Real-time prediction of clinical interventions remains a challenge within intensive care units (ICUs). This task is complicated by data sources that are noisy, sparse, heterogeneous and outcomes that are imbalanced. In this paper, we integrate data from all available ICU sources (vitals, labs, notes, demographics) and focus on learning rich representations of this data to predict onset and weaning of multiple invasive interventions. In particular, we compare both long short-term memory networks (LSTM) and convolutional neural networks (CNN) for prediction of five intervention tasks: invasive ventilation, non-invasive ventilation, vasopressors, colloid boluses, and crystalloid boluses. Our predictions are done in a forward-facing manner to enable "real-time" performance, and predictions are made with a six hour gap time to support clinically actionable planning. We achieve state-of-the-art results on our predictive tasks using deep architectures. We explore the use of feature occlusion to interpret LSTM models, and compare this to the interpretability gained from examining inputs that maximally activate CNN outputs. We show that our models are able to significantly outperform baselines in intervention prediction, and provide insight into model learning, which is crucial for the adoption of such models in practice.
Recent studies have applied recurrent neural networks (RNNs) to modeling sequential EHR data to tag ICU signals with billing code labels , to identify the impact of different drugs for diabetes . @cite_2 compared CNNs to LSTMs for longitudinal outcome prediction on billing codes using lab tests. With regard to interpretability, @cite_3 used temporal attention to identify important features in early diagnostic prediction of chronic diseases from time-ordered billing codes. Others have focused on using representations of clinical notes or patient physiological signals to predict mortality .
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We have recently seen many successful applications of recurrent neural networks (RNNs) on electronic medical records (EMRs), which contain histories of patients' diagnoses, medications, and other various events, in order to predict the current and future states of patients. Despite the strong performance of RNNs, it is often challenging for users to understand why the model makes a particular prediction. Such black-box nature of RNNs can impede its wide adoption in clinical practice. Furthermore, we have no established methods to interactively leverage users' domain expertise and prior knowledge as inputs for steering the model. Therefore, our design study aims to provide a visual analytics solution to increase interpretability and interactivity of RNNs via a joint effort of medical experts, artificial intelligence scientists, and visual analytics researchers. Following the iterative design process between the experts, we design, implement, and evaluate a visual analytics tool called RetainVis, which couples a newly improved, interpretable, and interactive RNN-based model called RetainEX and visualizations for users' exploration of EMR data in the context of prediction tasks. Our study shows the effective use of RetainVis for gaining insights into how individual medical codes contribute to making risk predictions, using EMRs of patients with heart failure and cataract symptoms. Our study also demonstrates how we made substantial changes to the state-of-the-art RNN model called RETAIN in order to make use of temporal information and increase interactivity. This study will provide a useful guideline for researchers that aim to design an interpretable and interactive visual analytics tool for RNNs. Despite the recent advances in automatically describing image contents, their applications have been mostly limited to image caption datasets containing natural images (e.g., Flickr 30k, MSCOCO). In this paper, we present a deep learning model to efficiently detect a disease from an image and annotate its contexts (e.g., location, severity and the affected organs). We employ a publicly available radiology dataset of chest x-rays and their reports, and use its image annotations to mine disease names to train convolutional neural networks (CNNs). In doing so, we adopt various regularization techniques to circumvent the large normal-vs-diseased cases bias. Recurrent neural networks (RNNs) are then trained to describe the contexts of a detected disease, based on the deep CNN features. Moreover, we introduce a novel approach to use the weights of the already trained pair of CNN RNN on the domain-specific image text dataset, to infer the joint image text contexts for composite image labeling. Significantly improved image annotation results are demonstrated using the recurrent neural cascade model by taking the joint image text contexts into account. Neural network based approaches have recently produced record-setting performances in natural language understanding tasks such as word labeling. In the word labeling task, a tagger is used to assign a label to each word in an input sequence. Specifically, simple recurrent neural networks (RNNs) and convolutional neural networks (CNNs) have shown to significantly outperform the previous state-of-the-art - conditional random fields (CRFs). This paper investigates using long short-term memory (LSTM) neural networks, which contain input, output and forgetting gates and are more advanced than simple RNN, for the word labeling task. To explicitly model output-label dependence, we propose a regression model on top of the LSTM un-normalized scores. We also propose to apply deep LSTM to the task. We investigated the relative importance of each gate in the LSTM by setting other gates to a constant and only learning particular gates. Experiments on the ATIS dataset validated the effectiveness of the proposed models. Recently recurrent neural networks (RNNs) have demonstrated the ability to improve scene labeling through capturing long-range dependencies among image units. In this paper, we propose dense RNNs for scene labeling by exploring various long-range semantic dependencies among image units. In comparison with existing RNN based approaches, our dense RNNs are able to capture richer contextual dependencies for each image unit via dense connections between each pair of image units, which significantly enhances their discriminative power. Besides, to select relevant and meanwhile restrain irrelevant dependencies for each unit from dense connections, we introduce an attention model into dense RNNs. The attention model enables automatically assigning more importance to helpful dependencies while less weight to unconcerned dependencies. Integrating with convolutional neural networks (CNNs), our method achieves state-of-the-art performances on the PASCAL Context, MIT ADE20K and SiftFlow benchmarks.