Abstract

BackgroundDisease prediction based on electronic health records (EHRs) is essential for personalized healthcare. But it’s hard due to the special data structure and the interpretability requirement of methods. The structure of EHR is hierarchical: each patient has a sequence of admissions, and each admission has some co-occurrence diagnoses. However, the existing methods only partially model these characteristics and lack the interpretation for non-specialists.MethodsThis work proposes a time-aware and co-occurrence-aware deep learning network (TCoN), which is not only suitable for EHR data structure but also interpretable: the co-occurrence-aware self-attention (CS-attention) mechanism and time-aware gated recurrent unit (T-GRU) can model multilevel relations; the interpretation path and the diagnosis graph can make the result interpretable.ResultsThe method is tested on a real-world dataset for mortality prediction, readmission prediction, disease prediction, and next diagnoses prediction. Experimental results show that TCoN is better than baselines with 2.01% higher accuracy. Meanwhile, the method can give the interpretation of causal relationships and the diagnosis graph of each patient.ConclusionsThis work proposes a novel model—TCoN. It is an interpretable and effective deep learning method, that can model the hierarchical medical structure and predict medical events. The experiments show that it outperforms all state-of-the-art methods. Future work can apply the graph embedding technology based on more knowledge data such as doctor notes.

Highlights

  • Disease prediction based on electronic health records (EHRs) is essential for personalized healthcare

  • The new dataset comprises 19,993 hospital admissions of 7537 patients and 260,326 diagnoses with 4,893 unique codes defined by the International Classification of Diseases-9 version (ICD-9)

  • Each code is represented by a one-hot vector with 4,893 dimensions

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Summary

Introduction

Disease prediction based on electronic health records (EHRs) is essential for personalized healthcare. The structure of EHR is hierarchical: each patient has a sequence of admissions, and each admission has some co-occurrence diagnoses. Sun et al BMC Med Inform Decis Mak (2021) 21:305 relation. We call such issues as the co-occurrence relation, such as complication, causation, and continuity. EHR has both the time relation and the co-occurrence relation. Medical tasks such as disease prediction [1,2,3], concept representation [4, 5], and patient typing [6,7,8] are essential for personalized healthcare and medical research. A datadriven approach by learning from large accessible EHRs is the desiderata

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