Medical practices display power law behaviors similar to spoken languages

BMC Medical Informatics and Decision Making

Research Article

A Murat Kaynar¹  Philip S Crooke²  Jonathan D Paladino³  Christopher R Brackney⁴  John R Hotchkiss⁵ 

[1] Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA;Department of Mathematics, Vanderbilt University, Nashville, TN, USA;Department of Medicine, John A. Burns School of Medicine, Honolulu, HI, USA;Veteran’s Affairs Healthcare System, Pittsburgh, PA, USA;Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA;Veteran’s Affairs Healthcare System, Pittsburgh, PA, USA;Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA;Veteran’s Engineering Resource Center, Pittsburgh, PA, USA;

关键词: Power law;    Natural languages;    Mechanical ventilation;    Dialysis;    Medical practices;   

DOI  :  10.1186/1472-6947-13-102

 received in 2013-04-24, accepted in 2013-08-28,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMedical care commonly involves the apprehension of complex patterns of patient derangements to which the practitioner responds with patterns of interventions, as opposed to single therapeutic maneuvers. This complexity renders the objective assessment of practice patterns using conventional statistical approaches difficult.MethodsCombinatorial approaches drawn from symbolic dynamics are used to encode the observed patterns of patient derangement and associated practitioner response patterns as sequences of symbols. Concatenating each patient derangement symbol with the contemporaneous practitioner response symbol creates “words” encoding the simultaneous patient derangement and provider response patterns and yields an observed vocabulary with quantifiable statistical characteristics.ResultsA fundamental observation in many natural languages is the existence of a power law relationship between the rank order of word usage and the absolute frequency with which particular words are uttered. We show that population level patterns of patient derangement: practitioner intervention word usage in two entirely unrelated domains of medical care display power law relationships similar to those of natural languages, and that–in one of these domains–power law behavior at the population level reflects power law behavior at the level of individual practitioners.ConclusionsOur results suggest that patterns of medical care can be approached using quantitative linguistic techniques, a finding that has implications for the assessment of expertise, machine learning identification of optimal practices, and construction of bedside decision support tools.

【 授权许可】

Unknown   
© Paladino et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.