Lucas M. Glass

Zhenbang Wu, Huaxiu Yao, Zhe Su et al. · cmu

Drug recommendation assists doctors in prescribing personalized medications to patients based on their health conditions. Existing drug recommendation solutions adopt the supervised multi-label classification setup and only work with existing drugs with sufficient prescription data from many patients. However, newly approved drugs do not have much historical prescription data and cannot leverage existing drug recommendation methods. To address this, we formulate the new drug recommendation as a few-shot learning problem. Yet, directly applying existing few-shot learning algorithms faces two challenges: (1) complex relations among diseases and drugs and (2) numerous false-negative patients who were eligible but did not yet use the new drugs. To tackle these challenges, we propose EDGE, which can quickly adapt to the recommendation for a new drug with limited prescription data from a few support patients. EDGE maintains a drug-dependent multi-phenotype few-shot learner to bridge the gap between existing and new drugs. Specifically, EDGE leverages the drug ontology to link new drugs to existing drugs with similar treatment effects and learns ontology-based drug representations. Such drug representations are used to customize the metric space of the phenotype-driven patient representations, which are composed of a set of phenotypes capturing complex patient health status. Lastly, EDGE eliminates the false-negative supervision signal using an external drug-disease knowledge base. We evaluate EDGE on two real-world datasets: the public EHR data (MIMIC-IV) and private industrial claims data. Results show that EDGE achieves 7.3% improvement on the ROC-AUC score over the best baseline.

Rakshith S Srinivasa, Cheng Qian, Brandon Theodorou et al.

The ongoing pandemic has highlighted the importance of reliable and efficient clinical trials in healthcare. Trial sites, where the trials are conducted, are chosen mainly based on feasibility in terms of medical expertise and access to a large group of patients. More recently, the issue of diversity and inclusion in clinical trials is gaining importance. Different patient groups may experience the effects of a medical drug/ treatment differently and hence need to be included in the clinical trials. These groups could be based on ethnicity, co-morbidities, age, or economic factors. Thus, designing a method for trial site selection that accounts for both feasibility and diversity is a crucial and urgent goal. In this paper, we formulate this problem as a ranking problem with fairness constraints. Using principles of fairness in machine learning, we learn a model that maps a clinical trial description to a ranked list of potential trial sites. Unlike existing fairness frameworks, the group membership of each trial site is non-binary: each trial site may have access to patients from multiple groups. We propose fairness criteria based on demographic parity to address such a multi-group membership scenario. We test our method on 480 real-world clinical trials and show that our model results in a list of potential trial sites that provides access to a diverse set of patients while also ensuing a high number of enrolled patients.

Zhenbang Wu, Cao Xiao, Lucas M Glass et al.

Given a deep learning model trained on data from a source site, how to deploy the model to a target hospital automatically? How to accommodate heterogeneous medical coding systems across different hospitals? Standard approaches rely on existing medical code mapping tools, which have significant practical limitations. To tackle this problem, we propose AutoMap to automatically map the medical codes across different EHR systems in a coarse-to-fine manner: (1) Ontology-level Alignment: We leverage the ontology structure to learn a coarse alignment between the source and target medical coding systems; (2) Code-level Refinement: We refine the alignment at a fine-grained code level for the downstream tasks using a teacher-student framework. We evaluate AutoMap using several deep learning models with two real-world EHR datasets: eICU and MIMIC-III. Results show that AutoMap achieves relative improvements up to 3.9% (AUC-ROC) and 8.7% (AUC-PR) for mortality prediction, and up to 4.7% (AUC-ROC) and 3.7% (F1) for length-of-stay estimation. Further, we show that AutoMap can provide accurate mapping across coding systems. Lastly, we demonstrate that AutoMap can adapt to the two challenging scenarios: (1) mapping between completely different coding systems and (2) between completely different hospitals.

Zifeng Wang, Chufan Gao, Lucas M. Glass et al.

A clinical trial is an essential step in drug development, which is often costly and time-consuming. In silico trials are clinical trials conducted digitally through simulation and modeling as an alternative to traditional clinical trials. AI-enabled in silico trials can increase the case group size by creating virtual cohorts as controls. In addition, it also enables automation and optimization of trial design and predicts the trial success rate. This article systematically reviews papers under three main topics: clinical simulation, individualized predictive modeling, and computer-aided trial design. We focus on how machine learning (ML) may be applied in these applications. In particular, we present the machine learning problem formulation and available data sources for each task. We end with discussing the challenges and opportunities of AI for in silico trials in real-world applications.

