No Arabic abstract
This paper reports our preliminary work on medical incident prediction in general, and fall risk prediction in specific, using machine learning. Data for the machine learning are generated only from the particular subset of the electronic medical records (EMR) at Osaka Medical and Pharmaceutical University Hospital. As a result of conducting three experiments such as (1) machine learning algorithm comparison, (2) handling imbalance, and (3) investigation of explanatory variable contribution to the fall incident prediction, we find the investigation of explanatory variables the most effective.
Predicting highrisk vascular diseases is a significant issue in the medical domain. Most predicting methods predict the prognosis of patients from pathological and radiological measurements, which are expensive and require much time to be analyzed. Here we propose deep attention models that predict the onset of the high risky vascular disease from symbolic medical histories sequence of hypertension patients such as ICD-10 and pharmacy codes only, Medical History-based Prediction using Attention Network (MeHPAN). We demonstrate two types of attention models based on 1) bidirectional gated recurrent unit (R-MeHPAN) and 2) 1D convolutional multilayer model (C-MeHPAN). Two MeHPAN models are evaluated on approximately 50,000 hypertension patients with respect to precision, recall, f1-measure and area under the curve (AUC). Experimental results show that our MeHPAN methods outperform standard classification models. Comparing two MeHPANs, R-MeHPAN provides more better discriminative capability with respect to all metrics while C-MeHPAN presents much shorter training time with competitive accuracy.
We leverage deep sequential models to tackle the problem of predicting healthcare utilization for patients, which could help governments to better allocate resources for future healthcare use. Specifically, we study the problem of textit{divergent subgroups}, wherein the outcome distribution in a smaller subset of the population considerably deviates from that of the general population. The traditional approach for building specialized models for divergent subgroups could be problematic if the size of the subgroup is very small (for example, rare diseases). To address this challenge, we first develop a novel attention-free sequential model, SANSformers, instilled with inductive biases suited for modeling clinical codes in electronic medical records. We then design a task-specific self-supervision objective and demonstrate its effectiveness, particularly in scarce data settings, by pre-training each model on the entire health registry (with close to one million patients) before fine-tuning for downstream tasks on the divergent subgroups. We compare the novel SANSformer architecture with the LSTM and Transformer models using two data sources and a multi-task learning objective that aids healthcare utilization prediction. Empirically, the attention-free SANSformer models perform consistently well across experiments, outperforming the baselines in most cases by at least $sim 10$%. Furthermore, the self-supervised pre-training boosts performance significantly throughout, for example by over $sim 50$% (and as high as $800$%) on $R^2$ score when predicting the number of hospital visits.
The issue of disagreements amongst human experts is a ubiquitous one in both machine learning and medicine. In medicine, this often corresponds to doctor disagreements on a patient diagnosis. In this work, we show that machine learning models can be trained to give uncertainty scores to data instances that might result in high expert disagreements. In particular, they can identify patient cases that would benefit most from a medical second opinion. Our central methodological finding is that Direct Uncertainty Prediction (DUP), training a model to predict an uncertainty score directly from the raw patient features, works better than Uncertainty Via Classification, the two-step process of training a classifier and postprocessing the output distribution to give an uncertainty score. We show this both with a theoretical result, and on extensive evaluations on a large scale medical imaging application.
Medical coding translates professionally written medical reports into standardized codes, which is an essential part of medical information systems and health insurance reimbursement. Manual coding by trained human coders is time-consuming and error-prone. Thus, automated coding algorithms have been developed, building especially on the recent advances in machine learning and deep neural networks. To solve the challenges of encoding lengthy and noisy clinical documents and capturing code associations, we propose a multitask recalibrated aggregation network. In particular, multitask learning shares information across different coding schemes and captures the dependencies between different medical codes. Feature recalibration and aggregation in shared modules enhance representation learning for lengthy notes. Experiments with a real-world MIMIC-III dataset show significantly improved predictive performance.
Automatic speech recognition (ASR) systems in the medical domain that focus on transcribing clinical dictations and doctor-patient conversations often pose many challenges due to the complexity of the domain. ASR output typically undergoes automatic punctuation to enable users to speak naturally, without having to vocalise awkward and explicit punctuation commands, such as period, add comma or exclamation point, while truecasing enhances user readability and improves the performance of downstream NLP tasks. This paper proposes a conditional joint modeling framework for prediction of punctuation and truecasing using pretrained masked language models such as BERT, BioBERT and RoBERTa. We also present techniques for domain and task specific adaptation by fine-tuning masked language models with medical domain data. Finally, we improve the robustness of the model against common errors made in ASR by performing data augmentation. Experiments performed on dictation and conversational style corpora show that our proposed model achieves ~5% absolute improvement on ground truth text and ~10% improvement on ASR outputs over baseline models under F1 metric.