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Evaluation of an Automated Pressure Ulcer Risk Assessment Model

The Ohio State University Medical Center Information Warehouse

George Hripcsak, MD, MS

Columbia University, New York

The key to timely interventions and reducing avoidable incidence is the early identification of patients at risk for developing pressure ulcers. To enable the automatic detection of such patients and inform acute care interdisciplinary providers, a filter feature model using heuristic statistical methods was applied to a relational database of retrospective patient data including demographics, medications, and clinical visit details. These attributes served as input for the C4.5 decision tree induction algorithm, which was used to classify patient risk. The validity of the resulting classification model, Electronic Pressure Ulcer Prediction (ePUP), was assessed using a fourfold cross-validation. The current results show a limited application of such a naïve classification algorithm for automating pressure ulcer risk assessments. Additional refinements will be necessary before the predictions of ePUP are sufficient for general clinical use and the improvement of patient safety in acute care settings, and during the transition from hospital to home.

Key Words: pressure ulcer • risk assessment • artificial intelligence • decision trees • models • decision support

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