Cheng Qian, Lucas Glass, Nikos Sidiropoulos

Forecasting project expenses is a crucial step for businesses to avoid budget overruns and project failures. Traditionally, this has been done by financial analysts or data science techniques such as time-series analysis. However, these approaches can be uncertain and produce results that differ from the planned budget, especially at the start of a project with limited data points. This paper proposes a constrained non-negative matrix completion model that predicts expenses by learning the likelihood of the project correlating with certain expense patterns in the latent space. The model is constrained on three probability simplexes, two of which are on the factor matrices and the third on the missing entries. Additionally, the predicted expense values are guaranteed to meet the budget constraint without the need of post-processing. An inexact alternating optimization algorithm is developed to solve the associated optimization problem and is proven to converge to a stationary point. Results from two real datasets demonstrate the effectiveness of the proposed method in comparison to state-of-the-art algorithms.

Yue Zhao, Zhi Qiao, Cao Xiao et al.

Despite the explosion of interest in healthcare AI research, the reproducibility and benchmarking of those research works are often limited due to the lack of standard benchmark datasets and diverse evaluation metrics. To address this reproducibility challenge, we develop PyHealth, an open-source Python toolbox for developing various predictive models on healthcare data. PyHealth consists of data preprocessing module, predictive modeling module, and evaluation module. The target users of PyHealth are both computer science researchers and healthcare data scientists. With PyHealth, they can conduct complex machine learning pipelines on healthcare datasets with fewer than ten lines of code. The data preprocessing module enables the transformation of complex healthcare datasets such as longitudinal electronic health records, medical images, continuous signals (e.g., electrocardiogram), and clinical notes into machine learning friendly formats. The predictive modeling module provides more than 30 machine learning models, including established ensemble trees and deep neural network-based approaches, via a unified but extendable API designed for both researchers and practitioners. The evaluation module provides various evaluation strategies (e.g., cross-validation and train-validation-test split) and predictive model metrics. With robustness and scalability in mind, best practices such as unit testing, continuous integration, code coverage, and interactive examples are introduced in the library's development. PyHealth can be installed through the Python Package Index (PyPI) or https://github.com/yzhao062/PyHealth .

Tianfan Fu, Cao Xiao, Xinhao Li et al.

Molecule optimization is a fundamental task for accelerating drug discovery, with the goal of generating new valid molecules that maximize multiple drug properties while maintaining similarity to the input molecule. Existing generative models and reinforcement learning approaches made initial success, but still face difficulties in simultaneously optimizing multiple drug properties. To address such challenges, we propose the MultI-constraint MOlecule SAmpling (MIMOSA) approach, a sampling framework to use input molecule as an initial guess and sample molecules from the target distribution. MIMOSA first pretrains two property agnostic graph neural networks (GNNs) for molecule topology and substructure-type prediction, where a substructure can be either atom or single ring. For each iteration, MIMOSA uses the GNNs' prediction and employs three basic substructure operations (add, replace, delete) to generate new molecules and associated weights. The weights can encode multiple constraints including similarity and drug property constraints, upon which we select promising molecules for next iteration. MIMOSA enables flexible encoding of multiple property- and similarity-constraints and can efficiently generate new molecules that satisfy various property constraints and achieved up to 49.6% relative improvement over the best baseline in terms of success rate. The code repository (including readme file, data preprocessing and model construction, evaluation) is available https://github.com/futianfan/MIMOSA.

Jintai Chen, Yaojun Hu, Mingchen Cai et al.

Clinical trials are pivotal for developing new medical treatments but typically carry risks such as patient mortality and enrollment failure that waste immense efforts spanning over a decade. Applying artificial intelligence (AI) to predict key events in clinical trials holds great potential for providing insights to guide trial designs. However, complex data collection and question definition requiring medical expertise have hindered the involvement of AI thus far. This paper tackles these challenges by presenting a comprehensive suite of 23 meticulously curated AI-ready datasets covering multi-modal input features and 8 crucial prediction challenges in clinical trial design, encompassing prediction of trial duration, patient dropout rate, serious adverse event, mortality rate, trial approval outcome, trial failure reason, drug dose finding, design of eligibility criteria. Furthermore, we provide basic validation methods for each task to ensure the datasets' usability and reliability. We anticipate that the availability of such open-access datasets will catalyze the development of advanced AI approaches for clinical trial design, ultimately advancing clinical trial research and accelerating medical solution development.

Brandon Theodorou, Lucas Glass, Cao Xiao et al.

