Many computational models were proposed to extract temporal patterns from clinical time series for each patient and among patient group for predictive healthcare. However, the common relations among patients (e.g., share the same doctor) were rarely considered. In this paper, we represent patients and clinicians relations by bipartite graphs addressing for example from whom a patient get a diagnosis. We then solve for the top eigenvectors of the graph Laplacian, and include the eigenvectors as latent representations of the similarity between patient-clinician pairs into a time-sensitive prediction model. We conducted experiments using real-world data to predict the initiation of first-line treatment for Chronic Lymphocytic Leukemia (CLL) patients. Results show that relational similarity can improve prediction over multiple baselines, for example a 5 incremental over long-short term memory baseline in terms of area under precision-recall curve.
Medical treatment prediction is a core research task of disease progression modeling. Recently, many deep learning models have made rapid advancements on this topic. In @cite_19 , a two-level attention model was designed to detect influential past visits and significant clinical variables for better prediction accuracy and interpretability. In @cite_17 , a graph-based attention model was proposed to extract hierarchical information from medical oncologies and improve RNN-based rare disease prediction. In @cite_1 , a bi-directional RNN was designed to remember information of both the past and future visits based on three attention mechanism to measure the relationship of different visits for prediction. In @cite_2 , a RNN architecture through dynamically matching temporal patterns was proposed to learn the similarity between two longitudinal patient record sequences for personalized prediction of Parkinson's Disease. Other similar approaches have also been proposed @cite_8 @cite_14 .
@cite_14 @cite_8 @cite_1 @cite_19 @cite_2 @cite_17
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The goal of diagnosis prediction task is to predict the future health information of patients from their historical Electronic Healthcare Records (EHR). The most important and challenging problem of diagnosis prediction is to design an accurate, robust and interpretable predictive model. Existing work solves this problem by employing recurrent neural networks (RNNs) with attention mechanisms, but these approaches suffer from the data sufficiency problem. To obtain good performance with insufficient data, graph-based attention models are proposed. However, when the training data are sufficient, they do not offer any improvement in performance compared with ordinary attention-based models. To address these issues, we propose KAME, an end-to-end, accurate and robust model for predicting patients' future health information. KAME not only learns reasonable embeddings for nodes in the knowledge graph, but also exploits general knowledge to improve the prediction accuracy with the proposed knowledge attention mechanism. With the learned attention weights, KAME allows us to interpret the importance of each piece of knowledge in the graph. Experimental results on three real world datasets show that the proposed KAME significantly improves the prediction performance compared with the state-of-the-art approaches, guarantees the robustness with both sufficient and insufficient data, and learns interpretable disease representations. Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, recorded in electronic medical records, are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors in space, models patient health state trajectories through explicit memory of historical records. Built on Long Short-Term Memory (LSTM), DeepCare introduces time parameterizations to handle irregular timed events by moderating the forgetting and consolidation of memory cells. DeepCare also incorporates medical interventions that change the course of illness and shape future medical risk. Moving up to the health state level, historical and present health states are then aggregated through multiscale temporal pooling, before passing through a neural network that estimates future outcomes. We demonstrate the efficacy of DeepCare for disease progression modeling, intervention recommendation, and future risk prediction. On two important cohorts with heavy social and economic burden -- diabetes and mental health -- the results show improved modeling and risk prediction accuracy. Diagnosis prediction aims to predict the future health status of patients according to their historical visit records, which is an important yet challenging task in healthcare informatics. Existing diagnosis prediction approaches mainly employ recurrent neural networks (RNNs) with attention mechanisms to make predictions. However, these approaches ignore the importance of code descriptions, i.e., the medical definitions of diagnosis codes. We believe that taking diagnosis code descriptions into account can help the state-of-the-art models not only to learn meaningful code representations, but also to improve the predictive performance. Thus, in this paper, we propose a simple, but general diagnosis prediction framework, which includes two basic components: diagnosis code embedding and predictive model. To learn the interpretable code embeddings, we apply convolutional neural networks (CNNs) to model medical descriptions of diagnosis codes extracted from online medical websites. The learned medical embedding matrix is used to embed the input visits into vector representations, which are fed into the predictive models. Any existing diagnosis prediction approach (referred to as the base model) can be cast into the proposed framework as the predictive model (called the enhanced model). We conduct experiments on two real medical datasets: the MIMIC-III dataset and the Heart Failure claim dataset. Experimental results show that the enhanced diagnosis prediction approaches significantly improve the prediction performance. With the advent of electronic health records, more data are continuously collected for individual patients, and more data are available for review from past patients. Despite this, it has not yet been possible to successfully use this data to systematically build clinical decision support systems that can produce personalized clinical recommendations to assist clinicians in providing individualized healthcare. In this paper, we present a novel approach, discovery engine (DE), that discovers which patient characteristics are most relevant for predicting the correct diagnosis and or recommending the best treatment regimen for each patient. We demonstrate the performance of DE in two clinical settings: diagnosis of breast cancer as well as a personalized recommendation for a specific chemotherapy regimen for breast cancer patients. For each distinct clinical recommendation, different patient features are relevant; DE can discover these different relevant features and use them to recommend personalized clinical decisions. The DE approach achieves a 16.6 improvement over existing state-of-the-art recommendation algorithms regarding kappa coefficients for recommending the personalized chemotherapy regimens. For diagnostic predictions, the DE approach achieves a 2.18 and 4.20 improvement over existing state-of-the-art prediction algorithms regarding prediction error rate and false positive rate, respectively. We also demonstrate that the performance of our approach is robust against missing information and that the relevant features discovered by DE are confirmed by clinical references.