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Analyzing large EHR databases to predict cancer progression and treatments has become a hot trend in recent years. An increasing number of modern deep learning models have been proposed to find the milestones of essential patient medical journey characteristics to predict their disease status and give healthcare professionals valuable insights. However, most of the existing methods are lack of consideration for the inter-relationship among different patients. We believe that more valuable information can be extracted, especially when patients with similar disease statuses visit the same doctors. Towards this end, a similar patient augmentation-based approach named SimPA is proposed to enhance the learning of patient representations and further predict lines of therapy transition. Our experiment results on a real-world multiple myeloma dataset show that our proposed approach outperforms state-of-the-art baseline approaches in terms of standard evaluation metrics for classification tasks.
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Registros Eletrônicos de Saúde , Humanos , Bases de Dados FactuaisRESUMO
Federated learning (FL), which provides a collaborative training scheme for distributed data sources with privacy concerns, has become a burgeoning and attractive research area. Most existing FL studies focus on taking unimodal data, such as image and text, as the model input and resolving the heterogeneity challenge, i.e., the challenge of non-identical distribution (non-IID) caused by a data distribution imbalance related to data labels and data amount. In real-world applications, data are usually described by multiple modalities. However, to the best of our knowledge, only a handful of studies have been conducted to improve system performance utilizing multimodal data. In this survey paper, we identify the significance of this emerging research topic of multimodal federated learning (MFL) and present a literature review on the state-of-art MFL methods. Furthermore, we categorize multimodal federated learning into congruent and incongruent multimodal federated learning based on whether all clients possess the same modal combinations. We investigate the feasible application tasks and related benchmarks for MFL. Lastly, we summarize the promising directions and fundamental challenges in this field for future research.
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BACKGROUND: Sleep is a complex and dynamic biological process characterized by different sleep patterns. Comprehensive sleep monitoring and analysis using multivariate polysomnography (PSG) records has achieved significant efforts to prevent sleep-related disorders. To alleviate the time consumption caused by manual visual inspection of PSG, automatic multivariate sleep stage classification has become an important research topic in medical and bioinformatics. RESULTS: We present a unified hybrid self-attention deep learning framework, namely HybridAtt, to automatically classify sleep stages by capturing channel and temporal correlations from multivariate PSG records. We construct a new multi-view convolutional representation module to learn channel-specific and global view features from the heterogeneous PSG inputs. The hybrid attention mechanism is designed to further fuse the multi-view features by inferring their dependencies without any additional supervision. The learned attentional representation is subsequently fed through a softmax layer to train an end-to-end deep learning model. CONCLUSIONS: We empirically evaluate our proposed HybridAtt model on a benchmark PSG dataset in two feature domains, referred to as the time and frequency domains. Experimental results show that HybridAtt consistently outperforms ten baseline methods in both feature spaces, demonstrating the effectiveness of HybridAtt in the task of sleep stage classification.
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Algoritmos , Aprendizado Profundo , Fases do Sono/fisiologia , Bases de Dados como Assunto , Eletroencefalografia/métodos , Humanos , Análise Multivariada , Polissonografia , Curva ROCRESUMO
BACKGROUND: Diagnosis aims to predict the future health status of patients according to their historical electronic health records (EHR), which is an important yet challenging task in healthcare informatics. Existing diagnosis prediction approaches mainly employ recurrent neural networks (RNN) with attention mechanisms to make predictions. However, these approaches ignore the importance of code descriptions, i.e., the medical definitions of diagnosis codes. We believe that taking diagnosis code descriptions into account can help the state-of-the-art models not only to learn meaning code representations, but also to improve the predictive performance, especially when the EHR data are insufficient. METHODS: We propose a simple, but general diagnosis prediction framework, which includes two basic components: diagnosis code embedding and predictive model. To learn the interpretable code embeddings, we apply convolutional neural networks (CNN) to model medical descriptions of diagnosis codes extracted from online medical websites. The learned medical embedding matrix is used to embed the input visits into vector representations, which are fed into the predictive models. Any existing diagnosis prediction approach (referred to as the base model) can be cast into the proposed framework as the predictive model (called the enhanced model). RESULTS: We conduct experiments on two real medical datasets: the MIMIC-III dataset and the Heart Failure claim dataset. Experimental results show that the enhanced diagnosis prediction approaches significantly improve the prediction performance. Moreover, we validate the effectiveness of the proposed framework with insufficient EHR data. Finally, we visualize the learned medical code embeddings to show the interpretability of the proposed framework. CONCLUSIONS: Given the historical visit records of a patient, the proposed framework is able to predict the next visit information by incorporating medical code descriptions.