Despite many efforts to address the disparities, the underrepresentation of gender, racial, and ethnic minorities in clinical trials remains a problem and undermines the efficacy of treatments on minorities. This paper focuses on the trial site selection task and proposes FRAMM, a deep reinforcement learning framework for fair trial site selection. We focus on addressing two real-world challenges that affect fair trial sites selection: the data modalities are often not complete for many potential trial sites, and the site selection needs to simultaneously optimize for both enrollment and diversity since the problem is necessarily a trade-off between the two with the only possible way to increase diversity post-selection being through limiting enrollment via caps. To address the missing data challenge, FRAMM has a modality encoder with a masked cross-attention mechanism for handling missing data, bypassing data imputation and the need for complete data in training. To handle the need for making efficient trade-offs, FRAMM uses deep reinforcement learning with a specifically designed reward function that simultaneously optimizes for both enrollment and fairness. We evaluate FRAMM using 4,392 real-world clinical trials ranging from 2016 to 2021 and show that FRAMM outperforms the leading baseline in enrollment-only settings while also achieving large gains in diversity. Specifically, it is able to produce a 9% improvement in diversity with similar enrollment levels over the leading baselines. That improved diversity is further manifested in achieving up to a 14% increase in Hispanic enrollment, 27% increase in Black enrollment, and 60% increase in Asian enrollment compared to selecting sites with an enrollment-only model.

Xinyan Li, Cheng Qian, Lucas Glass

Respiratory syncytial virus (RSV) is one of the most dangerous respiratory diseases for infants and young children. Due to the nonpharmaceutical intervention (NPI) imposed in the COVID-19 outbreak, the seasonal transmission pattern of RSV has been discontinued in 2020 and then shifted months ahead in 2021 in the northern hemisphere. It is critical to understand how COVID-19 impacts RSV and build predictive algorithms to forecast the timing and intensity of RSV reemergence in post-COVID-19 seasons. In this paper, we propose a deep coupled tensor factorization machine, dubbed as DeCom, for post COVID-19 RSV prediction. DeCom leverages tensor factorization and residual modeling. It enables us to learn the disrupted RSV transmission reliably under COVID-19 by taking both the regular seasonal RSV transmission pattern and the NPI into consideration. Experimental results on a real RSV dataset show that DeCom is more accurate than the state-of-the-art RSV prediction algorithms and achieves up to 46% lower root mean square error and 49% lower mean absolute error for country-level prediction compared to the baselines.

Cheng Qian, Kejun Huang, Lucas Glass et al.

Tensor completion aims at imputing missing entries from a partially observed tensor. Existing tensor completion methods often assume either multi-linear or nonlinear relationships between latent components. However, real-world tensors have much more complex patterns where both multi-linear and nonlinear relationships may coexist. In such cases, the existing methods are insufficient to describe the data structure. This paper proposes a Joint mUlti-linear and nonLinear IdentificAtion (JULIA) framework for large-scale tensor completion. JULIA unifies the multi-linear and nonlinear tensor completion models with several advantages over the existing methods: 1) Flexible model selection, i.e., it fits a tensor by assigning its values as a combination of multi-linear and nonlinear components; 2) Compatible with existing nonlinear tensor completion methods; 3) Efficient training based on a well-designed alternating optimization approach. Experiments on six real large-scale tensors demonstrate that JULIA outperforms many existing tensor completion algorithms. Furthermore, JULIA can improve the performance of a class of nonlinear tensor completion methods. The results show that in some large-scale tensor completion scenarios, baseline methods with JULIA are able to obtain up to 55% lower root mean-squared-error and save 67% computational complexity.

Cheng Qian, Nikos Kargas, Cao Xiao et al.

Real-world spatio-temporal data is often incomplete or inaccurate due to various data loading delays. For example, a location-disease-time tensor of case counts can have multiple delayed updates of recent temporal slices for some locations or diseases. Recovering such missing or noisy (under-reported) elements of the input tensor can be viewed as a generalized tensor completion problem. Existing tensor completion methods usually assume that i) missing elements are randomly distributed and ii) noise for each tensor element is i.i.d. zero-mean. Both assumptions can be violated for spatio-temporal tensor data. We often observe multiple versions of the input tensor with different under-reporting noise levels. The amount of noise can be time- or location-dependent as more updates are progressively introduced to the tensor. We model such dynamic data as a multi-version tensor with an extra tensor mode capturing the data updates. We propose a low-rank tensor model to predict the updates over time. We demonstrate that our method can accurately predict the ground-truth values of many real-world tensors. We obtain up to 27.2% lower root mean-squared-error compared to the best baseline method. Finally, we extend our method to track the tensor data over time, leading to significant computational savings.

