Artificial intelligence (AI) to improve patient outcomes in community oncology practices.

Abstract

e18098 Background: Artificial Intelligence(AI) for predictive analytics has been studied extensively in diagnostic imaging and genetic testing. Cognitive analytics adds by suggesting interventions that optimize health outcomes using real-time data and machine learning. Herein, we report the results of a pilot study of the Jvion, Inc. Cognitive Clinical Success Machine (CCSM), an eigen vector-based deep learning AI technology. Methods: The CCSM uses electronic medical record (EMR) and publicly available socioeconomic/behavioral databases to create a n-dimensional space within which patients are mapped along vectors resulting in thousands of relevant clusters of clinically/behaviorally similar patients. These clusters have a mathematical propensity to respond to a clinical intervention which are updated dynamically with new data from the site. The CCSM generates recommendations for the provider to consider as they develop a care plan based on the patients’ cluster. We tested and trained the CCSM technology at 3 US oncology practices for the risk (low, intermediate, high) of 4 specific outcomes: 30 day severe pain, 30 day mortality, 6 month clinical deterioration (ECOG-PS), and 6 month diagnosis of major depressive disorder (MDD). We report the accuracy of the CCSM based on the testing and training data sets. Area under the curve (AUC) was calculated to show goodness of fit of classification models for each outcome. Results: In the training/testing data set there were 371,787 patients from the 3 sites: female = 61.3%; age ≤ 50 = 21.3%, 51-65 = 26.9%, > 65 = 51.9%; white/Caucasian = 43.4%, black/African American = 5.9%, unknown race = 43.4%. Cancer types were unknown/missing for 66.3% of patients and stage for 90.4% of patients. AUC range per vector: 30 day severe/recurrent pain = 0.85-0.90; 30-day mortality = 0.86-0.97; 6-month ECOG-PS decline of 1 point = 0.88-0.92; and 6-month diagnosis of MDD = 0.77-0.90. Conclusions: The high AUC indicates good separation between true positives/negatives (proper model specification for classifying the risk of each outcome) regardless of the degree of missing data for variables including cancer type and stage. Following testing, a 6 month pilot program was implemented (06/2018-11/2018). Final results of the pilot program are pending.