Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators

• Published in: Healthcare (Basel) Vol. 12; no. 9; p. 913
• Main Authors: Vera-Salmerón, Eugenio, Domínguez-Nogueira, Carmen, Sáez, José A, Romero-Béjar, José L, Mota-Romero, Emilio
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-05-2024
• Subjects: Algorithms; Bedsores; Classification; Clinical medicine; Data science; Decision making; Decision trees; Fecal incontinence; Health aspects; interpretability; Medical personnel; Methods; Nursing; Nursing care; Nutrition; Patients; Pressure ulcers; Prevention; Risk assessment; Risk factors; risk level; Skin; Variables; Spain; pressure ulcers; interpretability; classification; decision trees; risk level
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare12090913

Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient's requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.