Chaoqi Yang, Cao Xiao, Lucas Glass et al.

Deep learning is revolutionizing predictive healthcare, including recommending medications to patients with complex health conditions. Existing approaches focus on predicting all medications for the current visit, which often overlaps with medications from previous visits. A more clinically relevant task is to identify medication changes. In this paper, we propose a new recurrent residual network, named MICRON, for medication change prediction. MICRON takes the changes in patient health records as input and learns to update a hidden medication vector and the medication set recurrently with a reconstruction design. The medication vector is like the memory cell that encodes longitudinal information of medications. Unlike traditional methods that require the entire patient history for prediction, MICRON has a residual-based inference that allows for sequential updating based only on new patient features (e.g., new diagnoses in the recent visit) more efficiently. We evaluated MICRON on real inpatient and outpatient datasets. MICRON achieves 3.5% and 7.8% relative improvements over the best baseline in F1 score, respectively. MICRON also requires fewer parameters, which significantly reduces the training time to 38.3s per epoch with 1.5x speed-up.

Chaoqi Yang, Cao Xiao, Fenglong Ma et al.

Medication recommendation is an essential task of AI for healthcare. Existing works focused on recommending drug combinations for patients with complex health conditions solely based on their electronic health records. Thus, they have the following limitations: (1) some important data such as drug molecule structures have not been utilized in the recommendation process. (2) drug-drug interactions (DDI) are modeled implicitly, which can lead to sub-optimal results. To address these limitations, we propose a DDI-controllable drug recommendation model named SafeDrug to leverage drugs' molecule structures and model DDIs explicitly. SafeDrug is equipped with a global message passing neural network (MPNN) module and a local bipartite learning module to fully encode the connectivity and functionality of drug molecules. SafeDrug also has a controllable loss function to control DDI levels in the recommended drug combinations effectively. On a benchmark dataset, our SafeDrug is relatively shown to reduce DDI by 19.43% and improves 2.88% on Jaccard similarity between recommended and actually prescribed drug combinations over previous approaches. Moreover, SafeDrug also requires much fewer parameters than previous deep learning-based approaches, leading to faster training by about 14% and around 2x speed-up in inference.

Kexin Huang, Cao Xiao, Lucas M. Glass et al.

Thanks to the increasing availability of genomics and other biomedical data, many machine learning approaches have been proposed for a wide range of therapeutic discovery and development tasks. In this survey, we review the literature on machine learning applications for genomics through the lens of therapeutic development. We investigate the interplay among genomics, compounds, proteins, electronic health records (EHR), cellular images, and clinical texts. We identify twenty-two machine learning in genomics applications across the entire therapeutics pipeline, from discovering novel targets, personalized medicine, developing gene-editing tools all the way to clinical trials and post-market studies. We also pinpoint seven important challenges in this field with opportunities for expansion and impact. This survey overviews recent research at the intersection of machine learning, genomics, and therapeutic development.

Zhen Lin, Cao Xiao, Lucas Glass et al.

Despite deep learning (DL) success in classification problems, DL classifiers do not provide a sound mechanism to decide when to refrain from predicting. Recent works tried to control the overall prediction risk with classification with rejection options. However, existing works overlook the different significance of different classes. We introduce Set-classifier with Class-specific RIsk Bounds (SCRIB) to tackle this problem, assigning multiple labels to each example. Given the output of a black-box model on the validation set, SCRIB constructs a set-classifier that controls the class-specific prediction risks with a theoretical guarantee. The key idea is to reject when the set classifier returns more than one label. We validated SCRIB on several medical applications, including sleep staging on electroencephalogram (EEG) data, X-ray COVID image classification, and atrial fibrillation detection based on electrocardiogram (ECG) data. SCRIB obtained desirable class-specific risks, which are 35\%-88\% closer to the target risks than baseline methods.

Tianfan Fu, Kexin Huang, Cao Xiao et al.

