论文标题
用于保留患者艾滋病毒护理患者的机器学习系统
A Machine Learning System for Retaining Patients in HIV Care
论文作者
论文摘要
保留艾滋病毒(PLWH)在医疗服务中的人至关重要,这对于防止病毒的新传播并允许PLWH过着正常和健康的寿命。与艾滋病毒提供者保持定期任命并每天服用一生非常困难。 51%的PLWH对其药物不遵守,并最终退出医疗服务。当前重新链接个体护理的方法是反应性的(患者掉落后),因此不是很有效。我们描述了我们的系统,以预测谁最有可能辍学的风险,以供芝加哥大学艾滋病毒诊所和芝加哥公共卫生系使用。根据资源限制,随着时间的推移稳定性以及公平性的预测性能选择模型。我们的系统适用于临床环境中的护理点系统,以及批处理预测系统,以支持城市层面的常规干预措施。对于临床模型的基线,我们的模型的表现要好3倍,而对于全市范围的模型,我们的模型比基线要好2.3倍。该守则已在GitHub上发布,我们希望这种方法,尤其是我们对公平性的关注,将被其他诊所和公共卫生机构采用,以遏制HIV流行病。
Retaining persons living with HIV (PLWH) in medical care is paramount to preventing new transmissions of the virus and allowing PLWH to live normal and healthy lifespans. Maintaining regular appointments with an HIV provider and taking medication daily for a lifetime is exceedingly difficult. 51% of PLWH are non-adherent with their medications and eventually drop out of medical care. Current methods of re-linking individuals to care are reactive (after a patient has dropped-out) and hence not very effective. We describe our system to predict who is most at risk to drop-out-of-care for use by the University of Chicago HIV clinic and the Chicago Department of Public Health. Models were selected based on their predictive performance under resource constraints, stability over time, as well as fairness. Our system is applicable as a point-of-care system in a clinical setting as well as a batch prediction system to support regular interventions at the city level. Our model performs 3x better than the baseline for the clinical model and 2.3x better than baseline for the city-wide model. The code has been released on github and we hope this methodology, particularly our focus on fairness, will be adopted by other clinics and public health agencies in order to curb the HIV epidemic.