Abstract

One major impediment to the wider use of deep learning for clinical decision making is the difficulty of assigning a level of confidence to model predictions. Currently, deep Bayesian neural networks and sparse Gaussian processes are the main two scalable uncertainty estimation methods. However, deep Bayesian neural networks suffer from lack of expressiveness, and more expressive models such as deep kernel learning, which is an extension of sparse Gaussian process, captures only the uncertainty from the higher-level latent space. Therefore, the deep learning model under it lacks interpretability and ignores uncertainty from the raw data. In this paper, we merge features of the deep Bayesian learning framework with deep kernel learning to leverage the strengths of both methods for a more comprehensive uncertainty estimation. Through a series of experiments on predicting the first incidence of heart failure, diabetes and depression applied to large-scale electronic medical records, we demonstrate that our method is better at capturing uncertainty than both Gaussian processes and deep Bayesian neural networks in terms of indicating data insufficiency and identifying misclassifications, with a comparable generalization performance. Furthermore, by assessing the accuracy and area under the receiver operating characteristic curve over the predictive probability, we show that our method is less susceptible to making overconfident predictions, especially for the minority class in imbalanced datasets. Finally, we demonstrate how uncertainty information derived by the model can inform risk factor analysis towards model interpretability.

Highlights

  • Introduction of uncertaintyThe uncertainty in modelling can be divided into three categories: aleatoric uncertainty, epistemic uncertainty, and predictive uncertainty

  • We evaluated the area under the receiver operating characteristics (AUROC) curve and the average precision (AP)[31]; both of them were calculated based on the mean predictive probability, which is a probability averaged over samples sampled from the predictive distribution

  • We split each dataset from stage B (HF, diabetes and depression) into 70% training set and 30% validation set

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Summary

Introduction

Introduction of uncertaintyThe uncertainty in modelling can be divided into three categories: aleatoric uncertainty, epistemic uncertainty, and predictive uncertainty. We explored a risk model for detecting the first incidence of three common chronic diseases, namely, heart failure (HF), diabetes and depression, using structured electronic health records (EHRs) from the Clinical Practice Research Datalink (CPRD). We used diagnoses (ICD-10), medications (British National Formulary code), event date (time stamp for each diagnosis and medication) and date of birth as historical medical trajectory to predict whether the first incidence of aforementioned conditions would be diagnosed in the following six months for a patient, and the conditions are treated as separate prediction tasks. The design is summarized, and the ICD-codes for HF, diabetes, and depression are listed in the Supplementary. They were taken from previous ­publications[8,9]

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