Improving Clinical Decision Making With a Two-Stage Recommender System.

Abstract

Clinical decision-making is complex and time-intensive. To help in this effort, clinical recommender systems (RS) have been designed to facilitate healthcare practitioners with personalized advice. However, designing an effective clinical RS poses challenges due to the multifaceted nature of clinical data and the demand for tailored recommendations. In this article, we introduce a 2-Stage Recommendation framework for clinical decision-making, which leverages a publicly accessible dataset of electronic health records. In the first stage, a deep neural network-based model is employed to extract a set of candidate items, such as diagnoses, medications, and prescriptions, from a patient's electronic health records. Subsequently, the second stage utilizes a deep learning model to rank and pinpoint the most relevant items for healthcare providers. Both retriever and ranker are based on pre-trained transformer models that are stacked together as a pipeline. To validate our model, we compared its performance against several baseline models using different evaluation metrics. The results reveal that our proposed model attains a performance gain of approximately 12.3% macro-average F1 compared to the second best performing baseline. Qualitative analysis across various dimensions also confirms the model's high performance. Furthermore, we discuss challenges like data availability, privacy concerns, and shed light on future exploration in this domain.