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Data mining techniques for temporal point processes applied to insurance claims data

Abstract

We explore data mining on databases consisting of insurance claims information. This dissertation focuses on two major topics we considered by way of data mining procedures. One is the development of a classification rule using kernels and support vector machines. The other is the discovery of association rules using the Apriori algorithm, its extensions, as well as a new association rules technique. With regard to the first topic we address the question-can kernel methods using an SVM classifier be used to predict patients at risk of type 2 diabetes using three years of insurance claims data? We report the results of a study in which we tested the performance of new methods for data extracted from the MarketScan® database. We summarize the results of applying popular kernels, as well as new kernels constructed specifically for this task, for support vector machines on data derived from this database. We were able to predict patients at risk of type 2 diabetes with nearly 80% success when combining a number of specialized kernels. The specific form of the data, that of a timed sequence, led us to develop two new kernels inspired by dynamic time warping. The Global Time Warping (GTW) and Local Time Warping (LTW) kernels build on an existing time warping kernel by including the timing coefficients present in classical time warping, while providing a solution for the diagonal dominance present in most alignment methods. We show that the LTW kernel performs significantly better than the existing time warping kernel when the times contained relevant information. With regard to the second topic, we provide a new theorem on closed rules that could help substantially improve the time to find a specific type of rule. An insurance claims database contains codes indicating associated diagnoses and the resulting procedures for each claim. The rules that we consider are of the form diagnoses imply procedures. In addition, we introduce a new class of interesting association rules in the context of medical claims databases and illustrate their potential uses by extracting example rules from the MarketScan® database.

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Subject

association rules
closed rules
data mining
diabetes
insurance claims
kernel methods
time warping
statistics

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