Predicting health risks from electronic health records (EHR) is a topic of recent interest. Deep learning models have achieved success by modeling temporal and feature interaction. However, these methods learn insufficient representations and lead to poor performance when it comes to patients with few visits or sparse records. Inspired by the fact that doctors may compare the patient with typical patients and make decisions from similar cases, we propose a Progressive Prototypical Network (PPN) to select typical patients as prototypes and utilize their information to enhance the representation of the given patient. In particular, a progressive prototype memory and two prototype separation losses are proposed to update prototypes. Besides, a novel integration is introduced for better fusing information from patients and prototypes. Experiments on three real-world datasets demonstrate that our model brings improvement on all metrics. To make our results better understood by physicians, we developed an application at http://ppn.ai-care.top. Our code is released at https://github.com/yzhHoward/PPN.

With the widespread adoption of electronic health records (EHR) data, deep learning techniques have been broadly utilized for various health prediction tasks. Nevertheless, the labeled data scarcity issue restricts the prediction power of these deep models. To enhance the generalization capability of deep learning models when faced with such situations, a common trend is to train generative adversarial networks (GANs) or diffusion models for data augmentation. However, due to limitations in sample size and potential label imbalance issues, these methods are prone to mode collapse problems. This results in the generation of new samples that fail to preserve the subtype structure within EHR data, thereby limiting their practicality in health prediction tasks that generally require detailed patient phenotyping. Aiming at the above problems, we propose a Prototype-based Mixup method, dubbed ProtoMix, which combines prior knowledge of intrinsic data features from subtype centroids (i.e., prototypes) to guide the synthesis of new samples. Specifically, ProtoMix employs a prototype-guided mixup training task to shift the decision boundary away from the subtypes. Then, ProtoMix optimizes the sampling weights in different areas of the data manifold via a prototype-guided mixup sampling strategy. Throughout the training process, ProtoMix dynamically expands the training distribution using an adaptive mixing coefficient computation method. Experimental evaluations on three real-world datasets demonstrate the efficacy of ProtoMix.

Due to the insufficiency of electronic health records (EHR) data utilized in practical diagnosis prediction scenarios, most works are devoted to learning powerful patient representations either from structured EHR data (e.g., temporal medical events, lab test results, etc.) or unstructured data (e.g., clinical notes, etc.). However, synthesizing rich information from both of them still needs to be explored. Firstly, the heterogeneous semantic biases across them heavily hinder the synthesis of representation spaces, which is critical for diagnosis prediction. Secondly, the intermingled quality of partial clinical notes leads to inadequate representations of to-be-predicted patients. Thirdly, typical attention mechanisms mainly focus on aggregating information from similar patients, ignoring important auxiliary information from others. To tackle these challenges, we propose a novel visit sequences-clinical notes joint learning approach, dubbed VecoCare. It performs a Gromov-Wasserstein Distance (GWD)-based contrastive learning task and an adaptive masked language model task in a sequential pre-training manner to reduce heterogeneous semantic biases. After pre-training, VecoCare further aggregates information from both similar and dissimilar patients through a dual-channel retrieval mechanism. We conduct diagnosis prediction experiments on two real-world datasets, which indicates that VecoCare outperforms state-of-the-art approaches. Moreover, the findings discovered by VecoCare are consistent with the medical researches.

Many recommender systems optimize click through rates (CTRs) as one of their core goals, and it further breaks down to predicting each item's click probability for a user (user-item click probability) and recommending the top ones to this particular user. User-item click probability is then estimated as a single term, and the basic assumption is that the user has different preferences over items. This is presumably true, but from real-world data, we observe that some people are naturally more active in clicking on items while some are not. This intrinsic tendency contributes to their user-item click probabilities. Besides this, when a user sees a particular item she likes, the click probability for this item increases due to this user-item preference.

Multimodal electronic health record (EHR) data are widely used in clinical applications. Conventional methods usually assume that each sample (patient) is associated with the unified observed modalities, and all modalities are available for each sample. However, missing modality caused by various clinical and social reasons is a common issue in real-world clinical scenarios. Existing methods mostly rely on solving a generative model that learns a mapping from the latent space to the original input space, which is an unstable ill-posed inverse problem. To relieve the underdetermined system, we propose a model solving a direct problem, dubbed learning with Missing Modalities in Multimodal healthcare data (M3Care). M3Care is an end-to-end model compensating the missing information of the patients with missing modalities to perform clinical analysis. Instead of generating raw missing data, M3Care imputes the task-related information of the missing modalities in the latent space by the auxiliary information from each patient's similar neighbors, measured by a task-guided modality-adaptive similarity metric, and thence conducts the clinical tasks. The task-guided modality-adaptive similarity metric utilizes the uncensored modalities of the patient and the other patients who also have the same uncensored modalities to find similar patients. Experiments on real-world datasets show that M3Care outperforms the state-of-the-art baselines. Moreover, the findings discovered by M3Care are consistent with experts and medical knowledge, demonstrating the capability and the potential of providing useful insights and explanations.

