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Register a new userMissed calls, Automated Calls and Health Support: Using AI to improve maternal health outcomes by increasing program engagement
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Added by
Harshavardhan Kamarthi
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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India accounts for 11% of maternal deaths globally where a woman dies in childbirth every fifteen minutes. Lack of access to preventive care information is a significant problem contributing to high maternal morbidity and mortality numbers, especially in low-income households. We work with ARMMAN, a non-profit based in India, to further the use of call-based information programs by early-on identifying women who might not engage on these programs that are proven to affect health parameters positively.We analyzed anonymized call-records of over 300,000 women registered in an awareness program created by ARMMAN that uses cellphone calls to regularly disseminate health related information. We built robust deep learning based models to predict short term and long term dropout risk from call logs and beneficiaries demographic information. Our model performs 13% better than competitive baselines for short-term forecasting and 7% better for long term forecasting. We also discuss the applicability of this method in the real world through a pilot validation that uses our method to perform targeted interventions.
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India has a maternal mortality ratio of 113 and child mortality ratio of 2830 per 100,000 live births. Lack of access to preventive care information is a major contributing factor for these deaths, especially in low resource households. We partner with ARMMAN, a non-profit based in India employing a call-based information program to disseminate health-related information to pregnant women and women with recent child deliveries. We analyze call records of over 300,000 women registered in the program created by ARMMAN and try to identify women who might not engage with these call programs that are proven to result in positive health outcomes. We built machine learning based models to predict the long term engagement pattern from call logs and beneficiaries demographic information, and discuss the applicability of this method in the real world through a pilot validation. Through a randomized controlled trial, we show that using our models predictions to make interventions boosts engagement metrics by 61.37%. We then formulate the intervention planning problem as restless multi-armed bandits (RMABs), and present preliminary results using this approach.
We study how language on social media is linked to diseases such as atherosclerotic heart disease (AHD), diabetes and various types of cancer. Our proposed model leverages state-of-the-art sentence embeddings, followed by a regression model and clustering, without the need of additional labelled data. It allows to predict community-level medical outcomes from language, and thereby potentially translate these to the individual level. The method is applicable to a wide range of target variables and allows us to discover known and potentially novel correlations of medical outcomes with life-style aspects and other socioeconomic risk factors.
Deep learning using neural networks has provided advances in image style transfer, merging the content of one image (e.g., a photo) with the style of another (e.g., a painting). Our research shows this concept can be extended to analyse the design of streetscapes in relation to health and wellbeing outcomes. An Australian population health survey (n=34,000) was used to identify the spatial distribution of health and wellbeing outcomes, including general health and social capital. For each outcome, the most and least desirable locations formed two domains. Streetscape design was sampled using around 80,000 Google Street View images per domain. Generative adversarial networks translated these images from one domain to the other, preserving the main structure of the input image, but transforming the `style from locations where self-reported health was bad to locations where it was good. These translations indicate that areas in Melbourne with good general health are characterised by sufficient green space and compactness of the urban environment, whilst streetscape imagery related to high social capital contained more and wider footpaths, fewer fences and more grass. Beyond identifying relationships, the method is a first step towards computer-generated design interventions that have the potential to improve population health and wellbeing.
Predictive modeling with electronic health record (EHR) data is anticipated to drive personalized medicine and improve healthcare quality. Constructing predictive statistical models typically requires extraction of curated predictor variables from normalized EHR data, a labor-intensive process that discards the vast majority of information in each patients record. We propose a representation of patients entire, raw EHR records based on the Fast Healthcare Interoperability Resources (FHIR) format. We demonstrate that deep learning methods using this representation are capable of accurately predicting multiple medical events from multiple centers without site-specific data harmonization. We validated our approach using de-identified EHR data from two U.S. academic medical centers with 216,221 adult patients hospitalized for at least 24 hours. In the sequential format we propose, this volume of EHR data unrolled into a total of 46,864,534,945 data points, including clinical notes. Deep learning models achieved high accuracy for tasks such as predicting in-hospital mortality (AUROC across sites 0.93-0.94), 30-day unplanned readmission (AUROC 0.75-0.76), prolonged length of stay (AUROC 0.85-0.86), and all of a patients final discharge diagnoses (frequency-weighted AUROC 0.90). These models outperformed state-of-the-art traditional predictive models in all cases. We also present a case-study of a neural-network attribution system, which illustrates how clinicians can gain some transparency into the predictions. We believe that this approach can be used to create accurate and scalable predictions for a variety of clinical scenarios, complete with explanations that directly highlight evidence in the patients chart.
Pervasive health games have a potential to impact health-related behaviors. And, similar to other types of interventions, engagement and adherence in health games is the keystone for examining their short- and long-term effects. Many health-based applications have turned to gamification principles specifically to. enhance their engagement. However, according to many reports, only 41% of participants are retained in single player games and 29% in social games after 90 days. These statistics raise multiple questions about factors influencing adherence and engagement. This paper presents an in-depth mixed-methods investigation of game design factors affecting engagement with and adherence to a pervasive commercial health game, called SpaPlay. We analyzed interview and game behavior log data using theoretical constructs of sustained engagement to identify design elements affecting engagement and adherence. Our findings indicate that design elements associated with autonomy. and relatedness from the Self-Determination Theory and integrability, a measure of how well activities align with a persons life style, are important factors affecting engagement and adherence.
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