Abstract:Chronic Obstructive Pulmonary Disorder (COPD) is an irreversible and progressive disease which is highly heritable. Clinically, COPD is defined using the summary measures derived from a spirometry test but these are not always adequate. Here we show that using the high-dimensional raw spirogram can provide a richer signal compared to just using the summary measures. We design a transformer-based deep learning technique to process the raw spirogram values along with demographic information and predict clinically-relevant endpoints related to COPD. Our method is able to perform better than prior works while being more computationally efficient. Using the weights learned by the model, we make the framework more interpretable by identifying parts of the spirogram that are important for the model predictions. Pairing up with a board-certified pulmonologist, we also provide clinical insights into the different aspects of the spirogram and show that the explanations obtained from the model align with underlying medical knowledge.
Abstract:Long COVID is a general term of post-acute sequelae of COVID-19. Patients with long COVID can endure long-lasting symptoms including fatigue, headache, dyspnea and anosmia, etc. Identifying the cohorts with severe long-term complications in COVID-19 could benefit the treatment planning and resource arrangement. However, due to the heterogeneous phenotype presented in long COVID patients, it is difficult to predict their outcomes from their longitudinal data. In this study, we proposed a spatiotemporal attention mechanism to weigh feature importance jointly from the temporal dimension and feature space. Considering that medical examinations can have interchangeable orders in adjacent time points, we restricted the learning of short-term dependency with a Local-LSTM and the learning of long-term dependency with the joint spatiotemporal attention. We also compared the proposed method with several state-of-the-art methods and a method in clinical practice. The methods are evaluated on a hard-to-acquire clinical dataset of patients with long COVID. Experimental results show the Local-LSTM with joint spatiotemporal attention outperformed related methods in outcome prediction. The proposed method provides a clinical tool for the severity assessment of long COVID.