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arXiv 2404.06723cs.LGcs.CL

面向具有语言监督的多模态电子健康记录的全局对比训练

Global Contrastive Training for Multimodal Electronic Health Records with Language Supervision

University of Florida(佛罗里达大学)
Yingbo Ma, Suraj Kolla, Zhenhong Hu, Dhruv Kaliraman, Victoria Nolan, Ziyuan Guan, Yuanfang Ren, Brooke Armfield, Tezcan Ozrazgat-Baslanti, Jeremy A. Balch, Tyl… 展开作者

Yingbo Ma, Suraj Kolla, Zhenhong Hu, Dhruv Kaliraman, Victoria Nolan, Ziyuan Guan, Yuanfang Ren, Brooke Armfield, Tezcan Ozrazgat-Baslanti, Jeremy A. Balch, Tyler J. Loftus, Parisa Rashidi, Azra Bihorac, Benjamin Shickel

AI总结:

本文提出融合时间交叉注意力transformer、动态嵌入分词与全局对比损失的语言监督多模态EHR框架,并在三家医院逾12万例手术的九类术后并发症预测中优于现有方法。

摘要:

现代电子健康记录(EHR)凭借其广泛的覆盖范围、规模和时间粒度,在通过序列深度学习追踪个性化患者健康轨迹方面具有巨大前景。然而,鉴于EHR的高维度、多模态、稀疏性、不同记录频率以及时间不规则性等复杂特征,如何有效利用来自EHR的多种模态构成了重大挑战。为此,本文提出了一种新颖的多模态对比学习框架,特别聚焦于医学时间序列和临床笔记。为应对医学时间序列中稀疏性和不规则时间间隔的挑战,该框架将时间交叉注意力transformer与动态嵌入和分词方案相结合,用于学习多模态特征表示。为利用医学时间序列与临床笔记之间相互关联的关系,该框架配备了全局对比损失,将患者的多模态特征表示与相应的出院小结进行对齐。由于出院小结唯一地属于个体患者,并代表患者住院过程的整体视图,机器学习模型会通过全局对比被引导学习具有判别力的多模态特征。在真实世界EHR数据集上进行的大量实验表明,在使用来自UF health system、拆分至三家医院(UF Health Gainesville、UF Health Jacksonville和UF Health Jacksonville-North)的多模态数据,为超过120,000例大型住院手术预测九种术后并发症发生情况这一示例任务上,我们的框架优于最先进方法。

英文摘要:

Modern electronic health records (EHRs) hold immense promise in tracking personalized patient health trajectories through sequential deep learning, owing to their extensive breadth, scale, and temporal granularity. Nonetheless, how to effectively leverage multiple modalities from EHRs poses significant challenges, given its complex characteristics such as high dimensionality, multimodality, sparsity, varied recording frequencies, and temporal irregularities. To this end, this paper introduces a novel multimodal contrastive learning framework, specifically focusing on medical time series and clinical notes. To tackle the challenge of sparsity and irregular time intervals in medical time series, the framework integrates temporal cross-attention transformers with a dynamic embedding and tokenization scheme for learning multimodal feature representations. To harness the interconnected relationships between medical time series and clinical notes, the framework equips a global contrastive loss, aligning a patient's multimodal feature representations with the corresponding discharge summaries. Since discharge summaries uniquely pertain to individual patients and represent a holistic view of the patient's hospital stay, machine learning models are led to learn discriminative multimodal features via global contrasting. Extensive experiments with a real-world EHR dataset demonstrated that our framework outperformed state-of-the-art approaches on the exemplar task of predicting the occurrence of nine postoperative complications for more than 120,000 major inpatient surgeries using multimodal data from UF health system split among three hospitals (UF Health Gainesville, UF Health Jacksonville, and UF Health Jacksonville-North).

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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