Deep learning models have been applied to many healthcare tasks based on electronic medical records (EMR) data and shown substantial performance. Existing methods commonly embed the records of a single patient into a representation for medical tasks. Such methods learn inadequate representations and lead to inferior performance, especially when the patient’s data is sparse or low-quality. Aiming at the above problem, we propose GRASP, a generic framework for healthcare models. For a given patient, GRASP first finds patients in the dataset who have similar conditions and similar results (i.e., the similar patients), and then enhances the representation learning and prognosis of the given patient by leveraging knowledge extracted from these similar patients. GRASP defines similarities with different meanings between patients for different clinical tasks, and finds similar patients with useful information accordingly, and then learns cohort representation to extract valuable knowledge contained in the similar patients. The cohort information is fused with the current patient’s representation to conduct final clinical tasks. Experimental evaluations on two real-world datasets show that GRASP can be seamlessly integrated into state-of-the-art models with consistent performance improvements. Besides, under the guidance of medical experts, we verified the findings extracted by GRASP, and the findings are consistent with the existing medical knowledge, indicating that GRASP can generate useful insights for relevant predictions.

Due to the characteristics of COVID-19, the epidemic develops rapidly and overwhelms health service systems worldwide. Many patients suffer from life-threatening systemic problems and need to be carefully monitored in ICUs. An intelligent prognosis can help physicians take an early intervention, prevent adverse outcomes, and optimize the medical resource allocation, which is urgently needed, especially in this ongoing global pandemic crisis. However, in the early stage of the epidemic outbreak, the data available for analysis is limited due to the lack of effective diagnostic mechanisms, the rarity of the cases, and privacy concerns. In this paper, we propose a distilled transfer learning framework, which leverages the existing publicly available online Electronic Medical Records to enhance the prognosis for inpatients with emerging infectious diseases. It learns to embed the COVID-19-related medical features based on massive existing EMR data. The transferred parameters are further trained to imitate the teacher model’s representation based on distillation, which embeds the health status more comprehensively on the source dataset. We conduct Length-of-Stay prediction experiments for patients in ICUs on real-world COVID-19 datasets. The experiment results indicate that our proposed model consistently outperforms competitive baseline methods. In order to further verify the scalability of o deal with different clinical tasks on different EMR datasets, we conduct an additional mortality prediction experiment on End-Stage Renal Disease datasets. The extensive experiments demonstrate that an benefit the prognosis for emerging pandemics and other diseases with limited EMR.

Deep learning-based health status representation learning and clinical prediction have raised much research interest in recent years. Existing models have shown superior performance, but there are still several major issues that have not been fully taken into consideration. First, the historical variation pattern of the biomarker in diverse time scales plays a vital role in indicating the health status, but it has not been explicitly extracted by existing works. Second, key factors that strongly indicate the health risk are different among patients. It is still challenging to adaptively make use of the features for patients in diverse conditions. Third, using prediction models as the black box will limit the reliability in clinical practice. However, none of the existing works can provide satisfying interpretability and meanwhile achieve high prediction performance. In this work, we develop a general health status representation learning model, named AdaCare. It can capture the long and short-term variations of biomarkers as clinical features to depict the health status in multiple time scales. It also models the correlation between clinical features to enhance the ones which strongly indicate the health status and thus can maintain a state-of-the-art performance in terms of prediction accuracy while providing qualitative interpretability. We conduct a health risk prediction experiment on two real-world datasets. Experiment results indicate that AdaCare outperforms state-of-the-art approaches and provides effective interpretability, which is verifiable by clinical experts.

Predicting the patient's clinical outcome from the historical electronic medical records (EMR) is a fundamental research problem in medical informatics. Most deep learning-based solutions for EMR analysis concentrate on learning the clinical visit embedding and exploring the relations between visits. Although those works have shown superior performances in healthcare prediction, they fail to explore the personal characteristics during the clinical visits thoroughly. Moreover, existing works usually assume that the more recent record weights more in the prediction, but this assumption is not suitable for all conditions. In this paper, we propose ConCare to handle the irregular EMR data and extract feature interrelationship to perform individualized healthcare prediction. Our solution can embed the feature sequences separately by modeling the time-aware distribution. ConCare further improves the multi-head self-attention via the cross-head decorrelation, so that the inter-dependencies among dynamic features and static baseline information can be effectively captured to form the personal health context. Experimental results on two real-world EMR datasets demonstrate the effectiveness of ConCare. The medical findings extracted by ConCare are also empirically confirmed by human experts and medical literature.