A cross-modal clinical prediction system for intensive care unit patient outcome

Abstract

Electronic Health Records (EHRs) are becoming an encyclopedia of clinical concepts, encompassing diagnoses, medications and clinical descriptions to describe patients’ health conditions. The abundance of EHR data presents unprecedented opportunities for leveraging machine learning in clinical predictive tasks. However, the complex process of acquiring healthcare data in some settings like Intensive Care Unit (ICU) gives rise to various challenges in mining EHR, such as modality diversity, heterogeneity, data silo and data quality problems, etc. In this paper, to overcome the data heterogeneity and data quality issues, we propose a Code-Text cross-modal Contrastive Learning (CTCL) framework specifically designed for predicting ICU patient outcomes. This framework leverages both structured (multi-view medical codes) and unstructured (clinical notes) EHR data to extract patient representations. To capture the complicated intra and inter interactions among medical codes, CTCL employs a multi-view graph convolution network to extract code encodings and a cross-view contrastive loss to regularize the model parameters. To enhance patient representations across different modalities, a cross-modal contrastive learning module is introduced. Experimental evaluations on the eICU-CRD database demonstrate that CTCL outperforms state-of-the-art competitors on the ICU mortality prediction task and in-hospital readmission prediction task. Furthermore, ablation studies and discussions demonstrate the effectiveness of each module of the framework.