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Drug-related fall risk in hospitals: a machine learning approach

Abstract

Objective

To compare the performance of machine-learning models with the Medication Fall Risk Score (MFRS) in predicting fall risk related to prescription medications.

Methods

This is a retrospective case-control study of adult and older adult patients in a tertiary hospital in Porto Alegre, RS, Brazil. Prescription drugs and drug classes were investigated. Data were exported to the RStudio software for statistical analysis. The variables were analyzed using Logistic Regression, Naive Bayes, Random Forest, and Gradient Boosting algorithms. Algorithm validation was performed using 10-fold cross validation. The Youden index was the metric selected to evaluate the models. The project was approved by the Research Ethics Committee.

Results

The machine-learning model showing the best performance was the one developed by the Naive Bayes algorithm. The model built from a data set of a specific hospital showed better results for the studied population than did MFRS, a generalizable tool.

Conclusion

Risk-prediction tools that depend on proper application and registration by professionals require time and attention that could be allocated to patient care. Prediction models built through machine-learning algorithms can help identify risks to improve patient care.

Accidental falls; Drug utilization; Supervised machine learning; Patient safety

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br