Clinical trials are crucial for drug development but are time consuming, expensive, and often burdensome on patients. More importantly, clinical trials face uncertain outcomes due to issues with efficacy, safety, or problems with patient recruitment. If we were better at predicting the results of clinical trials, we could avoid having to run trials that will inevitably fail more resources could be devoted to trials that are likely to succeed. In this paper, we propose Hierarchical INteraction Network (HINT) for more general, clinical trial outcome predictions for all diseases based on a comprehensive and diverse set of web data including molecule information of the drugs, target disease information, trial protocol and biomedical knowledge. HINT first encode these multi-modal data into latent embeddings, where an imputation module is designed to handle missing data. Next, these embeddings will be fed into the knowledge embedding module to generate knowledge embeddings that are pretrained using external knowledge on pharmaco-kinetic properties and trial risk from the web. Then the interaction graph module will connect all the embedding via domain knowledge to fully capture various trial components and their complex relations as well as their influences on trial outcomes. Finally, HINT learns a dynamic attentive graph neural network to predict trial outcome. Comprehensive experimental results show that HINT achieves strong predictive performance, obtaining 0.772, 0.607, 0.623, 0.703 on PR-AUC for Phase I, II, III, and indication outcome prediction, respectively. It also consistently outperforms the best baseline method by up to 12.4\% on PR-AUC.

Nikos Kargas, Cheng Qian, Nicholas D. Sidiropoulos et al.

Accurate prediction of the transmission of epidemic diseases such as COVID-19 is crucial for implementing effective mitigation measures. In this work, we develop a tensor method to predict the evolution of epidemic trends for many regions simultaneously. We construct a 3-way spatio-temporal tensor (location, attribute, time) of case counts and propose a nonnegative tensor factorization with latent epidemiological model regularization named STELAR. Unlike standard tensor factorization methods which cannot predict slabs ahead, STELAR enables long-term prediction by incorporating latent temporal regularization through a system of discrete-time difference equations of a widely adopted epidemiological model. We use latent instead of location/attribute-level epidemiological dynamics to capture common epidemic profile sub-types and improve collaborative learning and prediction. We conduct experiments using both county- and state-level COVID-19 data and show that our model can identify interesting latent patterns of the epidemic. Finally, we evaluate the predictive ability of our method and show superior performance compared to the baselines, achieving up to 21% lower root mean square error and 25% lower mean absolute error for county-level prediction.

Zhi Qiao, Austin Bae, Lucas M. Glass et al.

To test the possibility of differentiating chest x-ray images of COVID-19 against other pneumonia and healthy patients using deep neural networks. We construct the X-ray imaging data from two publicly available sources, which include 5508 chest x-ray images across 2874 patients with four classes: normal, bacterial pneumonia, non-COVID-19 viral pneumonia, and COVID-19. To identify COVID-19, we propose a Focal Loss Based Neural Ensemble Network (FLANNEL), a flexible module to ensemble several convolutional neural network (CNN) models and fuse with a focal loss for accurate COVID-19 detection on class imbalance data. FLANNEL consistently outperforms baseline models on COVID-19 identification task in all metrics. Compared with the best baseline, FLANNEL shows a higher macro-F1 score with 6% relative increase on Covid-19 identification task where it achieves 0.7833(0.07) in Precision, 0.8609(0.03) in Recall, and 0.8168(0.03) F1 score.

Chacha Chen, Junjie Liang, Fenglong Ma et al.

Successful health risk prediction demands accuracy and reliability of the model. Existing predictive models mainly depend on mining electronic health records (EHR) with advanced deep learning techniques to improve model accuracy. However, they all ignore the importance of publicly available online health data, especially socioeconomic status, environmental factors, and detailed demographic information for each location, which are all strong predictive signals and can definitely augment precision medicine. To achieve model reliability, the model needs to provide accurate prediction and uncertainty score of the prediction. However, existing uncertainty estimation approaches often failed in handling high-dimensional data, which are present in multi-sourced data. To fill the gap, we propose UNcertaInTy-based hEalth risk prediction (UNITE) model. Building upon an adaptive multimodal deep kernel and a stochastic variational inference module, UNITE provides accurate disease risk prediction and uncertainty estimation leveraging multi-sourced health data including EHR data, patient demographics, and public health data collected from the web. We evaluate UNITE on real-world disease risk prediction tasks: nonalcoholic fatty liver disease (NASH) and Alzheimer's disease (AD). UNITE achieves up to 0.841 in F1 score for AD detection, up to 0.609 in PR-AUC for NASH detection, and outperforms various state-of-the-art baselines by up to $19\%$ over the best baseline. We also show UNITE can model meaningful uncertainties and can provide evidence-based clinical support by clustering similar patients.

Kexin Huang, Tianfan Fu, Dawood Khan et al.

