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Objective We propose a data-driven method to detect temporal patterns of disease progression in high-dimensional claims data based on gradient boosting with stability selection. Materials and methods We identified patients with chronic obstructive pulmonary disease in a German health insurance claims database with 6.5 million individuals and divided them into a group of patients with the highest disease severity and a group of control patients with lower severity. We then used gradient boosting with stability selection to determine variables correlating with a chronic obstructive pulmonary disease diagnosis of highest severity and subsequently model the temporal progression of the disease using the selected variables. Results We identified a network of 20 diagnoses (e.g. respiratory failure), medications (e.g. anticholinergic drugs) and procedures associated with a subsequent chronic obstructive pulmonary disease diagnosis of highest severity. Furthermore, the network successfully captured temporal patterns, such as disease progressions from lower to higher severity grades. Discussion The temporal trajectories identified by our data-driven approach are compatible with existing knowledge about chronic obstructive pulmonary disease showing that the method can reliably select relevant variables in a high-dimensional context. Conclusion We provide a generalizable approach for the automatic detection of disease trajectories in claims data. This could help to diagnose diseases early, identify unknown risk factors and optimize treatment plans.
Faced with the increasing needs of companies, optimal dimensioning of IT hardware is becoming challenging for decision makers. In terms of analytical infrastructures, a highly evolutionary environment causes volatile, time dependent workloads in its components, and intelligent, flexible task distribution between local systems and cloud services is attractive. With the aim of developing a flexible and efficient design for analytical infrastructures, this paper proposes a flexible architecture model, which allocates tasks following a machine-specific decision heuristic. A simulation benchmarks this system with existing strategies and identifies the new decision maxim as superior in a first scenario-based simulation.