# Forecasting Emergency Department Crowding with Advanced Machine Learning Models and Multivariable Input

arXiv: https://arxiv.org/abs/2308.16544 · HTML: https://mlsanity.com/paper/2308.16544/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 9 of its 51 references that are in the map.
- First posted on arXiv 31 Aug 2023.

## Builds on (most cited first, 9 of 9)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Optuna: A Next-generation Hyperparameter Optimization Framework](https://mlsanity.com/paper/1907.10902/) (2019)
- [DeepAR: Probabilistic Forecasting with Autoregressive Recurrent Networks](https://mlsanity.com/paper/1704.04110/) (2017)
- [Temporal Fusion Transformers for Interpretable Multi-horizon Time Series Forecasting](https://mlsanity.com/paper/1912.09363/) (2019)
- [N-BEATS: Neural basis expansion analysis for interpretable time series forecasting](https://mlsanity.com/paper/1905.10437/) (2019)
- [Darts: User-Friendly Modern Machine Learning for Time Series](https://mlsanity.com/paper/2110.03224/) (2021)
- [A Temporal Fusion Transformer for Long-term Explainable Prediction of Emergency Department Overcrowding](https://mlsanity.com/paper/2207.00610/) (2022)
- [Early Warning Software for Emergency Department Crowding](https://mlsanity.com/paper/2301.09108/) (2023)

## Abstract (arXiv)

Emergency department (ED) crowding is a significant threat to patient safety and it has been repeatedly associated with increased mortality. Forecasting future service demand has the potential patient outcomes. Despite active research on the subject, several gaps remain: 1) proposed forecasting models have become outdated due to quick influx of advanced machine learning models (ML), 2) amount of multivariable input data has been limited and 3) discrete performance metrics have been rarely reported. In this study, we document the performance of a set of advanced ML models in forecasting ED occupancy 24 hours ahead. We use electronic health record data from a large, combined ED with an extensive set of explanatory variables, including the availability of beds in catchment area hospitals, traffic data from local observation stations, weather variables, etc. We show that N-BEATS and LightGBM outpeform benchmarks with 11 % and 9 % respective improvements and that DeepAR predicts next day crowding with an AUC of 0.76 (95 % CI 0.69-0.84). To the best of our knowledge, this is the first study to document the superiority of LightGBM and N-BEATS over statistical benchmarks in the context of ED forecasting.