Article ; Online: Temporal self-attention for risk prediction from electronic health records using non-stationary kernel approximation.
Artificial intelligence in medicine
2024 Volume 149, Page(s) 102802
Abstract: Effective modeling of patient representation from electronic health records (EHRs) is increasingly becoming a vital research topic. Yet, modeling the non-stationarity in EHR data has received less attention. Most existing studies follow a strong ... ...
Abstract | Effective modeling of patient representation from electronic health records (EHRs) is increasingly becoming a vital research topic. Yet, modeling the non-stationarity in EHR data has received less attention. Most existing studies follow a strong assumption of stationarity in patient representation from EHRs. However, in practice, a patient's visits are irregularly spaced over a relatively long period of time, and disease progression patterns exhibit non-stationarity. Furthermore, the time gaps between patient visits often encapsulate significant domain knowledge, potentially revealing undiscovered patterns that characterize specific medical conditions. To address these challenges, we introduce a new method which combines the self-attention mechanism with non-stationary kernel approximation to capture both contextual information and temporal relationships between patient visits in EHRs. To assess the effectiveness of our proposed approach, we use two real-world EHR datasets, comprising a total of 76,925 patients, for the task of predicting the next diagnosis code for a patient, given their EHR history. The first dataset is a general EHR cohort and consists of 11,451 patients with a total of 3,485 unique diagnosis codes. The second dataset is a disease-specific cohort that includes 65,474 pregnant patients and encompasses a total of 9,782 unique diagnosis codes. Our experimental evaluation involved nine prediction models, categorized into three distinct groups. Group 1 comprises the baselines: original self-attention with positional encoding model, RETAIN model, and LSTM model. Group 2 includes models employing self-attention with stationary kernel approximations, specifically incorporating three variations of Bochner's feature maps. Lastly, Group 3 consists of models utilizing self-attention with non-stationary kernel approximations, including quadratic, cubic, and bi-quadratic polynomials. The experimental results demonstrate that non-stationary kernels significantly outperformed baseline methods for NDCG@10 and Hit@10 metrics in both datasets. The performance boost was more substantial in dataset 1 for the NDCG@10 metric. On the other hand, stationary Kernels showed significant but smaller gains over baselines and were nearly as effective as Non-stationary Kernels for Hit@10 in dataset 2. These findings robustly validate the efficacy of employing non-stationary kernels for temporal modeling of EHR data, and emphasize the importance of modeling non-stationary temporal information in healthcare prediction tasks. |
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MeSH term(s) | Humans ; Electronic Health Records ; Algorithms ; Disease Progression |
Language | English |
Publishing date | 2024-02-10 |
Publishing country | Netherlands |
Document type | Journal Article |
ZDB-ID | 645179-2 |
ISSN | 1873-2860 ; 0933-3657 |
ISSN (online) | 1873-2860 |
ISSN | 0933-3657 |
DOI | 10.1016/j.artmed.2024.102802 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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