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Register a new userTransfer Learning in Electronic Health Records through Clinical Concept Embedding
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Added by
Abdelaali Hassaine
Publication date
2021
fields
Informatics Engineering
and research's language is
English
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Deep learning models have shown tremendous potential in learning representations, which are able to capture some key properties of the data. This makes them great candidates for transfer learning: Exploiting commonalities between different learning tasks to transfer knowledge from one task to another. Electronic health records (EHR) research is one of the domains that has witnessed a growing number of deep learning techniques employed for learning clinically-meaningful representations of medical concepts (such as diseases and medications). Despite this growth, the approaches to benchmark and assess such learned representations (or, embeddings) is under-investigated; this can be a big issue when such embeddings are shared to facilitate transfer learning. In this study, we aim to (1) train some of the most prominent disease embedding techniques on a comprehensive EHR data from 3.1 million patients, (2) employ qualitative and quantitative evaluation techniques to assess these embeddings, and (3) provide pre-trained disease embeddings for transfer learning. This study can be the first comprehensive approach for clinical concept embedding evaluation and can be applied to any embedding techniques and for any EHR concept.
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Recurrent Neural Networks (RNNs) are often used for sequential modeling of adverse outcomes in electronic health records (EHRs) due to their ability to encode past clinical states. These deep, recurrent architectures have displayed increased performance compared to other modeling approaches in a number of tasks, fueling the interest in deploying deep models in clinical settings. One of the key elements in ensuring safe model deployment and building user trust is model explainability. Testing with Concept Activation Vectors (TCAV) has recently been introduced as a way of providing human-understandable explanations by comparing high-level concepts to the networks gradients. While the technique has shown promising results in real-world imaging applications, it has not been applied to structured temporal inputs. To enable an application of TCAV to sequential predictions in the EHR, we propose an extension of the method to time series data. We evaluate the proposed approach on an open EHR benchmark from the intensive care unit, as well as synthetic data where we are able to better isolate individual effects.
The use of collaborative and decentralized machine learning techniques such as federated learning have the potential to enable the development and deployment of clinical risk predictions models in low-resource settings without requiring sensitive data be shared or stored in a central repository. This process necessitates communication of model weights or updates between collaborating entities, but it is unclear to what extent patient privacy is compromised as a result. To gain insight into this question, we study the efficacy of centralized versus federated learning in both private and non-private settings. The clinical prediction tasks we consider are the prediction of prolonged length of stay and in-hospital mortality across thirty one hospitals in the eICU Collaborative Research Database. We find that while it is straightforward to apply differentially private stochastic gradient descent to achieve strong privacy bounds when training in a centralized setting, it is considerably more difficult to do so in the federated setting.
Today, despite decades of developments in medicine and the growing interest in precision healthcare, vast majority of diagnoses happen once patients begin to show noticeable signs of illness. Early indication and detection of diseases, however, can provide patients and carers with the chance of early intervention, better disease management, and efficient allocation of healthcare resources. The latest developments in machine learning (more specifically, deep learning) provides a great opportunity to address this unmet need. In this study, we introduce BEHRT: A deep neural sequence transduction model for EHR (electronic health records), capable of multitask prediction and disease trajectory mapping. When trained and evaluated on the data from nearly 1.6 million individuals, BEHRT shows a striking absolute improvement of 8.0-10.8%, in terms of Average Precision Score, compared to the existing state-of-the-art deep EHR models (in terms of average precision, when predicting for the onset of 301 conditions). In addition to its superior prediction power, BEHRT provides a personalised view of disease trajectories through its attention mechanism; its flexible architecture enables it to incorporate multiple heterogeneous concepts (e.g., diagnosis, medication, measurements, and more) to improve the accuracy of its predictions; and its (pre-)training results in disease and patient representations that can help us get a step closer to interpretable predictions.
Increasing volume of Electronic Health Records (EHR) in recent years provides great opportunities for data scientists to collaborate on different aspects of healthcare research by applying advanced analytics to these EHR clinical data. A key requirement however is obtaining meaningful insights from high dimensional, sparse and complex clinical data. Data science approaches typically address this challenge by performing feature learning in order to build more reliable and informative feature representations from clinical data followed by supervised learning. In this paper, we propose a predictive modeling approach based on deep learning based feature representations and word embedding techniques. Our method uses different deep architectures (stacked sparse autoencoders, deep belief network, adversarial autoencoders and variational autoencoders) for feature representation in higher-level abstraction to obtain effective and robust features from EHRs, and then build prediction models on top of them. Our approach is particularly useful when the unlabeled data is abundant whereas labeled data is scarce. We investigate the performance of representation learning through a supervised learning approach. Our focus is to present a comparative study to evaluate the performance of different deep architectures through supervised learning and provide insights in the choice of deep feature representation techniques. Our experiments demonstrate that for small data sets, stacked sparse autoencoder demonstrates a superior generality performance in prediction due to sparsity regularization whereas variational autoencoders outperform the competing approaches for large data sets due to its capability of learning the representation distribution
Increasing volume of Electronic Health Records (EHR) in recent years provides great opportunities for data scientists to collaborate on different aspects of healthcare research by applying advanced analytics to these EHR clinical data. A key requirement however is obtaining meaningful insights from high dimensional, sparse and complex clinical data. Data science approaches typically address this challenge by performing feature learning in order to build more reliable and informative feature representations from clinical data followed by supervised learning. In this paper, we propose a predictive modeling approach based on deep learning based feature representations and word embedding techniques. Our method uses different deep architectures (stacked sparse autoencoders, deep belief network, adversarial autoencoders and variational autoencoders) for feature representation in higher-level abstraction to obtain effective and robust features from EHRs, and then build prediction models on top of them. Our approach is particularly useful when the unlabeled data is abundant whereas labeled data is scarce. We investigate the performance of representation learning through a supervised learning approach. Our focus is to present a comparative study to evaluate the performance of different deep architectures through supervised learning and provide insights in the choice of deep feature representation techniques. Our experiments demonstrate that for small data sets, stacked sparse autoencoder demonstrates a superior generality performance in prediction due to sparsity regularization whereas variational autoencoders outperform the competing approaches for large data sets due to its capability of learning the representation distribution.
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