Summary: | Mortality prediction for intensive care unit (ICU) patients is a challenging problem that requires extracting discriminative and informative features. This study presents a proof of concept for exploring features that can provide clinical insight. Through a feature engineering approach, it is attempted to improve ICU mortality prediction in field conditions with low frequently measured data (i.e., hourly to bi-hourly). Features are explored by investigating the vital signs measurements of ICU patients, labelled with mortality or survival at discharge. The vital signs of interest in this study are heart and respiration rate, oxygen saturation and blood pressure. The latter comprises systolic, diastolic and mean arterial pressure. In the feature exploration process, it is aimed to extract simple and interpretable features that can provide clinical insight. For this purpose, a classifier is required that maximises the margin between the two classes (i.e., survival and mortality) with minimum tolerance to misclassification errors. Moreover, it preferably has to provide a linear decision surface in the original feature space without mapping to an unlimited dimensionality feature space. Therefore, a linear hard margin support vector machine (SVM) classifier is suggested. The extracted features are grouped in three categories: statistical, dynamic and physiological. Each category plays an important role in enhancing classification error performance. After extracting several features within the three categories, a manual feature fine-tuning is applied to consider only the most efficient features. The final classification, considering mortality as the positive class, resulted in an accuracy of <inline-formula> <math display="inline"> <semantics> <mrow> <mn>91.56</mn> <mo>%</mo> </mrow> </semantics> </math> </inline-formula>, sensitivity of <inline-formula> <math display="inline"> <semantics> <mrow> <mn>90.59</mn> <mo>%</mo> </mrow> </semantics> </math> </inline-formula>, precision of <inline-formula> <math display="inline"> <semantics> <mrow> <mn>86.52</mn> <mo>%</mo> </mrow> </semantics> </math> </inline-formula> and <i>F<inline-formula> <math display="inline"> <semantics> <msub> <mrow></mrow> <mn>1</mn> </msub> </semantics> </math> </inline-formula></i>-score of <inline-formula> <math display="inline"> <semantics> <mrow> <mn>88.50</mn> <mo>%</mo> </mrow> </semantics> </math> </inline-formula>. The obtained results show that the proposed feature engineering approach and the extracted features are valid to be considered and further enhanced for the mortality prediction purpose. Moreover, the proposed feature engineering approach moved the modelling methodology from black-box modelling to grey-box modelling in combination with the powerful classifier of SVMs.
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