diff --git a/ML/2-modeling.R b/ML/2-modeling.R index b48e024..cddc966 100644 --- a/ML/2-modeling.R +++ b/ML/2-modeling.R @@ -395,9 +395,9 @@ model_data %>% dplyr::mutate(tsh_level = ifelse(TSH > 4.2, "high", "low")) %>% dplyr::group_by(tsh_level, ft4_dia) %>% dplyr::summarise( - n = n() + n = dplyr::n() ) %>% - mutate(freq = n / sum(n)) + dplyr::mutate(freq = n / sum(n)) diff --git a/chapter5.qmd b/chapter5.qmd index 5fc45c2..aab303d 100644 --- a/chapter5.qmd +++ b/chapter5.qmd @@ -43,4 +43,39 @@ adjustment, race explaining 6.5 percent of the variation in TSH levels included in developing a future algorithm. However, as it stands, the current data set has incomplete data for patient race and ethnicity. +### Other Limitations + +Should I write about my computer? - It is not capable of running the +more powerful algorithm + +### Future Studies + +Explain how to fix these issues. + ## Real World Applications + +While the current algorithm did not quite achieve an accuracy ready for +deployment, it is hypothesized that a system like this could be +implemented in clinical decision-making systems. As stated previously, +current practice is a physician (or other care providers) orders a TSH, +and if the value is outside laboratory-established reference ranges, the +Free T4 is added on. In the current study database, this reflex testing +was non-diagnostic 76% of the time for elevated TSH values and 67% for +decreased TSH values. Using clinical decision support first to predict +whether the Free T4 would be diagnostic, the care provider can use this +prediction and other patient signs and symptoms to determine if running +a Free T4 lab test is needed. + +Similarly to Luo et al., the idea that the diagnostic information +offered by Free T4 often duplicates what other diagnostic tests provide +suggests a notion of "informationally" redundant testing [-@luo2016]. It +is speculated that informationally redundant testing occurs in various +diagnostic settings and diagnostic workups. It is much more frequent +than the more traditionally defined and narrowly framed notion of +redundant testing, which most often includes unintended duplications of +the same or similar tests. Under this narrow definition, redundant +laboratory testing is estimated to waste more than \$5 billion annually +in the United States, potentially dwarfed by the waste from +informationally redundant testing [@luo2016]. However, since Free T4 and +all other tests used in this study are performed on automated +instruments, the cost savings to the lab and patient may be minimal.