The efficacy of a drug depends on its binding affinity to the therapeutic target and pharmacokinetics. Deep learning (DL) has demonstrated remarkable progress in predicting drug efficacy. We develop MolDesigner, a human-in-the-loop web user-interface (UI), to assist drug developers leverage DL predictions to design more effective drugs. A developer can draw a drug molecule in the interface. In the backend, more than 17 state-of-the-art DL models generate predictions on important indices that are crucial for a drug's efficacy. Based on these predictions, drug developers can edit the drug molecule and reiterate until satisfaction. MolDesigner can make predictions in real-time with a latency of less than a second.

Yue Yu, Kexin Huang, Chao Zhang et al.

Thanks to the increasing availability of drug-drug interactions (DDI) datasets and large biomedical knowledge graphs (KGs), accurate detection of adverse DDI using machine learning models becomes possible. However, it remains largely an open problem how to effectively utilize large and noisy biomedical KG for DDI detection. Due to its sheer size and amount of noise in KGs, it is often less beneficial to directly integrate KGs with other smaller but higher quality data (e.g., experimental data). Most of the existing approaches ignore KGs altogether. Some try to directly integrate KGs with other data via graph neural networks with limited success. Furthermore, most previous works focus on binary DDI prediction whereas the multi-typed DDI pharmacological effect prediction is a more meaningful but harder task. To fill the gaps, we propose a new method SumGNN: knowledge summarization graph neural network, which is enabled by a subgraph extraction module that can efficiently anchor on relevant subgraphs from a KG, a self-attention based subgraph summarization scheme to generate a reasoning path within the subgraph, and a multi-channel knowledge and data integration module that utilizes massive external biomedical knowledge for significantly improved multi-typed DDI predictions. SumGNN outperforms the best baseline by up to 5.54\%, and the performance gain is particularly significant in low data relation types. In addition, SumGNN provides interpretable prediction via the generated reasoning paths for each prediction.

Rakshith S Srinivasa, Cao Xiao, Lucas Glass et al.

The attention mechanism has demonstrated superior performance for inference over nodes in graph neural networks (GNNs), however, they result in a high computational burden during both training and inference. We propose FastGAT, a method to make attention based GNNs lightweight by using spectral sparsification to generate an optimal pruning of the input graph. This results in a per-epoch time that is almost linear in the number of graph nodes as opposed to quadratic. We theoretically prove that spectral sparsification preserves the features computed by the GAT model, thereby justifying our algorithm. We experimentally evaluate FastGAT on several large real world graph datasets for node classification tasks under both inductive and transductive settings. FastGAT can dramatically reduce (up to \textbf{10x}) the computational time and memory requirements, allowing the usage of attention based GNNs on large graphs.

Junyi Gao, Cao Xiao, Lucas M. Glass et al.

Clinical trials play important roles in drug development but often suffer from expensive, inaccurate and insufficient patient recruitment. The availability of massive electronic health records (EHR) data and trial eligibility criteria (EC) bring a new opportunity to data driven patient recruitment. One key task named patient-trial matching is to find qualified patients for clinical trials given structured EHR and unstructured EC text (both inclusion and exclusion criteria). How to match complex EC text with longitudinal patient EHRs? How to embed many-to-many relationships between patients and trials? How to explicitly handle the difference between inclusion and exclusion criteria? In this paper, we proposed CrOss-Modal PseudO-SiamEse network (COMPOSE) to address these challenges for patient-trial matching. One path of the network encodes EC using convolutional highway network. The other path processes EHR with multi-granularity memory network that encodes structured patient records into multiple levels based on medical ontology. Using the EC embedding as query, COMPOSE performs attentional record alignment and thus enables dynamic patient-trial matching. COMPOSE also introduces a composite loss term to maximize the similarity between patient records and inclusion criteria while minimize the similarity to the exclusion criteria. Experiment results show COMPOSE can reach 98.0% AUC on patient-criteria matching and 83.7% accuracy on patient-trial matching, which leads 24.3% improvement over the best baseline on real-world patient-trial matching tasks.

Kexin Huang, Cao Xiao, Lucas Glass et al.

