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Retrospective analysis and time series forecasting with automated machine learning of ascariasis, enterobiasis and cystic echinococcosis in Romania

ABSTRACT: The epidemiology of neglected tropical diseases (NTD) is persistently underprioritized, despite NTD being widespread among the poorest populations and in the least developed countries on earth. This situation necessitates thorough and efficient public health intervention. Romania is at the brink of becoming a developed country. However, this South-Eastern European country appears to be a region that is susceptible to an underestimated burden of parasitic diseases despite recent public health reforms. Moreover, there is an evident lack of new epidemiologic data on NTD after Romania’s accession to the European Union (EU) in 2007. Using the national ICD-10 dataset for hospitalized patients in Romania, we generated time series datasets for 2008–2018. The objective was to gain deep understanding of the epidemiological distribution of three selected and highly endemic parasitic diseases, namely, ascariasis, enterobiasis and cystic echinococcosis (CE), during this period and forecast their courses for the ensuing two years. Through descriptive and inferential analysis, we observed a decline in case numbers for all three NTD. Several distributional particularities at regional level emerged. Furthermore, we performed predictions using a novel automated time series (AutoTS) machine learning tool and could interestingly show a stable course for these parasitic NTD. Such predictions can help public health officials and medical organizations to implement targeted disease prevention and control. To our knowledge, this is the first study involving a retrospective analysis of ascariasis, enterobiasis and CE on a nationwide scale in Romania. It is also the first to use AutoTS technology for parasitic NTD. Author summary Eastern and South-Eastern Europe is known to be severely affected by parasitic neglected tropical diseases (NTD) due to its tumultuous historical events of the past decades and to its uncontrolled socio-economic fluctuations. Romania is an example of such a South-Eastern European country that was known to have a high parasitic NTD burden after the fall of Communism in 1989 but has since made significant developmental improvements. However, there is scarce data regarding the incidences of parasitic NTD in Romania after its accession to the European Union in 2007. By using the ICD-10 dataset of Romania over the period 2008–2018, we performed a retrospective epidemiologic analysis of three of its most relevant parasitic diseases, ascariasis, enterobiasis and cystic echinococcosis (CE) and confirmed a downward trend strongly correlating with the country’s decreasing poverty rate. By employing a novel technology called automated time series machine learning we predicted the progress of these diseases for the ensuing two years of 2019 and 2020. Forecasted rates were observed to be constant. Such machine learning tools can help public health officials in adapting and improving targeted measures to combat parasitic NTD.

SUBMITTER: Benecke J

PROVIDER: S-EPMC8584970 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceForecasting the volume of hospital discharges has important implications for resource allocation and represents an opportunity to improve patient safety at periods of elevated risk.ObjectiveTo determine the performance of a new time-series machine learning method for forecasting hospital discharge volume compared with simpler methods.DesignA retrospective cohort study of daily hospital discharge volumes at 2 large, New England academic medical centers between January 1, 2005, and December 31, 2014 (hospital 1), or January 1, 2005, and December 31, 2010 (hospital 2), comparing time-series forecasting methods for prediction was performed. Data analysis was conducted from February 28, 2017, to August 30, 2018. Group-level data for all discharges from inpatient units were included. In addition to conventional methods, a technique originally developed for allocating data center resources, and comparison strategies for incorporating prior data and frequency of model updates, was conducted to identify the model application that optimized forecast accuracy.Main outcomes and measuresModel calibration as measured by R2 and, secondarily, number of days with errors greater than 1 SD of daily volume.ResultsDuring the forecasted year, hospital 1 had 54?411 discharges (daily mean, 149) and hospital 2 had 47?456 discharges (daily mean, 130). The machine learning method was well calibrated at both sites (R2, 0.843 and 0.726, respectively) and made errors greater than 1 SD of daily volume on only 13 and 22 days, respectively, of the forecast year at the 2 sites. Last-value-carried-forward models performed somewhat less well (calibration R2, 0.781 and 0.596, respectively) with 13 and 46 errors of 1 SD or greater, respectively. More frequent retraining and training sets of longer than 1 year had minimal effects on the machine learning method's performance.Conclusions and relevanceVolume of hospital discharges can perhaps be reliably forecasted using simple carry-forward models as well as methods drawn from machine learning. The benefit of the latter does not appear to be dependent on extensive training data and may enable forecasts up to 1 year in advance with superior absolute accuracy to carry-forward models.

Project description:The emergence of new technologies to synthesize and analyze big data with high-performance computing has increased our capacity to more accurately predict crop yields. Recent research has shown that machine learning (ML) can provide reasonable predictions faster and with higher flexibility compared to simulation crop modeling. However, a single machine learning model can be outperformed by a "committee" of models (machine learning ensembles) that can reduce prediction bias, variance, or both and is able to better capture the underlying distribution of the data. Yet, there are many aspects to be investigated with regard to prediction accuracy, time of the prediction, and scale. The earlier the prediction during the growing season the better, but this has not been thoroughly investigated as previous studies considered all data available to predict yields. This paper provides a machine leaning based framework to forecast corn yields in three US Corn Belt states (Illinois, Indiana, and Iowa) considering complete and partial in-season weather knowledge. Several ensemble models are designed using blocked sequential procedure to generate out-of-bag predictions. The forecasts are made in county-level scale and aggregated for agricultural district and state level scales. Results show that the proposed optimized weighted ensemble and the average ensemble are the most precise models with RRMSE of 9.5%. Stacked LASSO makes the least biased predictions (MBE of 53 kg/ha), while other ensemble models also outperformed the base learners in terms of bias. On the contrary, although random k-fold cross-validation is replaced by blocked sequential procedure, it is shown that stacked ensembles perform not as good as weighted ensemble models for time series data sets as they require the data to be non-IID to perform favorably. Comparing our proposed model forecasts with the literature demonstrates the acceptable performance of forecasts made by our proposed ensemble model. Results from the scenario of having partial in-season weather knowledge reveals that decent yield forecasts with RRMSE of 9.2% can be made as early as June 1st. Moreover, it was shown that the proposed model performed better than individual models and benchmark ensembles at agricultural district and state-level scales as well as county-level scale. To find the marginal effect of each input feature on the forecasts made by the proposed ensemble model, a methodology is suggested that is the basis for finding feature importance for the ensemble model. The findings suggest that weather features corresponding to weather in weeks 18-24 (May 1st to June 1st) are the most important input features.

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Retrospective analysis and time series forecasting with automated machine learning of ascariasis, enterobiasis and cystic echinococcosis in Romania

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