Abstract

ObjectiveOur goal was to research and develop exploratory analysis tools for clinical notes, which now are underrepresented to limit the diversity of data insights on medically relevant applications.ResultsWe characterize how exploratory analysis can affect representation learning on clinical narratives and present several self-developed tools to explore sepsis. Our experiments focus on patients with sepsis in the MIMIC-III Clinical Database or in our institution’s research patient data repository. We found that global embeddings assist in learning local representations of clinical notes. Second, aligning at any specific time facilitates the use of learning models by pooling more available clinical notes to form a training set. Furthermore, reconstruction of the timeline enhances downstream-processing techniques by emphasizing temporal expressions and temporal relationships in clinical documentation. We demonstrate that clustering helps plot various types of clinical notes against a scale, which conveys a sense of the range or spread of the data and is useful for understanding data correlations. Appropriate exploratory analysis tools provide keen insights into preprocessing clinical notes, thereby further enhancing downstream analysis capabilities, making data driven medicine possible. Our examples can help generate better data representation of clinical documentation for models with improved performance and interpretability.

Highlights

  • Sepsis, a global health concern [1], is defined as “lifethreatening organ dysfunction caused by a dysregulated host response to infection [2, 3].” With high rates of morbidity, readmission, and mortality, [3–6], sepsis is considered one of the 12 leading causes of death in the United States [7]

  • Our main finding was that it is possible to develop novel exploratory analysis tools to improve representation learning on clinical narratives to explore sepsis

  • Appropriate exploratory analysis tools provide a keen insight into clinical notes to help generate better data representations for models with improved performance and interpretability

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Summary

Results

Our embedding-based exploratory analysis tool can assist in a variety of informatics related tasks with an O(n) time complexity. These tasks include the detection of clinical sublanguages and the automated generation of prototype templates. As shown in Additional file 1: Table S2, we merged sepsis nursing notes related to the same patient with adjacent time periods together. The format for reconstruction results in sequential data that includes information on the “cause of sepsis,” “symptoms related to sepsis”, and “duration (days or hours) between clinical entities (e.g., symptoms).”. Framing the problem as “does fever occur in this case of sepsis within a specified time?” is a sequence classification task that involves predicting a class label for a given input sequence.

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