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Register a new userModeling Diagnostic Label Correlation for Automatic ICD Coding
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Chao-Wei Huang
Publication date
2021
fields
Informatics Engineering
and research's language is
English
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Given the clinical notes written in electronic health records (EHRs), it is challenging to predict the diagnostic codes which is formulated as a multi-label classification task. The large set of labels, the hierarchical dependency, and the imbalanced data make this prediction task extremely hard. Most existing work built a binary prediction for each label independently, ignoring the dependencies between labels. To address this problem, we propose a two-stage framework to improve automatic ICD coding by capturing the label correlation. Specifically, we train a label set distribution estimator to rescore the probability of each label set candidate generated by a base predictor. This paper is the first attempt at learning the label set distribution as a reranking module for medical code prediction. In the experiments, our proposed framework is able to improve upon best-performing predictors on the benchmark MIMIC datasets. The source code of this project is available at https://github.com/MiuLab/ICD-Correlation.
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Automatic International Classification of Diseases (ICD) coding is defined as a kind of text multi-label classification problem, which is difficult because the number of labels is very large and the distribution of labels is unbalanced. The label-wise attention mechanism is widely used in automatic ICD coding because it can assign weights to every word in full Electronic Medical Records (EMR) for different ICD codes. However, the label-wise attention mechanism is computational redundant and costly. In this paper, we propose a pseudo label-wise attention mechanism to tackle the problem. Instead of computing different attention modes for different ICD codes, the pseudo label-wise attention mechanism automatically merges similar ICD codes and computes only one attention mode for the similar ICD codes, which greatly compresses the number of attention modes and improves the predicted accuracy. In addition, we apply a more convenient and effective way to obtain the ICD vectors, and thus our model can predict new ICD codes by calculating the similarities between EMR vectors and ICD vectors. Extensive experiments show the superior performance of our model. On the public MIMIC-III dataset and private Xiangya dataset, our model achieves micro f1 of 0.583 and 0.806, respectively, which outperforms other competing models. Furthermore, we verify the ability of our model in predicting new ICD codes. The case study shows how pseudo label-wise attention works, and demonstrates the effectiveness of pseudo label-wise attention mechanism.
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Diagnostic or procedural coding of clinical notes aims to derive a coded summary of disease-related information about patients. Such coding is usually done manually in hospitals but could potentially be automated to improve the efficiency and accuracy of medical coding. Recent studies on deep learning for automated medical coding achieved promising performances. However, the explainability of these models is usually poor, preventing them to be used confidently in supporting clinical practice. Another limitation is that these models mostly assume independence among labels, ignoring the complex correlation among medical codes which can potentially be exploited to improve the performance. We propose a Hierarchical Label-wise Attention Network (HLAN), which aimed to interpret the model by quantifying importance (as attention weights) of words and sentences related to each of the labels. Secondly, we propose to enhance the major deep learning models with a label embedding (LE) initialisation approach, which learns a dense, continuous vector representation and then injects the representation into the final layers and the label-wise attention layers in the models. We evaluated the methods using three settings on the MIMIC-III discharge summaries: full codes, top-50 codes, and the UK NHS COVID-19 shielding codes. Experiments were conducted to compare HLAN and LE initialisation to the state-of-the-art neural network based methods. HLAN achieved the best Micro-level AUC and $F_1$ on the top-50 code prediction and comparable results on the NHS COVID-19 shielding code prediction to other models. By highlighting the most salient words and sentences for each label, HLAN showed more meaningful and comprehensive model interpretation compared to its downgraded baselines and the CNN-based models. LE initialisation consistently boosted most deep learning models for automated medical coding.
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