Molecular interaction networks are powerful resources for the discovery. They are increasingly used with machine learning methods to predict biologically meaningful interactions. While deep learning on graphs has dramatically advanced the prediction prowess, current graph neural network (GNN) methods are optimized for prediction on the basis of direct similarity between interacting nodes. In biological networks, however, similarity between nodes that do not directly interact has proved incredibly useful in the last decade across a variety of interaction networks. Here, we present SkipGNN, a graph neural network approach for the prediction of molecular interactions. SkipGNN predicts molecular interactions by not only aggregating information from direct interactions but also from second-order interactions, which we call skip similarity. In contrast to existing GNNs, SkipGNN receives neural messages from two-hop neighbors as well as immediate neighbors in the interaction network and non-linearly transforms the messages to obtain useful information for prediction. To inject skip similarity into a GNN, we construct a modified version of the original network, called the skip graph. We then develop an iterative fusion scheme that optimizes a GNN using both the skip graph and the original graph. Experiments on four interaction networks, including drug-drug, drug-target, protein-protein, and gene-disease interactions, show that SkipGNN achieves superior and robust performance, outperforming existing methods by up to 28.8\% of area under the precision recall curve (PR-AUC). Furthermore, we show that unlike popular GNNs, SkipGNN learns biologically meaningful embeddings and performs especially well on noisy, incomplete interaction networks.

Kexin Huang, Cao Xiao, Lucas Glass et al.

Drug target interaction (DTI) prediction is a foundational task for in silico drug discovery, which is costly and time-consuming due to the need of experimental search over large drug compound space. Recent years have witnessed promising progress for deep learning in DTI predictions. However, the following challenges are still open: (1) the sole data-driven molecular representation learning approaches ignore the sub-structural nature of DTI, thus produce results that are less accurate and difficult to explain; (2) existing methods focus on limited labeled data while ignoring the value of massive unlabelled molecular data. We propose a Molecular Interaction Transformer (MolTrans) to address these limitations via: (1) knowledge inspired sub-structural pattern mining algorithm and interaction modeling module for more accurate and interpretable DTI prediction; (2) an augmented transformer encoder to better extract and capture the semantic relations among substructures extracted from massive unlabeled biomedical data. We evaluate MolTrans on real world data and show it improved DTI prediction performance compared to state-of-the-art baselines.

Kexin Huang, Tianfan Fu, Lucas Glass et al.

Accurate prediction of drug-target interactions (DTI) is crucial for drug discovery. Recently, deep learning (DL) models for show promising performance for DTI prediction. However, these models can be difficult to use for both computer scientists entering the biomedical field and bioinformaticians with limited DL experience. We present DeepPurpose, a comprehensive and easy-to-use deep learning library for DTI prediction. DeepPurpose supports training of customized DTI prediction models by implementing 15 compound and protein encoders and over 50 neural architectures, along with providing many other useful features. We demonstrate state-of-the-art performance of DeepPurpose on several benchmark datasets.

Siddharth Biswal, Cao Xiao, Lucas M. Glass et al.

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

Xingyao Zhang, Cao Xiao, Lucas M. Glass et al.

Clinical trials are essential for drug development but often suffer from expensive, inaccurate and insufficient patient recruitment. The core problem of patient-trial matching is to find qualified patients for a trial, where patient information is stored in electronic health records (EHR) while trial eligibility criteria (EC) are described in text documents available on the web. How to represent longitudinal patient EHR? How to extract complex logical rules from EC? Most existing works rely on manual rule-based extraction, which is time consuming and inflexible for complex inference. To address these challenges, we proposed DeepEnroll, a cross-modal inference learning model to jointly encode enrollment criteria (text) and patients records (tabular data) into a shared latent space for matching inference. DeepEnroll applies a pre-trained Bidirectional Encoder Representations from Transformers(BERT) model to encode clinical trial information into sentence embedding. And uses a hierarchical embedding model to represent patient longitudinal EHR. In addition, DeepEnroll is augmented by a numerical information embedding and entailment module to reason over numerical information in both EC and EHR. These encoders are trained jointly to optimize patient-trial matching score. We evaluated DeepEnroll on the trial-patient matching task with demonstrated on real world datasets. DeepEnroll outperformed the best baseline by up to 12.4% in average F1.

Limeng Cui, Siddharth Biswal, Lucas M. Glass et al.

Rare diseases affect hundreds of millions of people worldwide but are hard to detect since they have extremely low prevalence rates (varying from 1/1,000 to 1/200,000 patients) and are massively underdiagnosed. How do we reliably detect rare diseases with such low prevalence rates? How to further leverage patients with possibly uncertain diagnosis to improve detection? In this paper, we propose a Complementary pattern Augmentation (CONAN) framework for rare disease detection. CONAN combines ideas from both adversarial training and max-margin classification. It first learns self-attentive and hierarchical embedding for patient pattern characterization. Then, we develop a complementary generative adversarial networks (GAN) model to generate candidate positive and negative samples from the uncertain patients by encouraging a max-margin between classes. In addition, CONAN has a disease detector that serves as the discriminator during the adversarial training for identifying rare diseases. We evaluated CONAN on two disease detection tasks. For low prevalence inflammatory bowel disease (IBD) detection, CONAN achieved .96 precision recall area under the curve (PR-AUC) and 50.1% relative improvement over best baseline. For rare disease idiopathic pulmonary fibrosis (IPF) detection, CONAN achieves .22 PR-AUC with 41.3% relative improvement over the best baseline.

