Data Visualization and Data Summary - Text Mining Techniques for Healthcare Provider Quality Determination - page 71

the National Library of Medicine), it is usually in a technical, non-clinical journal to show improvements
in the methodology (Hong, Chen, & Harris, 2008; Pfeiffer, 1985), or in DNA studies. (Fu, Borneman,
Ye, & Chrobak, 2005)
Nevertheless, medicine must and will focus more on the study of outlier patients; that is, to investigate
patients with extreme conditions instead of focusing just on the average or typical patient. Outlier patient
costs can often overwhelm the system even when they form just a small percentage of the total number of
patients. However, a keyword search of the term “outlier” in Medline returned just 188 articles total. Most
of the returned papers had to do with outlier lab results and quality control (Ahrens, 1999; Novis, Walsh,
Dale, & Howanitz, 2004) rather than with patients with extreme treatment needs. Just a handful of papers
discussed outlier physician performance. (Harley, Mohammed, Hussain, Yates, & Almasri, 2005)
Exactly one paper considered length of stay and the term, 'outlier'. It examined the length of stay of
patients in the intensive care unit; all of the patients in ICU can be considered extreme or outlier.(Weiss-
man, 1997) This paper clearly demonstrated the problem of assuming a normal distribution and estimating
averages when the data were clearly skewed. The paper also showed that any current method used to define
outliers tended to under-estimate the number of outliers, and the extremes in the added costs of outliers.
This result was confirmed in a dissertation on costs and outliers.(Battioui, 2007) Therefore, future trends
can only go in the direction of more concern for the impact of the outlier, or most severe patients.

Table 9. Osteoporosis medications by outpatient fractures

Row
number

RevisedRXName STRENGTH OF

Rx/PRESCR MED
DOSE)

QUANTITY OF
Rx/PRESCR MED
_Sum

3-DIGIT
ICD-9-CM
CODE

3-DIGIT
ICD-9-CM
CODE

3-DIGIT
ICD-9-CM
CODE

1 Fosamax® 35 4 805 -1 -1

2 Fosamax® 70 12 825 -1 -1

3 Fosamax® 70 156 824 -1 -1

4 Fosamax® 70 156 824 -1 -1

5 Fosamax® 70 156 824 -1 -1

6 Fosamax® 70 156 824 -1 -1

7 Fosamax® 70 156 824 -1 -1

8 Fosamax® 70 156 824 -1 -1

9 Fosamax® 70 156 824 -1 -1

10 Fosamax® 70 156 824 -1 -1

11

Fosamax® 70 156 824 -1 -1

12 Fosamax® 70 156 824 -1 -1

13 Fosamax® 70 156 824 -1 -1

14 Fosamax® 70 156 824 -1 -1

15 Actonel® 30 32 823 -1 -1

16 Actonel® 30 32 823 -1 -1

17 Actonel® 30 32 823 -1 -1

18 Fosamax® 70 4 820 812 814

19 Fosamax® 70 4 820 812 814