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Electronic health records (EHR), present challenges of incomplete and imbalanced data in clinical predictions. Previous studies addressed these two issues with two-step separately, which caused the decrease in the performance of prediction tasks. In this paper, we propose a unified framework to simultaneously addresses the challenges of incomplete and imbalanced data in EHR. Based on the framework, we develop a model called Missing Value Imputation and Imbalanced Learning Generative Adversarial Network (MVIIL-GAN). We use MVIIL-GAN to perform joint learning on the imputation process of high missing rate data and the conditional generation process of EHR data. The joint learning is achieved by introducing two discriminators to distinguish the fake data from the generated data at sample-level and variable-level. MVIIL-GAN integrate the missing values imputation and data generation in one step, improving the consistency of parameter optimization and the performance of prediction tasks. We evaluate our framework using the public dataset MIMIC-IV with high missing rates data and imbalanced data. Experimental results show that MVIIL-GAN outperforms existing methods in prediction performance. The implementation of MVIIL-GAN can be found at https://github.com/Peroxidess/MVIIL-GAN.
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Registros Eletrônicos de Saúde , AprendizagemRESUMO
Lung cancer is with the highest morbidity and mortality, and detecting cancerous lesions early is essential for reducing mortality rates. Deep learning-based lung nodule detection techniques have shown better scalability than traditional methods. However, pulmonary nodule test results often include a number of false positive outcomes. In this paper, we present a novel asymmetric residual network called 3D ARCNN that leverages 3D features and spatial information of lung nodules to improve classification performance. The proposed framework uses an internally cascaded multi-level residual model for fine-grained learning of lung nodule features and multi-layer asymmetric convolution to address the problem of large neural network parameters and poor reproducibility. We evaluate the proposed framework on the LUNA16 dataset and achieve a high detection sensitivity of 91.6%, 92.7%, 93.2%, and 95.8% for 1, 2, 4, and 8 false positives per scan, respectively, with an average CPM index of 0.912. Quantitative and qualitative evaluations demonstrate the superior performance of our framework compared to existing methods. 3D ARCNN framework can effectively reduce the possibility of false positive lung nodules in the clinical.
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Neoplasias Pulmonares , Tomografia Computadorizada por Raios X , Humanos , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Redes Neurais de ComputaçãoRESUMO
Nested entities and relationship extraction are two tasks for analysis of electronic medical records. However, most of existing medical information extraction models consider these tasks separately, resulting in a lack of consistency between them. In this paper, we propose a joint medical entity-relation extraction model with progressive recognition and targeted assignment (PRTA). Entities and relations share the information of sequence and word embedding layers in the joint decoding stage. They are trained simultaneously and realize information interaction by updating the shared parameters. Specifically, we design a compound triangle strategy for the nested entity recognition and an adaptive multi-space interactive strategy for relationship extraction. Then, we construct a parameter-shared information space based on semantic continuity to decode entities and relationships. Extensive experiments were conducted on the Private Liver Disease Dataset (PLDD) provided by Beijing Friendship Hospital of Capital Medical University and public datasets (NYT, ACE04 and ACE05). The results show that our method outperforms existing SOTA methods in most indicators, and effectively handles nested entities and overlapping relationships.
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Registros Eletrônicos de Saúde , Humanos , Mineração de Dados/métodos , Algoritmos , Bases de Dados Factuais , HepatopatiasRESUMO
Background: Medical imaging is critical in clinical practice, and high value radiological reports can positively assist clinicians. However, there is a lack of methods for determining the value of reports. Objective: The purpose of this study was to establish an ensemble learning classification model using natural language processing (NLP) applied to the Chinese free text of radiological reports to determine their value for liver lesion detection in patients with colorectal cancer (CRC). Methods: Radiological reports of upper abdominal computed tomography (CT) and magnetic resonance imaging (MRI) were divided into five categories according to the results of liver lesion detection in patients with CRC. The NLP methods including word segmentation, stop word removal, and n-gram language model establishment were applied for each dataset. Then, a word-bag model was built, high-frequency words were selected as features, and an ensemble learning classification model was constructed. Several machine learning methods were applied, including logistic regression (LR), random forest (RF), and so on. We compared the accuracy between priori choosing pertinent word strings and our machine language methodologies. Results: The dataset of 2790 patients included CT without contrast (10.2%), CT with/without contrast (73.3%), MRI without contrast (1.8%), and MRI with/without contrast (14.6%). The ensemble learning classification model determined the value of reports effectively, reaching 95.91% in the CT with/without contrast dataset using XGBoost. The logistic regression, random forest, and support vector machine also achieved good classification accuracy, reaching 95.89%, 95.04%, and 95.00% respectively. The results of XGBoost were visualized using a confusion matrix. The numbers of errors in categories I, II and V were very small. ELI5 was used to select important words for each category. Words such as "no abnormality", "suggest", "fatty liver", and "transfer" showed a relatively large degree of positive correlation with classification accuracy. The accuracy based on string pattern search method model was lower than that of machine learning. Conclusions: The learning classification model based on NLP was an effective tool for determining the value of radiological reports focused on liver lesions. The study made it possible to analyze the value of medical imaging examinations on a large scale.
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OBJECTIVE: Percutaneous microwave ablation is an essential and safe method for the treatment of liver cancer. As one therapeutic dose, ablation time is crucial to the treatment effect determined by the physicians. However, due to the different experiences of physicians and the significant individual differences of patients, the final treatment effect is also different, which makes it difficult for the ablation time recorded in the electronic health records (EHRs) to follow the same pattern. To solve this problem, we propose a data mining method based on historical treatment data recorded in EHR, which uses a robust relapse risk as strong supervision to correct the ablation time. The prediction results of this method are closer to the situation of patients without relapse, which can provide physicians with reference. METHODS: In the proposed method, we introduce the optimization method to iteratively minimize the postoperative relapse risk and utilize gradient propagation between the risk and ablation time during iteration to correct the latter. We also apply a self-attention mechanism to find the global dependencies between each feature in EHR to improve the final prediction performance of the model. RESULTS: Comparative experimental results show that compared with other baseline model, the proposed model achieves better performance on R-square, MAE, and MSE metric. The results of ablation experiments show that the integration of label correction and self-attention mechanism can improve the model performance. CONCLUSIONS: We using relapse risk as strong supervision related to the ablation time can effectively correct the deviation of the ablation time as weak supervision. The self-attention mechanism in the proposed model can significantly improve the prediction performance.
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Ablação por Cateter , Registros Eletrônicos de Saúde , Micro-Ondas , Mineração de Dados , Atenção à Saúde , Humanos , Neoplasias Hepáticas/cirurgia , Médicos , RecidivaRESUMO
In order to reduce the energy consumption of the legged robot in walking, this paper designs a kind of nonlinear elastic joint from the flexible variable-stiffness joint based on the mammal walking on the limb and optimizes the leg structure of the legged robot. The motor is rigidly connected to the articulated lever. When the lever is accelerated or decelerated, the elastic unit is introduced. The system can be considered as a special variable-rate elastic system. This paper will study it from theory and simulation experiments. Based on the dynamic analysis, a functional relationship between the output torque and the torsion spring stiffness and between the energy consumption and the torsion spring stiffness was established. By finding the extremum, the two optimum torsional spring stiffness that can minimize the required output average torque and the energy consumed during one cycle of motion were deduced. The results show that using this design in a reasonable position can effectively reduce the energy consumption of the system and can achieve up to a 50% reduction in energy consumption.