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MeSIN: Multilevel Selective and Interactive Network for Medication Recommendation

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 Added by Yang An
 Publication date 2021
and research's language is English




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Recommending medications for patients using electronic health records (EHRs) is a crucial data mining task for an intelligent healthcare system. It can assist doctors in making clinical decisions more efficiently. However, the inherent complexity of the EHR data renders it as a challenging task: (1) Multilevel structures: the EHR data typically contains multilevel structures which are closely related with the decision-making pathways, e.g., laboratory results lead to disease diagnoses, and then contribute to the prescribed medications; (2) Multiple sequences interactions: multiple sequences in EHR data are usually closely correlated with each other; (3) Abundant noise: lots of task-unrelated features or noise information within EHR data generally result in suboptimal performance. To tackle the above challenges, we propose a multilevel selective and interactive network (MeSIN) for medication recommendation. Specifically, MeSIN is designed with three components. First, an attentional selective module (ASM) is applied to assign flexible attention scores to different medical codes embeddings by their relevance to the recommended medications in every admission. Second, we incorporate a novel interactive long-short term memory network (InLSTM) to reinforce the interactions of multilevel medical sequences in EHR data with the help of the calibrated memory-augmented cell and an enhanced input gate. Finally, we employ a global selective fusion module (GSFM) to infuse the multi-sourced information embeddings into final patient representations for medications recommendation. To validate our method, extensive experiments have been conducted on a real-world clinical dataset. The results demonstrate a consistent superiority of our framework over several baselines and testify the effectiveness of our proposed approach.



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Medication recommendation is an important healthcare application. It is commonly formulated as a temporal prediction task. Hence, most existing works only utilize longitudinal electronic health records (EHRs) from a small number of patients with multiple visits ignoring a large number of patients with a single visit (selection bias). Moreover, important hierarchical knowledge such as diagnosis hierarchy is not leveraged in the representation learning process. To address these challenges, we propose G-BERT, a new model to combine the power of Graph Neural Networks (GNNs) and BERT (Bidirectional Encoder Representations from Transformers) for medical code representation and medication recommendation. We use GNNs to represent the internal hierarchical structures of medical codes. Then we integrate the GNN representation into a transformer-based visit encoder and pre-train it on EHR data from patients only with a single visit. The pre-trained visit encoder and representation are then fine-tuned for downstream predictive tasks on longitudinal EHRs from patients with multiple visits. G-BERT is the first to bring the language model pre-training schema into the healthcare domain and it achieved state-of-the-art performance on the medication recommendation task.
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