Evaluating the clinical similarities between pairwise patients is a fundamental problem in healthcare informatics. A proper patient similarity measure enables various downstream applications, such as cohort study and treatment comparative effectiveness research. One major carrier for conducting patient similarity research is Electronic Health Records(EHRs), which are usually heterogeneous, longitudinal, and sparse. Though existing studies on learning patient similarity from EHRs have shown being useful in solving real clinical problems, their applicability is limited due to the lack of medical interpretations. Moreover, most previous methods assume a vector-based representation for patients, which typically requires aggregation of medical events over a certain time period. As a consequence, temporal information will be lost. In this paper, we propose a patient similarity evaluation framework based on the temporal matching of longitudinal patient EHRs. Two efficient methods are presented, unsupervised and supervised, both of which preserve the temporal properties in EHRs. The supervised scheme takes a convolutional neural network architecture and learns an optimal representation of patient clinical records with medical concept embedding. The empirical results on real-world clinical data demonstrate substantial improvement over the baselines. We make our code and sample data available for further study.
There are many research have been conducted on clustering patients based on machine learning. In order to rate patients health perceptions, Sewitch @cite_25 make cluster analysis using k-means to identify the patients groups based on the discovering the multivariate pattern. To capture underlying structure in the history of present illness section from patients EHR, Henao @cite_32 proposed a statistical model that groups patients based on text data in the initial history of present illness (HPI) and final diagnosis (DX) of a patient’s EHR. For human disease gene expression, Huang @cite_9 presented a new recursive K-means spectral clustering method (ReKS) to efficient cluster human diseases. Most of these research have demonstrate effectiveness of their model with real-world experiments, that convinces us of the applicability of clustering patients on cohorts discovering.
@cite_9 @cite_32 @cite_25
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Display Omitted Survival prediction of HCC patients is modeled in a real and high complex scenario.Its complexity is due to a small dataset with heterogeneous and missing input data.We propose a new cluster-based oversampling method to overcome these drawbacks.Neural networks and logistic regression are applied in the classification stage.Experimental results show that our method outperforms previous existing approaches. Liver cancer is the sixth most frequently diagnosed cancer and, particularly, Hepatocellular Carcinoma (HCC) represents more than 90 of primary liver cancers. Clinicians assess each patients treatment on the basis of evidence-based medicine, which may not always apply to a specific patient, given the biological variability among individuals. Over the years, and for the particular case of Hepatocellular Carcinoma, some research studies have been developing strategies for assisting clinicians in decision making, using computational methods (e.g. machine learning techniques) to extract knowledge from the clinical data. However, these studies have some limitations that have not yet been addressed: some do not focus entirely on Hepatocellular Carcinoma patients, others have strict application boundaries, and none considers the heterogeneity between patients nor the presence of missing data, a common drawback in healthcare contexts. In this work, a real complex Hepatocellular Carcinoma database composed of heterogeneous clinical features is studied. We propose a new cluster-based oversampling approach robust to small and imbalanced datasets, which accounts for the heterogeneity of patients with Hepatocellular Carcinoma. The preprocessing procedures of this work are based on data imputation considering appropriate distance metrics for both heterogeneous and missing data (HEOM) and clustering studies to assess the underlying patient groups in the studied dataset (K-means). The final approach is applied in order to diminish the impact of underlying patient profiles with reduced sizes on survival prediction. It is based on K-means clustering and the SMOTE algorithm to build a representative dataset and use it as training example for different machine learning procedures (logistic regression and neural networks). The results are evaluated in terms of survival prediction and compared across baseline approaches that do not consider clustering and or oversampling using the Friedman rank test. Our proposed methodology coupled with neural networks outperformed all others, suggesting an improvement over the classical approaches currently used in Hepatocellular Carcinoma prediction models. Clustering of gene expression data simplifies subsequent data analyses and forms the basis of numerous approaches for biomarker identification, prediction of clinical outcome, and personalized therapeutic strategies. The most popular clustering methods such as K-means and hierarchical clustering are intuitive and easy to use, but they require arbitrary choices on their various parameters (number of clusters for K-means, and a threshold to cut the tree for hierarchical clustering). Human disease gene expression data are in general more difficult to cluster efficiently due to background (genotype) heterogeneity, disease stage and progression differences and disease subtyping; all of which cause gene expression datasets to be more heterogeneous. Spectral clustering has been recently introduced in many fields as a promising alternative to standard clustering methods. The idea is that pairwise comparisons can help reveal global features through the eigen techniques. In this paper, we developed a new recursive K-means spectral clustering method (ReKS) for disease gene expression data. We benchmarked ReKS on three large-scale cancer datasets and we compared it to different clustering methods with respect to execution time, background models and external biological knowledge. We found ReKS to be superior to the hierarchical methods and equally good to K-means, but much faster than them and without the requirement for a priori knowledge of K. Overall, ReKS offers an attractive alternative for efficient clustering of human disease data. 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. We propose a mixture model for text data designed to capture underlying structure in the history of present illness section of electronic medical records data. Additionally, we propose a method to induce bias that leads to more homogeneous sets of diagnoses for patients in each cluster. We apply our model to a collection of electronic records from an emergency department and compare our results to three other relevant models in order to assess performance. Results using standard metrics demonstrate that patient clusters from our model are more homogeneous when compared to others, and qualitative analyses suggest that our approach leads to interpretable patient sub-populations when applied to real data. Finally, we demonstrate an example of our patient clustering model to identify adverse drug events.