Tackeun Kim

Sungjin Park, Seongsu Bae, Jiho Kim et al.

As the volume of Electronic Health Records (EHR) sharply grows, there has been emerging interest in learning the representation of EHR for healthcare applications. Representation learning of EHR requires appropriate modeling of the two dominant modalities in EHR: structured data and unstructured text. In this paper, we present MedGTX, a pre-trained model for multi-modal representation learning of the structured and textual EHR data. MedGTX uses a novel graph encoder to exploit the graphical nature of structured EHR data, and a text encoder to handle unstructured text, and a cross-modal encoder to learn a joint representation space. We pre-train our model through four proxy tasks on MIMIC-III, an open-source EHR data, and evaluate our model on two clinical benchmarks and three novel downstream tasks which tackle real-world problems in EHR data. The results consistently show the effectiveness of pre-training the model for joint representation of both structured and unstructured information from EHR. Given the promising performance of MedGTX, we believe this work opens a new door to jointly understanding the two fundamental modalities of EHR data.

Seongsu Bae, Daeun Kyung, Jaehee Ryu et al.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC-CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

Hyungyung Lee, Da Young Lee, Wonjae Kim et al.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

Daeun Kyung, Junu Kim, Tackeun Kim et al.

Chest X-ray (CXR) is an important diagnostic tool widely used in hospitals to assess patient conditions and monitor changes over time. Recently, generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic CXRs. However, these models mainly focus on conditional generation using single-time-point data, i.e., generating CXRs conditioned on their corresponding reports from a specific time. This limits their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. Results show that our framework generates high-quality, realistic future images that effectively capture potential temporal changes. This suggests that our framework could be further developed to support clinical decision-making and provide valuable insights for patient monitoring and treatment planning in the medical field. The code is available at https://github.com/dek924/EHRXDiff.