The cardiology practice you are working with has two physicians on staff: Dr. Johnson and Dr. Wu. While the practice has many patients, they are interested in identifying which patients who visit are at high risk of all-cause mortality within the next 6 months. Having an outpatient visit sometime in 2016 makes up the inclusion criteria for the analytics. The target variable is whether the patient passed away within 6 months of their visit.
Now that we've reviewed the details of the modeling assignment, let's take a look at the five patients in the database. The preliminary data sent to you by the cardiology practice includes information on five patients, distributed across six tables. The following are case vignettes for each of the patients. Note that this section is heavy on clinical terminology related to cardiovascular diseases. We encourage you to use available online resources to answer your questions about this terminology. A comprehensive clinical reference is Harrison's Principles of Internal Medicine (Kasper et al., 2005), the information for which is given at the end of the chapter.
The following is the information about the patients:
- Patient ID-1: Patient #1 in the database is a 65-year-old male who has congestive heart failure (CHF), a chronic condition in which the heart is unable to pump blood properly to the rest of the body. He also has hypertension (high blood pressure), which is a risk factor for CHF. He visited his cardiologist, Dr. Johnson, on 9/1/2016 and 17/1/2016. On his January 9th visit, he was found to have an elevated BP (154/94) and an elevated B-natriuretic peptide (BNP) lab value of 350. BNP is a marker of CHF severity. He was subsequently placed on lisinopril and furosemide, which are first-line treatments for CHF and hypertension. Unfortunately, he passed away on May 15th, 2016.
- Patient ID-2: Patient #2 is a 39-year-old female with a history of angina pectoris (cardiovascular-related chest pain upon exercising) and diabetes mellitus. Diabetes mellitus is a risk factor for myocardial infarction (heart attack; a late, often fatal manifestation of atherosclerotic heart disease), and angina pectoris can be seen as an early manifestation of atherosclerotic heart disease. She visited her cardiologist, Dr. Wu, on January 15th, 2016, at which time she was found to have an elevated blood glucose level of 225, a sign of uncontrolled diabetes. She was started on metformin for her diabetes, as well as nitroglycerin, aspirin, and metoprolol for her angina.
- Patient ID-3: Patient #3 is a 32-year-old female who sees Dr. Johnson for management of her hypertension. During her visit on February 1st, 2016 her blood pressure was elevated at 161/100. She was started on valsartan/hydrochlorothiazide, an anti-hypertensive combination.
- Patient ID: 4: Patient #4 is a 51-year-old male who has severe CHF with pulmonary hypertension. He saw Dr. Wu on February 27th, 2016. During that visit, his weight was 211 lbs and his blood pressure was slightly elevated at 143/84. His BNP level was highly elevated at 1,000. He was given lisinopril and furosemide for his CHF as well as diltiazem for his pulmonary hypertension. Unfortunately, he passed away on June 8th, 2016.
- Patient ID-5: The last patient in our database, patient #5, is a 58-year-old male who presented to Dr. Wu on March 1st, 2016 with a history of CHF and diabetes mellitus Type 2. During the visit, his glucose was elevated at 318 and BNP was moderately elevated at 400. He was started on lisinopril and furosemide for his CHF and metformin for his diabetes.