Medication recommendation aims to suggest personalized drug combinations to patients based on their longitudinal medical histories stored in electronic health record (EHR) datasets. Patients' Dynamic Treatment Regimes (DTRs) determine how patients' drug combinations change along with the evolution of disease treatment. DTRs are effective for comprehending disease-treatment dynamics and for recommending a timely and personalized combination of medications for patients. However, existing medication recommender systems (MRSs) overlook the multiple treatment pathways generated by the intervention of DTRs and can only recommend a single treatment paradigm, ignoring the fact that patients may be at different treatment stages and thus require different treatment regime. Such disregard leads to a significant limitation in recommending personalized medication combinations tailored to different treatment stages, yielding greatly compromised accuracy and applicability of MRSs. Moreover, existing methods often overlook the time interval information over patients' successive visits, which is critical to indicate patients' treatment evolution. To address these significant gaps, we propose a Time-aware Medication Recommendation Framework via Intervention of Dynamic Treatment Regimes, called MR-DTR. To explicitly illustrate the intervention processes of DTRs on similar patients, we employ a co-guided graph to connect various patient sequences. In addition, to fully utilize the time interval information, we design a time-aware guidance mechanism dedicated to the co-guided graph to efficiently learn medication representation using the patient's guidance information. We also introduce relative time intervals in the encoder to act as positional information. Extensive experiments on two real-world datasets demonstrate that MR-DTR surpasses state-of-the-art models in terms of recommendation performance. Our code is available at: https://github.com/liyifo/MR-DTR.

The inherent complexity of real-world time series data, combined with the cost and infeasibility of manual labeling, presents considerable challenges to time series representation learning. Most existing studies tend to utilize data augmentation techniques to construct positive and negative samples and leverage a comparative learning framework to generate time series representations. However, they typically employ simple data augmentation techniques, such as jitter and cropping, to construct positive samples while randomly selecting irrelevant samples as negative ones, which are easily distinguished and unable to guide comparative learning to capture subtle discriminative features. Furthermore, they usually employ only a single positive sample for comparative learning, which is insufficient to model the diversity and hurts the robustness. To address these issues, this paper proposes a Time Series representation learning framework via Dual Reference Contrasting (TS-DRC). Specifically, we first utilize Markov transition field or Gramian angular field to transform the anchor sample of time series into image representations, which are adopted as positive samples. Then, we incorporate two positive samples (dual references) and one negative sample into the comparative learning framework, and devise a novel optimization objective to guide the model to capture more discriminate features, mitigate overfitting, and enhance the robustness. Extensive experiments conducted on four public real-world datasets demonstrate that our TS-DRC outperforms other state-of-the-art baselines.Our code is available at: https://github.com/yurui12138/TS-DRC.

Next basket recommender systems (NBRs) aim to recommend a user’s next (shopping) basket of items via modeling the user’s preferences towards items based on the user’s purchase history, usually a sequence of historical baskets. Due to its wide applicability in the real-world E-commerce industry, the studies NBR have attracted increasing attention in recent years. NBRs have been widely studied and much progress has been achieved in this area with a variety of NBR approaches having been proposed. However, an important issue is that there is a lack of a systematic and unified evaluation over the various NBR approaches. Different studies often evaluate NBR approaches on different datasets, under different experimental settings, making it hard to fairly and effectively compare the performance of different NBR approaches. To bridge this gap, in this work, we conduct a systematical empirical study in NBR area. Specifically, we review the representative work in NBR and analyze their cons and pros. Then, we run the selected NBR algorithms on the same datasets, under the same experimental setting and evaluate their performances using the same measurements. This provides a unified framework to fairly compare different NBR approaches. We hope this study can provide a valuable reference for the future research in this vibrant area.

Sequential diagnosis prediction on the Electronic Health Record (EHR) has been proven crucial for predictive analytics in the medical domain. EHR data, sequential records of a patient’s interactions with healthcare systems, has numerous inherent characteristics of temporality, irregularity and data insufficiency. Some recent works train healthcare predictive models by making use of sequential information in EHR data, but they are vulnerable to irregular, temporal EHR data with the states of admission/discharge from hospital, and insufficient data. To mitigate this, we propose an end-to-end robust transformer-based model called SETOR, which exploits neural ordinary differential equation to handle both irregular intervals between a patient’s visits with admitted timestamps and length of stay in each visit, to alleviate the limitation of insufficient data by integrating medical ontology, and to capture the dependencies between the patient’s visits by employing multi-layer transformer blocks. Experiments conducted on two real-world healthcare datasets show that, our sequential diagnoses prediction model SETOR not only achieves better predictive results than previous state-of-the-art approaches, irrespective of sufficient or insufficient training data, but also derives more interpretable embeddings of medical codes. The experimental codes are available at the GitHub repository1.1Github repository: https://github.com/Xueping/SETOR

Electronic health records (EHRs) are longitudinal records of a patient's interactions with healthcare systems. A patient's EHR data is organized as a three-level hierarchy from top to bottom: patient journey - all the experiences of diagnoses and treatments over a period of time; individual visit - a set of medical codes in a particular visit; and medical code - a specific record in the form of medical codes. As EHRs begin to amass in millions, the potential benefits, which these data might hold for medical research and medical outcome prediction, are staggering - including, for example, predicting future admissions to hospitals, diagnosing illnesses or determining the efficacy of medical treatments. Each of these analytics tasks requires a domain knowledge extraction method to transform the hierarchical patient journey into a vector representation for further prediction procedure. The representations should embed a sequence of visits and a set of medical codes with a specific timestamp, which are crucial to any downstream prediction tasks. Hence, expressively powerful representations are appealing to boost learning performance. To this end, we propose a novel self-attention mechanism that captures the contextual dependency and temporal relationships within a patient's healthcare journey. An end-to-end bidirectional temporal encoder network (BiteNet) then learns representations of the patient's journeys, based solely on the proposed attention mechanism. We have evaluated the effectiveness of our methods on two supervised prediction and two unsupervised clustering tasks with a real-world EHR dataset. The empirical results demonstrate the proposed BiteNet model produces higher-quality representations than state-of-the-art baseline methods.

In longitudinal electronic health records (EHRs), the event records of a patient are distributed over a long period of time and the temporal relations between the events reflect sufficient domain knowledge to benefit prediction tasks such as the rate of inpatient mortality. Medical concept embedding as a feature extraction method that transforms a set of medical concepts with a specific time stamp into a vector, which will be fed into a supervised learning algorithm. The quality of the embedding significantly determines the learning performance over the medical data. In this paper, we propose a medical concept embedding method based on applying a self-attention mechanism to represent each medical concept. We propose a novel attention mechanism which captures the contextual information and temporal relationships between medical concepts. A light-weight neural net, "Temporal Self-Attention Network (TeSAN)", is then proposed to learn medical concept embedding based solely on the proposed attention mechanism. To test the effectiveness of our proposed methods, we have conducted clustering and prediction tasks on two public EHRs datasets comparing TeSAN against five state-of-the-art embedding methods. The experimental results demonstrate that the proposed TeSAN model is superior to all the compared methods. To the best of our knowledge, this work is the first to exploit temporal self-attentive relations between medical events.