A New Trained Supervised Method for Calculating Patient Similarity

Abstract

Personalized predictive modelling has been growing rapidly with the increasing availability of Electronic Health Records. This approach aims to improve a model's predictive performance by fitting a unique model to each individual. We train the model on a subset of the training data consisting of individuals similar to the individual being predicted, identified through some similarity metric. Earlier studies show that using a personalized model trained on a customized subset of the data leads to better prediction than using a global model trained on the full dataset. In this work, we develop a new patient similarity metric to improve the prediction of a personalized model for binary response data. Specifically, we introduce a weighted cosine similarity metric that extends the standard cosine similarity metric by assigning predictor-specific weights when computing similarity between participants. These weights are estimated using a supervised approach with the relaxed adaptive group lasso. Results from simulation studies and an analysis of intensive care unit data show that although our proposed similarity metric leads to a slight deterioration in calibration, it produces substantial gains in discrimination. Overall predictive performance measured by the Brier Score improves because the increase in discrimination outweighs the loss in calibration; therefore, our proposed similarity metric more effectively identifies similar participants, resulting in improved predictive accuracy.