. The interface designed in this study lays the foundation for human-AI collaboration in the classification of PSE reports. The insights gained from this research enhance the decision-making process in PSE report classification, enabling hospitals to more efficiently identify potential risks and hazards and enabling patient safety analysts to take timely actions to prevent patient harm.