Tree-Based Analysis: A Practical Approach to Create Clinical Decision-Making Tools

TY - JOUR

T1 - Tree-Based Analysis

T2 - A Practical Approach to Create Clinical Decision-Making Tools

AU - Banerjee, Mousumi

AU - Reynolds, Evan

AU - Andersson, Hedvig B.

AU - Nallamothu, Brahmajee K.

PY - 2019

Y1 - 2019

N2 - Tree-based methods have become one of the most flexible, intuitive, and powerful data analytic tools for exploring complex data structures. Tree-based methods provide a natural framework for creating patient subgroups for risk classification. In this article, we review methodological and practical aspects of tree-based methods, with a focus on diagnostic classification (binary outcome) and prognostication (censored survival outcome). Creating an ensemble of trees improves prediction accuracy and addresses instability in a single tree. Ensemble methods are described that rely on resampling from the original data. Finally, we present methods to identify a representative tree from the ensemble that can be used for clinical decision-making. The methods are illustrated using data on ischemic heart disease classification, and data from the SPRINT trial (Systolic Blood Pressure Intervention Trial) on adverse events in patients with high blood pressure.

AB - Tree-based methods have become one of the most flexible, intuitive, and powerful data analytic tools for exploring complex data structures. Tree-based methods provide a natural framework for creating patient subgroups for risk classification. In this article, we review methodological and practical aspects of tree-based methods, with a focus on diagnostic classification (binary outcome) and prognostication (censored survival outcome). Creating an ensemble of trees improves prediction accuracy and addresses instability in a single tree. Ensemble methods are described that rely on resampling from the original data. Finally, we present methods to identify a representative tree from the ensemble that can be used for clinical decision-making. The methods are illustrated using data on ischemic heart disease classification, and data from the SPRINT trial (Systolic Blood Pressure Intervention Trial) on adverse events in patients with high blood pressure.

KW - classification

KW - clinical decision-making

KW - coronary artery disease

KW - hypertension

KW - risk

U2 - 10.1161/CIRCOUTCOMES.118.004879

DO - 10.1161/CIRCOUTCOMES.118.004879

M3 - Journal article

C2 - 31043064

AN - SCOPUS:85065547868

SN - 1941-7713

VL - 12

JO - Circulation: Cardiovascular Quality and Outcomes

JF - Circulation: Cardiovascular Quality and Outcomes

IS - 5

M1 - e004879

ER -