Label-dependent and event-guided interpretable disease risk prediction using EHRs

Electronic health records (EHRs) contain patients' heterogeneous data that are collected from medical providers involved in the patient's care, including medical notes, clinical events, laboratory test results, symptoms, and diagnoses. In the field of modern healthcare, predicting whether patients would experience any risks based on their EHRs has emerged as a promising research area, in which artificial intelligence (AI) plays a key role. To make AI models practically applicable, it is required that the prediction results should be both accurate and interpretable. To achieve this goal, this paper proposed a label-dependent and event-guided risk prediction model (LERP) to predict the presence of multiple disease risks by mainly extracting information from unstructured medical notes. Our model is featured in the following aspects. First, we adopt a label-dependent mechanism that gives greater attention to words from medical notes that are semantically similar to the names of risk labels. Secondly, as the clinical events (e.g., treatments and drugs) can also indicate the health status of patients, our model utilizes the information from events and uses them to generate an event-guided representation of medical notes. Thirdly, both label-dependent and event-guided representations are integrated to make a robust prediction, in which the interpretability is enabled by the attention weights over words from medical notes. To demonstrate the applicability of the proposed method, we apply it to the MIMIC-III dataset, which contains real-world EHRs collected from hospitals. Our method is evaluated in both quantitative and qualitative ways.

Label Dependent Attention Model for Disease Risk Prediction Using Multimodal Electronic Health Records

Disease risk prediction has attracted increasing attention in the field of modern healthcare, especially with the latest advances in artificial intelligence (AI). Electronic health records (EHRs), which contain heterogeneous patient information, are widely used in disease risk prediction tasks. One challenge of applying AI models for risk prediction lies in generating interpretable evidence to support the prediction results while retaining the prediction ability. In order to address this problem, we propose the method of jointly embedding words and labels whereby attention modules learn the weights of words from medical notes according to their relevance to the names of risk prediction labels. This approach boosts interpretability by employing an attention mechanism and including the names of prediction tasks in the model. However, its application is only limited to the handling of textual inputs such as medical notes. In this paper, we propose a label dependent attention model LDAM to 1) improve the interpretability by exploiting Clinical-BERT (a biomedical language model pre-trained on a large clinical corpus) to encode biomedically meaningful features and labels jointly; 2) extend the idea of joint embedding to the processing of time-series data, and develop a multi-modal learning framework for integrating heterogeneous information from medical notes and time-series health status indicators. To demonstrate our method, we apply LDAM to the MIMIC-III dataset to predict different disease risks. We evaluate our method both quantitatively and qualitatively. Specifically, the predictive power of LDAM will be shown, and case studies will be carried out to illustrate its interpretability.