Andrea M D'Alessandro, Kaitlyn M Butterfield, Lerna Hanceroglu, Kim P Roberts
Listen to the Children: Elementary School Students' Perspectives on a Mindfulness Intervention
Journal of child and family studies
center medicare medicaid services cms imposes payment penalties readmissions following total joint replacement surgeries study focuses total hip knee shoulder arthroplasty procedures account joint replacement surgeries apart burden healthcare systems readmissions also troublesome patients several studies utilized structured data electronic health records ehr without considering gender payor bias adjustments study dataset 38581 total knee hip shoulder replacement surgeries performed 2015 2021 novant health gathered data used train random forest machine learning model predict combined endpoint emergency department ed visit unplanned readmissions within 30 days discharge discharge skilled nursing facility snf following surgery 98 features laboratory results diagnoses vitals medications utilization history extracted natural language processing nlp model finetuned clinical bert used generate nlp risk score feature patient based clinical notes address societal biases feature bias analysis performed conjunction propensity score matching threshold optimization algorithm fairlearn toolkit used mitigate gender payor biases promote fairness predictions model achieved area receiver operating characteristic curve auroc 0738 95 confidence interval 0724 0754 area precisionrecall curve auprc 0406 95 confidence interval 0384 0433 considering outcome prevalence 16 metrics indicate models ability accurately discriminate readmission nonreadmission cases within context total arthroplasty surgeries adjusting patient scores model mitigate bias based patient gender payor work culminated model identifies predictive protective features associated combined endpoint model serves tool empower healthcare providers proactively intervene based influential factors without introducing bias towards protected patient classes effectively mitigating risk negative outcomes ultimately improving quality care regardless socioeconomic factors