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arXiv 2602.20442cs.LGcs.AI

稀疏电子健康记录中未知缺失值的填补

Imputation of Unknown Missingness in Sparse Electronic Health Records

Jun Han, Josue Nassar, Sanjit Singh Batra, Aldo Cordova-Palomera, Vijay Nori, Robert E. Tillman

AI总结:

本文提出了一种基于变换器的去噪神经网络,用于解决电子健康记录中未知缺失值的填补问题,提高了医疗代码去噪的准确性,并在医院再入院预测任务中取得了显著提升。

摘要:

机器学习在推进医学领域方面具有巨大潜力,电子健康记录(EHRs)是主要的数据来源。然而,EHRs往往稀疏且包含缺失数据,这是由于数据收集和医疗提供者之间数据共享的各种挑战和限制所致。现有的填补缺失值技术大多专注于已知的未知数,例如实验室检查结果的缺失或不可用值;大多数并不明确处理难以区分什么缺失的情况。例如,EHR中的缺失诊断代码可能表示患者未被诊断出该状况,或者诊断已被做出,但未由提供者共享。此类情况属于未知未知数的范式。为了解决这一挑战,我们开发了一个通用算法,用于数据去噪以恢复二进制EHR中的未知缺失值。我们设计了一种基于变换器的去噪神经网络,其输出经过自适应阈值处理,以在预测数据缺失的情况下恢复值。我们的结果表明,与现有填补方法相比,在真实EHR数据集中对医疗代码进行去噪的准确性得到了提升,并且使用去噪数据在下游任务中的性能也有所提高。特别是,当将我们的方法应用于真实世界应用,即从EHR预测医院再入院时,我们的方法在统计上显著优于所有现有基线。

英文摘要:

Machine learning holds great promise for advancing the field of medicine, with electronic health records (EHRs) serving as a primary data source. However, EHRs are often sparse and contain missing data due to various challenges and limitations in data collection and sharing between healthcare providers. Existing techniques for imputing missing values predominantly focus on known unknowns, such as missing or unavailable values of lab test results; most do not explicitly address situations where it is difficult to distinguish what is missing. For instance, a missing diagnosis code in an EHR could signify either that the patient has not been diagnosed with the condition or that a diagnosis was made, but not shared by a provider. Such situations fall into the paradigm of unknown unknowns. To address this challenge, we develop a general purpose algorithm for denoising data to recover unknown missing values in binary EHRs. We design a transformer-based denoising neural network where the output is thresholded adaptively to recover values in cases where we predict data are missing. Our results demonstrate improved accuracy in denoising medical codes within a real EHR dataset compared to existing imputation approaches and leads to increased performance on downstream tasks using the denoised data. In particular, when applying our method to a real world application, predicting hospital readmission from EHRs, our method achieves statistically significant improvement over all existing baselines.

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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