Predictive Modeling


Predictive Modeling in health care strives to use health data to predict the ultimate cost of a claim based on claimant characteristics, and injury circumstance.

It can also be used to evaluate the efficacy a treatment based on specific injury and patient characteristics. These results can help inform treatment decision and adds to the understanding of evidence based medicine.

In workers comp this means developing a model that can help predict how quickly the claimant returns to work, the chances of a claim reopening at a later date and whether surgery or physical therapy are more effective treatment of a given injury type.

Evidence Based Medicine

wikipedia: "Evidence-based medicine (EBM) or evidence-based practice (EBP) aims to apply the best available evidence gained from the scientific method to clinical decision making.[1] It seeks to assess the strength of evidence of the risks and benefits of treatments (including lack of treatment) and diagnostic tests.[2] This helps clinicians to learn whether or not any treatment will do more good than harm.[3]
Evidence quality can be assessed based on the source type (from meta-analyses and systematic reviews of double-blind, placebo-controlled clinical trials at the top end, down to conventional wisdom at the bottom), as well as other factors including statistical validity, clinical relevance, currency, and peer-review acceptance."

Key Presentations:

Workers Comp Claims Predictive Modeling - How to Reduce WC Medical Costs

PRIDIT: An Example from Hospital Quality

Helpful links:

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