摘要或動機

Triage is the process by which nurses manage hospital emergency departments by assigning patients varying degrees of urgency. While triage algorithms such as the Emergency Severity Index (ESI) have been standardized worldwide, many of them are highly inconsistent, which could endanger the lives of thousands of patients. One way to improve on nurses’ accuracy is to use machine learning models (ML), which can learn from past data to make predictions. We tested six ML models: random forest, XGBoost, logistic regression, support vector machines, k-nearest neighbors, and multilayer perceptron. These models were tasked with predicting whether a patient would be admitted to the intensive care unit (ICU), another unit in the hospital, or be discharged. After training on data from more than 30,000 patients and testing using 10-fold cross-validation, we found that all six models outperformed ESI. Of the six, the random forest model achieved the highest average accuracy in predicting both ICU admission (81% vs. 69% using ESI; p<0.001) and hospitalization (75% vs. 57%; p<0.001). These models were then added to an Android application, which would accept patient data, predict their triage, and then add them to a priority-ordered waiting list. This approach may offer significant advantages over conventional triage: mainly, it has a higher accuracy than nurses and returns predictions instantaneously. It could also stand-in for triage nurses entirely in disasters, where medical personnel must deal with a large influx of patients in a short amount of time.