Modeling electronic health records in ensembles of semantic spaces for adverse drug event detection

Abstract

Adverse drug events (ADEs) are heavily under-reported in electronic health records (EHRs). Alerting systems that are able to detect potential ADEs on the basis of patient-specific EHR data would help to mitigate this problem. To that end, the use of machine learning has proven to be both efficient and effective; however, challenges remain in representing the heterogeneous EHR data, which moreover tends to be high-dimensional and exceedingly sparse, in a manner conducive to learning high-performing predictive models. Prior work has shown that distributional semantics - that is, natural language processing methods that, traditionally, model the meaning of words in semantic (vector) space on the basis of co-occurrence information - can be exploited to create effective representations of sequential EHR data of various kinds. When modeling data in semantic space, an important design decision concerns the size of the context window around an object of interest, which governs the scope of co-occurrence information that is taken into account and affects the composition of the resulting semantic space. Here, we report on experiments conducted on 27 clinical datasets, demonstrating that performance can be significantly improved by modeling EHR data in ensembles of semantic spaces, consisting of multiple semantic spaces built with different context window sizes. A follow-up investigation is conducted to study the impact on predictive performance as increasingly more semantic spaces are included in the ensemble, demonstrating that accuracy tends to improve with the number of semantic spaces, albeit not monotonically so. Finally, a number of different strategies for combining the semantic spaces are explored, demonstrating the advantage of early (feature) fusion over late (classifier) fusion. Semantic space ensembles allow multiple views of (sparse) data to be captured (densely) and thereby enable improved performance to be obtained on the task of detecting ADEs in EHRs.