For care of chronic diseases (e.g., depression, diabetes, hypertension), it is critical to identify effective treatment pathways that aim to promptly update the medication following the change of patient state and disease progression. This task is challenging because the optimal treatment pathway for each patient needs to be personalized due to the significant heterogeneity among individuals. Therefore, it is naturally promising to investigate how to use the abundant electronic health records to recommend effective and safe prescriptions. However, prescription recommendation needs to consider multiple aspects of life-critical evidence, such as the information relevance in terms of medical concepts, the health condition in terms of diagnosis history, and the further constraint in terms of side information (e.g., patient demographics and drug side effects). To this end, in this article, we propose a novel prescription recommendation framework named OntoPath to predict the next drug in disease treatment pathways, by building an ontology-aware hierarchical-attention model that integrates multiple medical evidence from domain knowledge guidance, medical history profiling, and side information utilization. Specifically, our method can be characterized from three aspects: (1) by incorporating the longitudinal diagnosis history, we enrich the profiling of patients in terms of comprehensive health conditions, which can largely influence a drug’s outcome on individual patients; (2) using the hierarchical disease and drug ontology structures, we are able to model the domain-specific relevance between patients and drugs at multiple levels of granularity and achieve in-depth collaborative filtering; (3) we introduce a pre-training stage to enhance the discriminativeness of network representations, which helps us obtain a premium model initialization to further boost the final recommendation training. We perform extensive experiments on a large-scale depression cohort with over 37,000 patients from a real-world medical claims database. The quantitative and qualitative results demonstrate the effectiveness of OntoPath through the consistent outperformance over state-of-the-art prescription recommendation baselines and the interpretation of model mechanism in case studies.

Diabetes is a chronic diseases that affects nearly half a billion people around the globe, and is almost always associated with a number of complications, including kidney failure, blindness, stroke, and heart attack. An important step towards improved diabetes care is to accurately predict the risk of diabetes complications and to identify the corresponding risk factors associated with the onset of each complication. In this paper, we study the problem of risk prediction and outcome-specific risk factor identification from readily available patient medical record data. We adopt a private-shared multi-task learning (MTL) model, which jointly models multiple complications with each task corresponding to the risk modeling of one complication. The MTL formulation not only boosts prediction performance but also enables identification of outcome-specific risk factors. Specifically, we decompose the coefficient matrix, in which each column (vector) corresponds to the coefficient of one complication risk model, into a shared component and an outcome-specific private component. The shared component is assumed to be low-rank to capture the relationships among complications in terms of overall diabetes health condition. The private component is assumed to be non-overlapping and sparse so that they are discriminative among the different complication outcomes. Further, the shared component and the private component for the same complication are assumed to be orthogonal. Extensive experimental results on a type 2 diabetes cohort extracted from a large electronic medical claims database show that the proposed method outperforms baseline models by a significant margin. Also the identified outcome-specific risk factors provide meaningful clinical insights. The results demonstrate that simultaneously modeling multiple risks through MTL not only improves prediction performance but also enables identification of outcome-specific risk factors.

Diabetes mellitus, commonly known as diabetes, is a chronic disease that often results in multiple complications. Risk prediction of diabetes complications is critical for healthcare professionals to design personalized treatment plans for patients in diabetes care for improved outcomes. In this paper, focusing on Type 2 diabetes mellitus (T2DM), we study the risk of developing complications after the initial T2DM diagnosis from longitudinal patient records. We propose a novel multi-task learning approach to simultaneously model multiple complications where each task corresponds to the risk modeling of one complication. Specifically, the proposed method strategically captures the relationships (1) between the risks of multiple T2DM complications, (2) between different risk factors, and (3) between the risk factor selection patterns, which assumes similar complications have similar contributing risk factors. The method uses coefficient shrinkage to identify an informative subset of risk factors from high-dimensional data, and uses a hierarchical Bayesian framework to allow domain knowledge to be incorporated as priors. The proposed method is favorable for healthcare applications because in addition to improved prediction performance, relationships among the different risks and among risk factors are also identified. Extensive experimental results on a large electronic medical claims database show that the proposed method outperforms state-of-the-art models by a significant margin. Furthermore, we show that the risk associations learned and the risk factors identified lead to meaningful clinical insights.

Type 2 diabetes mellitus (T2DM) is a chronic disease that usually results in multiple complications. Early identification of individuals at risk for complications after being diagnosed with T2DM is of significant clinical value. In this paper, we present a new data-driven predictive approach to predict when a patient will develop complications after the initial T2DM diagnosis. We propose a novel survival analysis method to model the time-to-event of T2DM complications designed to simultaneously achieve two important metrics: 1) accurate prediction of event times, and 2) good ranking of the relative risks of two patients. Moreover, to better capture the correlations of time-to-events of the multiple complications, we further develop a multi-task version of the survival model. To assess the performance of these approaches, we perform extensive experiments on patient level data extracted from a large electronic health record claims database. The results show that our new proposed survival analysis approach consistently outperforms traditional survival models and demonstrate the effectiveness of the multi-task framework over modeling each complication independently.

The proliferation of Electronic Health Records (EHRs) challenges data miners to discover potential and previously unknown patterns from a large collection of medical data. One of the tasks that we address in this paper is to reveal previously unknown effects of drugs on laboratory test results. We propose a method that leverages drug information to find a meaningful list of drugs that have an effect on the laboratory result. We formulate the problem as a convex non smooth function and develop a proximal gradient method to optimize it. The model has been evaluated on two important use cases: lowering low-density lipoproteins and glycated hemoglobin test results. The experimental results provide evidence that the proposed method is more accurate than the state-of-the-art method, rediscover drugs that are known to lower the levels of laboratory test results, and most importantly, discover additional potential drugs that may also lower these levels.