Siddharth Biswal, Cao Xiao, Lucas M. Glass et al.

Massive electronic health records (EHRs) enable the success of learning accurate patient representations to support various predictive health applications. In contrast, doctor representation was not well studied despite that doctors play pivotal roles in healthcare. How to construct the right doctor representations? How to use doctor representation to solve important health analytic problems? In this work, we study the problem on {\it clinical trial recruitment}, which is about identifying the right doctors to help conduct the trials based on the trial description and patient EHR data of those doctors. We propose doctor2vec which simultaneously learns 1) doctor representations from EHR data and 2) trial representations from the description and categorical information about the trials. In particular, doctor2vec utilizes a dynamic memory network where the doctor's experience with patients are stored in the memory bank and the network will dynamically assign weights based on the trial representation via an attention mechanism. Validated on large real-world trials and EHR data including 2,609 trials, 25K doctors and 430K patients, doctor2vec demonstrated improved performance over the best baseline by up to $8.7\%$ in PR-AUC. We also demonstrated that the doctor2vec embedding can be transferred to benefit data insufficiency settings including trial recruitment in less populated/newly explored country with $13.7\%$ improvement or for rare diseases with $8.1\%$ improvement in PR-AUC.

Kexin Huang, Cao Xiao, Trong Nghia Hoang et al.

Adverse drug-drug interactions (DDIs) remain a leading cause of morbidity and mortality. Identifying potential DDIs during the drug design process is critical for patients and society. Although several computational models have been proposed for DDI prediction, there are still limitations: (1) specialized design of drug representation for DDI predictions is lacking; (2) predictions are based on limited labelled data and do not generalize well to unseen drugs or DDIs; and (3) models are characterized by a large number of parameters, thus are hard to interpret. In this work, we develop a ChemicAl SubstrucTurE Representation (CASTER) framework that predicts DDIs given chemical structures of drugs.CASTER aims to mitigate these limitations via (1) a sequential pattern mining module rooted in the DDI mechanism to efficiently characterize functional sub-structures of drugs; (2) an auto-encoding module that leverages both labelled and unlabelled chemical structure data to improve predictive accuracy and generalizability; and (3) a dictionary learning module that explains the prediction via a small set of coefficients which measure the relevance of each input sub-structures to the DDI outcome. We evaluated CASTER on two real-world DDI datasets and showed that it performed better than state-of-the-art baselines and provided interpretable predictions.

Fan Zhang, Tong Wu, Yunlong Wang et al.

Many computational models were proposed to extract temporal patterns from clinical time series for each patient and among patient group for predictive healthcare. However, the common relations among patients (e.g., share the same doctor) were rarely considered. In this paper, we represent patients and clinicians relations by bipartite graphs addressing for example from whom a patient get a diagnosis. We then solve for the top eigenvectors of the graph Laplacian, and include the eigenvectors as latent representations of the similarity between patient-clinician pairs into a time-sensitive prediction model. We conducted experiments using real-world data to predict the initiation of first-line treatment for Chronic Lymphocytic Leukemia (CLL) patients. Results show that relational similarity can improve prediction over multiple baselines, for example a 5% incremental over long-short term memory baseline in terms of area under precision-recall curve.

Kezi Yu, Yunlong Wang, Yong Cai et al.

Rare diseases affecting 350 million individuals are commonly associated with delay in diagnosis or misdiagnosis. To improve those patients' outcome, rare disease detection is an important task for identifying patients with rare conditions based on longitudinal medical claims. In this paper, we present a deep learning method for detecting patients with exocrine pancreatic insufficiency (EPI) (a rare disease). The contribution includes 1) a large longitudinal study using 7 years medical claims from 1.8 million patients including 29,149 EPI patients, 2) a new deep learning model using generative adversarial networks (GANs) to boost rare disease class, and also leveraging recurrent neural networks to model patient sequence data, 3) an accurate prediction with 0.56 PR-AUC which outperformed benchmark models in terms of precision and recall.