Abstract

There have been prior attempts to utilize machine learning to address issues in the medical field, particularly in diagnoses using medical images and developing therapeutic regimens. However, few cases have demonstrated the usefulness of machine learning for enhancing health consciousness of patients or the public in general, which is necessary to cause behavioral changes. This paper describes a novel case wherein the uptake rate for colorectal cancer examinations has significantly increased due to the application of machine learning and nudge theory. The paper also discusses the effectiveness of social impact bonds (SIBs) as a scheme for realizing these applications. During a healthcare SIB project conducted in the city of Hachioji, Tokyo, machine learning, based on historical data obtained from designated periodical health examinations, digitalized medical insurance receipts, and medical examination records for colorectal cancer, was used to deduce segments for whom the examination was recommended. The result revealed that out of the 12,162 people for whom the examination was recommended, 3264 (26.8%) received it, which exceeded the upper expectation limit of the initial plan (19.0%). We conclude that this was a successful case that stimulated discussion on potential further applications of this approach to wider regions and more diseases.

Highlights

  • The goal of the project was to develop an artificial intelligence (AI) system, capable of extracting insights and developing predictions related to behavioral changes, for health promotion or disease prevention

  • This paper presents the novel case of significantly increasing the diagnostic rate of colorectal cancer (CRC) by applying a combination of machine learning, nudge theory and social impact bonds (SIBs)

  • The machine learning model was trained with the above-mentioned dataset to obtain an AUC of 0.8793

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Summary

Introduction

Based on the ranking of the occurrence of different types of cancer in Japan, the incidence rate of colorectal cancer (CRC) is fourth among cancers for men (115.9 ppm) and second for women (80.5 ppm) [1]. The mortality rate of CRC is the third highest of all cancers for men (42.9 ppm) and the highest for women (34.6 ppm) [1]. The CRC screening program, which uses the fecal occult blood test (FOBT), is a recognized effective approach, and is, reinforced by the public sector to reduce incidence and mortality rates [2]. Despite the expected effectiveness of the preventive approach, CRC screening is yet to be fully implemented, and fails to be recognized as important by the recipients, with uptake levels remaining at low levels. Whilst more than 38% of the population participated in a leading study in Japan in 2013, only 18.1% of the citizens of the city of Hachioji participated in 2016 [3]

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