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Codificação Clínica , Registros Eletrônicos de Saúde , Previsões , Insuficiência Cardíaca/diagnóstico , Computação em Informática Médica , Redes Neurais de Computação , Conjuntos de Dados como Assunto , Aprendizado Profundo , Insuficiência Cardíaca/classificação , Humanos , Modelos Estatísticos , PrognósticoRESUMO
We tested the potential for recommender system technology to provide personalized physical activity (PA) suggestions for inactive young adults with high bodyweight. We developed a recommender system using data from the 2017 Behavioral Risk Factor Surveillance System and assessed interest in using the system among 47 young adults (mean age = 23.0 years; 63.4% female; 65.0% White; mean BMI = 29.4). Eleven of these participants (mean age = 23.6 years; 90.9% female, 63.6% White; average BMI = 28.5) also received a PA recommendation and a follow-up interview. Approximately half of the survey participants were willing to use the recommender system, and participants interested in the recommender system differed from those unwilling to try the system (e.g., more likely to be female, worse self-perceived health). Furthermore, eight of the 11 interviewees tried the PA recommended to them, but had mixed reviews of the system's accuracy. Although our recommender system requires improvements, such systems have promise for supporting PA adoption.
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Urban dwellers are exposed to communicable diseases, such as influenza, in various urban spaces. Current disease models are able to predict health outcomes at the individual scale but are mostly validated at coarse scales due to the lack of fine-scaled ground truth data. Further, a large number of transmission-driving factors have been considered in these models. Because of the lack of individual-scaled validations, the effectiveness of factors at their intended scale is not substantiated. These gaps significantly undermine the efficacy of the models in assessing the vulnerability of individuals, communities, and urban society. The objectives of this study are twofold. First, we aim to model and, most importantly, validate influenza-like illness (ILI) symptoms at the individual scale based on four sets of transmission-driving factors pertinent to home-work space, service space, ambient environment, and demographics. The effort is supported by an ensemble approach. For the second objective, we investigate the effectiveness of the factor sets through an impact analysis. The validation accuracy reaches 73.2-95.1%. The validation substantiates the effectiveness of factors pertinent to urban spaces and unveils the underlying mechanism that connects urban spaces and population health. With more fine-scaled health data becoming available, the findings of this study may see increasing value in informing policies that improve population health and urban livability.
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Influenza Humana , Saúde da População , Viroses , Humanos , Influenza Humana/epidemiologia , PolíticasRESUMO
Clinical trials aim to study new tests and evaluate their effects on human health outcomes, which has a huge market size. However, carrying out clinical trials is expensive and time-consuming and often ends in no results. It will revolutionize clinical practice if we can develop an effective model to automatically estimate the status of a clinical trial and find out possible failure reasons. However, it is challenging to develop such a model because of the lack of a benchmark dataset. To address these challenges, in this paper, we first build a new dataset by extracting the publicly available clinical trial reports from ClinicalTrials.gov. The associated status of each report is treated as the status label. To analyze the failure reasons, domain experts help us manually annotate each failed report based on the description associated with it. More importantly, we examine several state-of-the-art text classification baselines on this task and find out that the unique format of the clinical trial protocols plays an essential role in affecting prediction accuracy, demonstrating the need for specially designed clinical trial classification models.
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Predicting adverse drug reactions (ADRs) of drugs is one of the most critical steps in drug development. By pre-estimating the adverse reactions, researchers and drug development companies can greatly prevent the potential ADR risks and tragedies. However, the current ADR prediction methods suffer from several limitations. First, the prediction results are based on pure drug-related information, which makes them impossible to be directly applied for the personalized ADR prediction task. The lack of personalization of models also makes rare adverse events hard to be predicted. Therefore, it is of great interest to develop a new personalized ADR prediction method by introducing additional sources, e.g., patient health records. However, few methods have tried to use additional sources. In the meantime, the variety of different source formats and structures makes this task more challenging. To address the above challenges, we propose a novel personalized multi-sourced-based drug adverse reaction prediction model named pADR. pADR first works on every single source to transform them into proper representations. Next, a hierarchical multi-sourced Transformer is designed to automatically model the interactions between different sources and fuse them together for the final adverse event prediction. Experimental results on a new multi-sourced ADR prediction dataset show that PADR outperforms state-of-the-art drug-based baselines. Moreover, the case and ablation studies also illustrate the effectiveness of our proposed fusion strategies and the reasonableness of each module design.
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Pretraining has proven to be a powerful technique in natural language processing (NLP), exhibiting remarkable success in various NLP downstream tasks. However, in the medical domain, existing pretrained models on electronic health records (EHR) fail to capture the hierarchical nature of EHR data, limiting their generalization capability across diverse downstream tasks using a single pretrained model. To tackle this challenge, this paper introduces a novel, general, and unified pretraining framework called MedHMP, specifically designed for hierarchically multimodal EHR data. The effectiveness of the proposed MedHMP is demonstrated through experimental results on eight downstream tasks spanning three levels. Comparisons against eighteen baselines further highlight the efficacy of our approach.
