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UID:pretalx-2026-AZZVUV@conferences.acspri.org.au
DTSTART;TZID=AEST:20261126T111500
DTEND;TZID=AEST:20261126T113000
DESCRIPTION:Background: Qualitative Comparative Analysis (QCA) is a case-ba
 sed method that examines combinations of causal conditions that lead to an
  outcome. Unlike variance-based methods\, which average the effects of ind
 ependent variables to explain an outcome and assume that the effect of eac
 h independent variable remains constant regardless of the values of other 
 variables\, case-based methods seek to explain outliers and unexplained va
 riance by producing open-ended\, descriptive results. Grounded in set theo
 ry\, QCA focuses on the effects of cases (rows) on an outcome by consideri
 ng observations as sets\, rather than focusing on the effects of variables
  (columns). Case-based methods can synthesise evidence and provide context
 ual information about cases that remain unexplained in variance-based anal
 yses. Traditional QCA has primarily included patient and clinical characte
 ristics as causal conditions\, with less attention given to incorporating 
 process conditions into case-based analyses.\n\nObjective: In this project
 \, we assess whether process features captured in electronic medical recor
 ds are sufficient or necessary conditions leading to 30-day unplanned read
 mission among patients with heart failure. We aim to extend causal conditi
 ons to include process conditions and use QCA to examine whether process f
 eatures are sufficient or necessary for discovering configurations associa
 ted with the outcome.\n\nMethods: We extracted eligible patients from the 
 de-identified\, publicly available Medical Information Mart for Intensive 
 Care (MIMIC-IV) database. Patients were included if they were aged ≥18 y
 ears and had a first heart failure hospitalisation between 2011 and 2022. 
 Patients deceased during the index hospitalisation were excluded. In total
 \, we extracted 12 tables from MIMIC-IV\, including hospital transfers\, p
 atient demographics\, laboratory measurements\, and procedures to create a
 n event log capturing patient trajectories from hospital admission to disc
 harge. Local process mining was then applied to identify the most common e
 vents observed in the dataset and were used to generate process features. 
 The events and their order were included in QCA to assess whether process 
 conditions were sufficient or necessary in configurational pathways leadin
 g to 30-day unplanned readmission.\n\nResults: A total of 285 patients wit
 h a first heart failure hospitalisation between 2011 and 2022 were identif
 ied. Of these\, 95 (33.3%) experienced a 30-day unplanned readmission. The
  average age was 67 years\, 94 (34.0%) patients were female\, 69.0% were C
 aucasian\, and the mean Charlson Comorbidity Index was 5.0. Local process 
 mining identified three events that were associated with the outcome: tran
 sfer to the operating room (OR)\, multi-lumen catheter insertion (ML)\, an
 d arterial line insertion (AL). The relationships between these events wer
 e also derived\, including AL→ML and AL→OR. By logically eliminating a
 nd synthesising the conditions and analysing the truth table\, we identifi
 ed that no single condition was sufficient to produce the outcome. However
 \, the combination of AL and ML was associated with readmission (N = 4) an
 d demonstrated perfect consistency (consistency = 1.0). Incorporating the 
 sequential process condition AL→ML also identified four readmission case
 s with a consistency score of 1.0\, indicating that all patients who follo
 wed this pathway were readmitted within 30 days.\n\nConclusion: By applyin
 g process mining to extract process conditions and integrating these condi
 tions into a set-theoretic\, case-based analysis\, we found that process f
 eatures were able to discover the cases leading to 30-day unplanned readmi
 ssion. The inclusion of process features in QCA offers more precise and me
 aningful insights into patient care pathways and demonstrates the potentia
 l value of combining process mining and case-based analysis in medicine.
DTSTAMP:20261013T070135Z
LOCATION:Holme Room
SUMMARY:Evidence Synthesis of 30-Day Unplanned Heart Failure Readmission th
 rough Case-based Local Process Discovery - Haeri Min
URL:https://conferences.acspri.org.au/2026/talk/AZZVUV/
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