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Autores principales: Verma, Khushboo, Michels, Alan, Gumusaneli, Ergi, Chitnis, Shilpa, Kumar, Smita Sinha, Thompson, Christopher, Esmail, Lena, Srinivasan, Guruprasath, Panchada, Chandini, Guha, Sushovan, Kumar, Satwant
Formato: Preprint
Publicado: 2025
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Acceso en línea:https://arxiv.org/abs/2502.04423
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author Verma, Khushboo
Michels, Alan
Gumusaneli, Ergi
Chitnis, Shilpa
Kumar, Smita Sinha
Thompson, Christopher
Esmail, Lena
Srinivasan, Guruprasath
Panchada, Chandini
Guha, Sushovan
Kumar, Satwant
author_facet Verma, Khushboo
Michels, Alan
Gumusaneli, Ergi
Chitnis, Shilpa
Kumar, Smita Sinha
Thompson, Christopher
Esmail, Lena
Srinivasan, Guruprasath
Panchada, Chandini
Guha, Sushovan
Kumar, Satwant
contents Referral workflow inefficiencies, including misaligned referrals and delays, contribute to suboptimal patient outcomes and higher healthcare costs. In this study, we investigated the possibility of predicting procedural needs based on primary care diagnostic entries, thereby improving referral accuracy, streamlining workflows, and providing better care to patients. A de-identified dataset of 2,086 orthopedic referrals from the University of Texas Health at Tyler was analyzed using machine learning models built on Base General Embeddings (BGE) for semantic extraction. To ensure real-world applicability, noise tolerance experiments were conducted, and oversampling techniques were employed to mitigate class imbalance. The selected optimum and parsimonious embedding model demonstrated high predictive accuracy (ROC-AUC: 0.874, Matthews Correlation Coefficient (MCC): 0.540), effectively distinguishing patients requiring surgical intervention. Dimensionality reduction techniques confirmed the model's ability to capture meaningful clinical relationships. A threshold sensitivity analysis identified an optimal decision threshold (0.30) to balance precision and recall, maximizing referral efficiency. In the predictive modeling analysis, the procedure rate increased from 11.27% to an optimal 60.1%, representing a 433% improvement with significant implications for operational efficiency and healthcare revenue. The results of our study demonstrate that referral optimization can enhance primary and surgical care integration. Through this approach, precise and timely predictions of procedural requirements can be made, thereby minimizing delays, improving surgical planning, and reducing administrative burdens. In addition, the findings highlight the potential of clinical decision support as a scalable solution for improving patient outcomes and the efficiency of the healthcare system.
format Preprint
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institution arXiv
publishDate 2025
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spellingShingle Primary Care Diagnoses as a Reliable Predictor for Orthopedic Surgical Interventions
Verma, Khushboo
Michels, Alan
Gumusaneli, Ergi
Chitnis, Shilpa
Kumar, Smita Sinha
Thompson, Christopher
Esmail, Lena
Srinivasan, Guruprasath
Panchada, Chandini
Guha, Sushovan
Kumar, Satwant
Machine Learning
Artificial Intelligence
Computation and Language
I.2.6; I.2.7; J.3; H.2.8
Referral workflow inefficiencies, including misaligned referrals and delays, contribute to suboptimal patient outcomes and higher healthcare costs. In this study, we investigated the possibility of predicting procedural needs based on primary care diagnostic entries, thereby improving referral accuracy, streamlining workflows, and providing better care to patients. A de-identified dataset of 2,086 orthopedic referrals from the University of Texas Health at Tyler was analyzed using machine learning models built on Base General Embeddings (BGE) for semantic extraction. To ensure real-world applicability, noise tolerance experiments were conducted, and oversampling techniques were employed to mitigate class imbalance. The selected optimum and parsimonious embedding model demonstrated high predictive accuracy (ROC-AUC: 0.874, Matthews Correlation Coefficient (MCC): 0.540), effectively distinguishing patients requiring surgical intervention. Dimensionality reduction techniques confirmed the model's ability to capture meaningful clinical relationships. A threshold sensitivity analysis identified an optimal decision threshold (0.30) to balance precision and recall, maximizing referral efficiency. In the predictive modeling analysis, the procedure rate increased from 11.27% to an optimal 60.1%, representing a 433% improvement with significant implications for operational efficiency and healthcare revenue. The results of our study demonstrate that referral optimization can enhance primary and surgical care integration. Through this approach, precise and timely predictions of procedural requirements can be made, thereby minimizing delays, improving surgical planning, and reducing administrative burdens. In addition, the findings highlight the potential of clinical decision support as a scalable solution for improving patient outcomes and the efficiency of the healthcare system.
title Primary Care Diagnoses as a Reliable Predictor for Orthopedic Surgical Interventions
topic Machine Learning
Artificial Intelligence
Computation and Language
I.2.6; I.2.7; J.3; H.2.8
url https://arxiv.org/abs/2502.04423