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The increasing reliance on online communities for healthcare information by patients and caregivers has led to the increase in the spread of misinformation, or subjective, anecdotal and inaccurate or non-specific recommendations, which, if acted on, could cause serious harm to the patients. Hence, there is an urgent need to connect users with accurate and tailored health information in a timely manner to prevent such harm. This article proposes an innovative approach to suggesting reliable information to participants in online communities as they move through different stages in their disease or treatment. We hypothesize that patients with similar histories of disease progression or course of treatment would have similar information needs at comparable stages. Specifically, we pose the problem of predicting topic tags or keywords that describe the future information needs of users based on their profiles, traces of their online interactions within the community (past posts, replies) and the profiles and traces of online interactions of other users with similar profiles and similar traces of past interaction with the target users. The result is a variant of the collaborative information filtering or recommendation system tailored to the needs of users of online health communities. We report results of our experiments on two unique datasets from two different social media platforms which demonstrates the superiority of the proposed approach over the state of the art baselines with respect to accurate and timely prediction of topic tags (and hence information sources of interest).
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Informação de Saúde ao Consumidor , Mídias Sociais , HumanosRESUMO
Electronic health records (EHR) have been widely applied to various tasks in the medical domain such as risk predictive modeling, which aims to predict further health conditions by analyzing patients' historical EHR. Existing work mainly focuses on modeling the sequential and temporal characteristics of EHR data with advanced deep learning techniques. However, the network architectures of these models are all manually designed based on experts' prior knowledge, which largely impedes non-experts from exploring this task. To address this issue, in this paper, we propose a novel automated risk prediction model named AutoMed to automatically search the optimal model architecture for modeling the complex EHR data and improving the performance of the risk prediction task. In particular, we follow the idea of neural architecture search to design a search space that contains three separate searchable modules. Two of them are used for analyzing sequential and temporal features of EHR data, respectively. The third is to automatically fuse both features together. Besides these three modules, AutoMed contains an embedding module and a prediction module. All the three searchable modules are jointly optimized in the search stage to derive the optimal model architecture. In such a way, the model design can be automatically achieved with few human interventions. Experimental results on three real-world datasets show that AutoMed outperforms state-of-the-art baselines in terms of PR-AUC, F1, and Cohen's Kappa. Moreover, the ablation study shows that AutoMed can obtain reasonable model architectures and offer useful insights to the future risk prediction model design.
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Diagnosis prediction aims to predict the patient's future diagnosis based on their Electronic Health Records (EHRs). Most existing works adopt recurrent neural networks (RNNs) to model the sequential EHR data. However, they mainly utilize medical codes and ignore other useful information such as patients' clinical features and demographics. We proposed a new model called MDP to augment the prediction performance by integrating the multimodal clinical data. MDP learns the clinical feature representation by adjusting the weights of clinical features based on a patient's current health condition and demographics. Also, the clinical feature representation, diagnosis codes representation and the demographic embedding are integrated to perform the prediction task. Experiments on a real-world dataset demonstrate that MDP outperforms the state-of-the-art methods.
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Registros Eletrônicos de Saúde , Redes Neurais de Computação , Previsões , HumanosRESUMO
Predicting patients' risk of developing certain diseases is an important research topic in healthcare. Accurately identifying and ranking the similarity among patients based on their historical records is a key step in personalized healthcare. The electric health records (EHRs), which are irregularly sampled and have varied patient visit lengths, cannot be directly used to measure patient similarity due to the lack of an appropriate representation. Moreover, there needs an effective approach to measure patient similarity on EHRs. In this paper, we propose two novel deep similarity learning frameworks which simultaneously learn patient representations and measure pairwise similarity. We use a convolutional neural network (CNN) to capture local important information in EHRs and then feed the learned representation into triplet loss or softmax cross entropy loss. After training, we can obtain pairwise distances and similarity scores. Utilizing the similarity information, we then perform disease predictions and patient clustering. Experimental results show that CNN can better represent the longitudinal EHR sequences, and our proposed frameworks outperform state-of-the-art distance metric learning methods.
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Algoritmos , Biologia Computacional/métodos , Aprendizado Profundo , Medicina de Precisão , Registros Eletrônicos de Saúde , Humanos , Modelos EstatísticosRESUMO
Monitoring the future health status of patients from the historical Electronic Health Record (EHR) is a core research topic in predictive healthcare. The most important challenges are to model the temporality of sequential EHR data and to interpret the prediction results. In order to reduce the future risk of diseases, we propose a multi-task framework that can monitor the multiple status ofdiagnoses. Patients' historical records are directly fed into a Recurrent Neural Network (RNN) which memorizes all the past visit information, and then a task-specific layer is trained to predict multiple diagnoses. Moreover, three attention mechanisms for RNNs are introduced to measure the relationships between past visits and current status. Experimental results show that the proposed attention-based RNNs can significantly improve the prediction accuracy compared to widely used approaches. With the attention mechanisms, the proposed framework is able to identify the visit information which is important to the final prediction.