Integrating Multimodal EHR Data for Mortality Prediction in ICU Sepsis Patients.

IF 1.8 4区 医学 Q3 MATHEMATICAL & COMPUTATIONAL BIOLOGY
Yi Wang, Weihua Li
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引用次数: 0

Abstract

Rapid and accurate prediction of mortality risk among intensive care unit (ICU) sepsis patients is crucial for timely intervention and improving patient outcomes. However, due to the multimodal and dynamic time-series nature of patient visit information and the limited data samples, it is challenging to obtain discriminative patient representations, leading to suboptimal mortality prediction results. To address this issue, we design a time-aware graph embedding attention model (TGAM) to integrate multimodal data and predict mortality in ICU sepsis patients. Our approach involves modeling and generating patient representations that encompass not only demographic information but also dynamic time-series data reflecting patient health status. Additionally, the graph convolutional network is used to obtain informative concept embeddings from medical ontologies, and an improved transformer is used to capture the temporal information of the patient's health status and handle missing values, overcoming the limitations of small samples. The experimental results on the MIMIC-III and MIMIC-IV datasets demonstrate that TGAM significantly improves prediction accuracy, with AUROC scores of 87.65% and 87.00% on the MIMIC-III and MIMIC-IV datasets, respectively, outperforming baseline models by over 5 percentage points. TGAM also achieves higher sensitivity, specificity, and AUPRC metrics, and lower Brier Score compared with baseline models, highlighting its effectiveness in identifying high-risk patients. These findings suggest that TGAM has the potential to become a valuable tool for identifying high-risk sepsis patients, enabling clinicians to make more informed and timely intervention decisions.

整合多模式电子病历数据预测ICU脓毒症患者死亡率。
快速准确地预测重症监护病房(ICU)脓毒症患者的死亡风险对于及时干预和改善患者预后至关重要。然而,由于患者就诊信息的多模态和动态时间序列性质,以及有限的数据样本,很难获得判别性的患者表征,导致死亡率预测结果不理想。为了解决这一问题,我们设计了一个时间感知图嵌入注意模型(TGAM)来整合多模态数据并预测ICU脓毒症患者的死亡率。我们的方法包括建模和生成患者表示,不仅包括人口统计信息,还包括反映患者健康状况的动态时间序列数据。此外,利用图卷积网络从医学本体中获取信息概念嵌入,并利用改进的变压器捕获患者健康状态的时间信息并处理缺失值,克服了小样本的局限性。在MIMIC-III和MIMIC-IV数据集上的实验结果表明,TGAM显著提高了预测精度,在MIMIC-III和MIMIC-IV数据集上的AUROC得分分别为87.65%和87.00%,优于基线模型5个百分点以上。与基线模型相比,TGAM还具有更高的敏感性、特异性和AUPRC指标,以及更低的Brier评分,突出了其在识别高危患者方面的有效性。这些发现表明,TGAM有潜力成为识别高风险脓毒症患者的有价值工具,使临床医生能够做出更明智和及时的干预决策。
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来源期刊
Statistics in Medicine
Statistics in Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.40
自引率
10.00%
发文量
334
审稿时长
2-4 weeks
期刊介绍: The journal aims to influence practice in medicine and its associated sciences through the publication of papers on statistical and other quantitative methods. Papers will explain new methods and demonstrate their application, preferably through a substantive, real, motivating example or a comprehensive evaluation based on an illustrative example. Alternatively, papers will report on case-studies where creative use or technical generalizations of established methodology is directed towards a substantive application. Reviews of, and tutorials on, general topics relevant to the application of statistics to medicine will also be published. The main criteria for publication are appropriateness of the statistical methods to a particular medical problem and clarity of exposition. Papers with primarily mathematical content will be excluded. The journal aims to enhance communication between statisticians, clinicians and medical researchers.
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