Modified Needleman-Wunsch algorithm for clinical pathway clustering.


Journal

Journal of biomedical informatics
ISSN: 1532-0480
Titre abrégé: J Biomed Inform
Pays: United States
ID NLM: 100970413

Informations de publication

Date de publication:
03 2021
Historique:
received: 30 09 2020
revised: 27 11 2020
accepted: 15 12 2020
pubmed: 29 12 2020
medline: 29 7 2021
entrez: 28 12 2020
Statut: ppublish

Résumé

Clinical pathways are used to guide clinicians to provide a standardised delivery of care. Because of their standardisation, the aim of clinical pathways is to reduce variation in both care process and patient outcomes. When learning clinical pathways from data through data mining, it is common practice to represent each patient pathway as a string corresponding to their movements through activities. Clustering techniques are popular methods for pathway mining, and therefore this paper focuses on distance metrics applied to string data for k-medoids clustering. The two main aims are to firstly, develop a technique that seamlessly integrates expert information with data and secondly, to develop a string distance metric for the purpose of process data. The overall goal was to allow for more meaningful clustering results to be found by adding context into the string similarity calculation. Eight common distance metrics and their applicability are discussed. These distance metrics prove to give an arbitrary distance, without consideration for context, and each produce different results. As a result, this paper describes the development of a new distance metric, the modified Needleman-Wunsch algorithm, that allows for expert interaction with the calculation by assigning groupings and rankings to activities, which provide context to the strings. This algorithm has been developed in partnership with UK's National Health Service (NHS) with the focus on a lung cancer pathway, however the handling of the data and algorithm allows for application to any disease type. This method is contained within Sim.Pro.Flow, a publicly available decision support tool.

Identifiants

pubmed: 33359110
pii: S1532-0464(20)30296-3
doi: 10.1016/j.jbi.2020.103668
pmc: PMC7973729
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

103668

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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Auteurs

Emma Aspland (E)

School of Mathematics, Cardiff University, Cardiff, United Kingdom. Electronic address: asplandel@cardiff.ac.uk.

Paul R Harper (PR)

School of Mathematics, Cardiff University, Cardiff, United Kingdom.

Daniel Gartner (D)

School of Mathematics, Cardiff University, Cardiff, United Kingdom.

Philip Webb (P)

Velindre Cancer Centre, Cardiff, United Kingdom.

Peter Barrett-Lee (P)

Velindre Cancer Centre, Cardiff, United Kingdom.

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