Machine learning has the potential of significantly improving daily operations in health care institutions but many persistent barriers are to be faced in order to ensure its wider acceptance. Among such obstacles are the accuracy and reliability. For a decision support system to be entrusted by the medical staff in clinical situations, it must perform with an accuracy comparable to or surpassing that of human medics, as well ashaving a universal applicability and not being subject to any bias. In this paper the MIMIC-IV Clinical Database will be utilized in order to: (1) Predict patient mortality and its associated risk factors in intensive care units (ICU) and: (2) Assess the reliability of utilizing the database as a basis for a clinical decision system. The cohort consisted of 523,740 hospitalizations, matched with each respective admitting diagnoses in ICD-9 format. The diagnoses were then converted from code to text-format, with the most frequently occurring factors (words) observed in deceased and surviving patients being analyzed with an Natural language Processing (NLP) algorithm. The results concluded that many of the observed risk factors were self-evident while others required further explanation, and that the performance was highly by selection of hyperparameters. Finally, the MIMIC-IV database can serve as a stable foundation for a clinical decision system but its reliability and universality shall also be taken into consideration. / Maskininlärninstekniker har en stor potential att gynna sjukvården men står inför ett flertal hinder för att fullständigt kunna tillämpas. Framförallt bör modellernas tolkningsbarhet och reproducerbarhet beaktas. För att att ett kliniskt beslutstodssystem skall vara fullständigt anförtrott av sjukvårdspersonal måste det kunna prestera med en jämförbar eller högre träffsäkerhet än sjukvårdspersonal, samt kunna tillämpas i åtskilliga sammanhang utan någon subjektivitet. Syftet med denna studie är att: (1) Förutspå patientdödsfall i intensivvårdsavdelningar och utreda dess riskfaktorer genom journalförd information från databasen MIMIC-IV och: 2) Bedöma databasens tillförlitlighet som underlag för ett kliniskt beslutstödssystem. Kohorten bestod av 523,740 insjuknanden som matchades med de diagnoser som ställdes vid deras sjukhusintag. Eftersom diagnoserna inskrevs i ICD-9-format omvandlades dessa till ord och de mest förekommande faktorerna (orden) för avlidna och överlevande patienter analyserades med en NLP-model (Natural Language Processing). Resultaten konkluderade att många av de förutspådda riskfaktorerna var uppenbara medan andra krävde ytterligare klargöranden. Dessutom kunde val av hyperparametrar stort påverka modellens kvalitet. MIMIC-IV-databasen kan utgöra ett gediget underlag för ett kliniskt beslutsystem men dess tillförlitlighet och relevans bör även tas i beaktande. / Kandidatexjobb i elektroteknik 2022, KTH, Stockholm

The increasing demand for healthcare services, coupled with the challenges of managing budgets and navigating complex regulations, has underscored the need for sustainable and efficient healthcare delivery. In response to this pressing issue, this thesis aims to optimize hospital efficiency using Artificial Intelligence (AI) techniques. The focus extends beyond improving surgical intraoperative time to encompass preoperative and postoperative periods as well. The research presents a novel Prescriptive Analytics System (PAS) designed to enhance the Surgical Success Rate (SSR) in surgeries and specifically in high volume arthroplasty. The SSR is a critical metric that reflects the successful completion of 4-surgeries during an 8-hour timeframe. By leveraging AI, the developed PAS has the potential to significantly improve the SSR from its current rate of 39% at The Ottawa Hospital to a remarkable 100%. The research is structured around five peer-reviewed journal papers, each addressing a specific aspect of the optimization of surgical efficiency. The first paper employs descriptive analytics to examine the factors influencing delays and overtime pay during surgeries. By identifying and analyzing these factors, insights are gained into the underlying causes of surgery inefficiencies. The second paper proposes three frameworks aimed at improving Operating Room (OR) throughput. These frameworks provide structured guidelines and strategies to enhance the overall efficiency of surgeries, encompassing preoperative, intraoperative, and postoperative stages. By streamlining the workflow and minimizing bottlenecks, the proposed frameworks have the potential to significantly optimize surgical operations. The third paper outlines a set of actions required to transform a selected predictive system into a prescriptive one. By integrating AI algorithms with decision support mechanisms, the system can offer actionable recommendations to surgeons during surgeries. This transformative step holds tremendous potential in enhancing surgical outcomes while reducing time. The fourth paper introduces a benchmarking and monitoring system for the selected framework that predicts SSR. Leveraging historical data, this system utilizes supervised machine learning algorithms to forecast the likelihood of successful outcomes based on various surgical team and procedural parameters. By providing real-time monitoring and predictive insights, surgeons can proactively address potential risks and improve decision-making during surgeries. Lastly, an application paper demonstrates the practical implementation of the prescriptive analytics system. The case study highlights how the system optimizes the allocation of resources and enables the scheduling of additional surgeries on days with a high predicted SSR. By leveraging the system's capabilities, hospitals can maximize their surgical capacity and improve overall patient care.