电子健康记录的可扩展和可解释的预测模型

Amela Fejza, P. Genevès, Nabil Layaïda, J. Bosson
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引用次数: 7

摘要

在住院期间早期识别有并发症风险的患者是目前医疗保健中最具挑战性的问题之一。并发症包括医院获得性感染、入住重症监护病房和院内死亡率。能够准确地预测病人的结果,是为某些病人量身定制治疗方案的关键先决条件,如果人们相信他们在没有额外干预的情况下会表现不佳的话。我们考虑并发症的风险预测问题,如住院病人的死亡率,从患者的电子健康记录。我们研究了在住院的第一天做出预测的问题,以及在病人住院期间每天做出更新的死亡率预测的问题。我们开发可扩展和可解释的分布式模型。关键的见解包括分析入院时已知的诊断和所使用的药物,这些诊断和药物在住院期间不断发展。我们利用分布式架构从庞大的训练数据集中学习可解释的模型。我们在数百家医院的100多万名患者中测试了我们的分析,并报告了从这些实验中吸取的教训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Scalable and Interpretable Predictive Models for Electronic Health Records
Early identification of patients at risk of developing complications during their hospital stay is currently one of the most challenging issues in healthcare. Complications include hospital-acquired infections, admissions to intensive care units, and in-hospital mortality. Being able to accurately predict the patients' outcomes is a crucial prerequisite for tailoring the care that certain patients receive, if it is believed that they will do poorly without additional intervention. We consider the problem of complication risk prediction, such as inpatient mortality, from the electronic health records of the patients. We study the question of making predictions on the first day at the hospital, and of making updated mortality predictions day after day during the patient's stay. We develop distributed models that are scalable and interpretable. Key insights include analysing diagnoses known at admission and drugs served, which evolve during the hospital stay. We leverage a distributed architecture to learn interpretable models from training datasets of gigantic size. We test our analyses with more than one million of patients from hundreds of hospitals, and report on the lessons learned from these experiments.
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