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      Patient Preference and Adherence (submit here)

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      Effective Analysis of Inpatient Satisfaction: The Random Forest Algorithm

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          Abstract

          Purpose

          To identify the factors influencing inpatient satisfaction by fitting the optimal discriminant model.

          Patients and Methods

          A cross-sectional survey of inpatient satisfaction was conducted with 3888 patients in 16 large public hospitals in Zhejiang Province. Independent variables were screened by single-factor analysis, and the importance of all variables was comprehensively evaluated. The relationship between patients’ overall satisfaction and influencing factors was established, the relative risk was evaluated by marginal benefit, and the optimal model was fitted using the receiver operating characteristic curve.

          Results

          Patients’ overall satisfaction was 79.73%. The five most influential factors on inpatient satisfaction, in this order, were: patients’ right to know, timely nursing response, satisfaction with medical staff service, integrity of medical staff, and accuracy of diagnosis. The prediction accuracy of the random forest model was higher than that of the multiple logistic regression and naive Bayesian models.

          Conclusion

          Inpatient satisfaction is related to healthcare quality, diagnosis, and treatment process. Rapid identification and active improvement of the factors affecting patient satisfaction can reduce public hospital operating costs and improve patient experiences and the efficiency of health resource allocation. Public hospitals should strengthen the exchange of medical information between doctors and patients, shorten waiting time, and improve the level of medical technology, service attitude, and transparency of information disclosure.

          Most cited references75

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          Machine Learning for Medical Imaging.

          Machine learning is a technique for recognizing patterns that can be applied to medical images. Although it is a powerful tool that can help in rendering medical diagnoses, it can be misapplied. Machine learning typically begins with the machine learning algorithm system computing the image features that are believed to be of importance in making the prediction or diagnosis of interest. The machine learning algorithm system then identifies the best combination of these image features for classifying the image or computing some metric for the given image region. There are several methods that can be used, each with different strengths and weaknesses. There are open-source versions of most of these machine learning methods that make them easy to try and apply to images. Several metrics for measuring the performance of an algorithm exist; however, one must be aware of the possible associated pitfalls that can result in misleading metrics. More recently, deep learning has started to be used; this method has the benefit that it does not require image feature identification and calculation as a first step; rather, features are identified as part of the learning process. Machine learning has been used in medical imaging and will have a greater influence in the future. Those working in medical imaging must be aware of how machine learning works. ©RSNA, 2017.
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            Big Data and Machine Learning in Health Care

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              Potential Biases in Machine Learning Algorithms Using Electronic Health Record Data

              A promise of machine learning in health care is the avoidance of biases in diagnosis and treatment; a computer algorithm could objectively synthesize and interpret the data in the medical record. Integration of machine learning with clinical decision support tools, such as computerized alerts or diagnostic support, may offer physicians and others who provide health care targeted and timely information that can improve clinical decisions. Machine learning algorithms, however, may also be subject to biases. The biases include those related to missing data and patients not identified by algorithms, sample size and underestimation, and misclassification and measurement error. There is concern that biases and deficiencies in the data used by machine learning algorithms may contribute to socioeconomic disparities in health care. This Special Communication outlines the potential biases that may be introduced into machine learning–based clinical decision support tools that use electronic health record data and proposes potential solutions to the problems of overreliance on automation, algorithms based on biased data, and algorithms that do not provide information that is clinically meaningful. Existing health care disparities should not be amplified by thoughtless or excessive reliance on machines.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                ppa
                ppa
                Patient preference and adherence
                Dove
                1177-889X
                07 April 2021
                2021
                : 15
                : 691-703
                Affiliations
                [1 ]School of Humanities and Social Sciences, Guangxi Medical University , Nanning, 530021, People’s Republic of China
                [2 ]School of Public Health, Sun Yat-Sen University , Guangzhou, 510080, People’s Republic of China
                [3 ]Department of Health Service Management, Humanities and Management School, Zhejiang Chinese Medical University , Hangzhou, 310000, People’s Republic of China
                [4 ]School of Basic Medicine, Guangxi Medical University , Nanning, 530021, People’s Republic of China
                [5 ]School of Information and Management, Guangxi Medical University , Nanning, 530021, People’s Republic of China
                Author notes
                Correspondence: Pinghua Zhu Email zhupinghua@gxmu.edu.cn
                Author information
                http://orcid.org/0000-0001-7221-7127
                Article
                294402
                10.2147/PPA.S294402
                8039189
                33854303
                d22bf9dc-450e-4c50-9484-92e3028b6326
                © 2021 Li et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 27 November 2020
                : 10 March 2021
                Page count
                Figures: 3, Tables: 3, References: 76, Pages: 13
                Categories
                Original Research

                Medicine
                random forest,inpatient satisfaction,public hospitals,key influencing factors
                Medicine
                random forest, inpatient satisfaction, public hospitals, key influencing factors

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