Miika Koskinen

Mine Öğretir, Miika Koskinen, Juha Sinisalo et al.

In healthcare, risk assessment of patient outcomes has been based on survival analysis for a long time, i.e. modeling time-to-event associations. However, conventional approaches rely on data from a single time-point, making them suboptimal for fully leveraging longitudinal patient history and capturing temporal regularities. Focusing on clinical real-world data and acknowledging its challenges, we utilize latent variable models to effectively handle irregular, noisy, and sparsely observed longitudinal data. We propose SeqRisk, a method that combines variational autoencoder (VAE) or longitudinal VAE (LVAE) with a transformer-based sequence aggregation and Cox proportional hazards module for risk prediction. SeqRisk captures long-range interactions, enhances predictive accuracy and generalizability, as well as provides partial explainability for sample population characteristics in attempts to identify high-risk patients. SeqRisk demonstrated robust performance under conditions of increasing sparsity, consistently surpassing existing approaches.

Manuel Haussmann, Tran Minh Son Le, Viivi Halla-aho et al.

Randomized controlled trials (RCTs) are the accepted standard for treatment effect estimation but they can be infeasible due to ethical reasons and prohibitive costs. Single-arm trials, where all patients belong to the treatment group, can be a viable alternative but require access to an external control group. We propose an identifiable deep latent-variable model for this scenario that can also account for missing covariate observations by modeling their structured missingness patterns. Our method uses amortized variational inference to learn both group-specific and identifiable shared latent representations, which can subsequently be used for {\em (i)} patient matching if treatment outcomes are not available for the treatment group, or for {\em (ii)} direct treatment effect estimation assuming outcomes are available for both groups. We evaluate the model on a public benchmark as well as on a data set consisting of a published RCT study and real-world electronic health records. Compared to previous methods, our results show improved performance both for direct treatment effect estimation as well as for effect estimation via patient matching.

Ya Gao, Hans Moen, Saila Koivusalo et al.

Nursing notes, an important part of Electronic Health Records (EHRs), track a patient's health during a care episode. Summarizing key information in nursing notes can help clinicians quickly understand patients' conditions. However, existing summarization methods in the clinical setting, especially abstractive methods, have overlooked nursing notes and require reference summaries for training. We introduce QGSumm, a novel query-guided self-supervised domain adaptation approach for abstractive nursing note summarization. The method uses patient-related clinical queries for guidance, and hence does not need reference summaries for training. Through automatic experiments and manual evaluation by an expert clinician, we study our approach and other state-of-the-art Large Language Models (LLMs) for nursing note summarization. Our experiments show: 1) GPT-4 is competitive in maintaining information in the original nursing notes, 2) QGSumm can generate high-quality summaries with a good balance between recall of the original content and hallucination rate lower than other top methods. Ultimately, our work offers a new perspective on conditional text summarization, tailored to clinical applications.

Siddharth Ramchandran, Gleb Tikhonov, Kalle Kujanpää et al.

Longitudinal datasets measured repeatedly over time from individual subjects, arise in many biomedical, psychological, social, and other studies. A common approach to analyse high-dimensional data that contains missing values is to learn a low-dimensional representation using variational autoencoders (VAEs). However, standard VAEs assume that the learnt representations are i.i.d., and fail to capture the correlations between the data samples. We propose the Longitudinal VAE (L-VAE), that uses a multi-output additive Gaussian process (GP) prior to extend the VAE's capability to learn structured low-dimensional representations imposed by auxiliary covariate information, and derive a new KL divergence upper bound for such GPs. Our approach can simultaneously accommodate both time-varying shared and random effects, produce structured low-dimensional representations, disentangle effects of individual covariates or their interactions, and achieve highly accurate predictive performance. We compare our model against previous methods on synthetic as well as clinical datasets, and demonstrate the state-of-the-art performance in data imputation, reconstruction, and long-term prediction tasks.

Siddharth Ramchandran, Miika Koskinen, Harri Lähdesmäki

Clinical patient records are an example of high-dimensional data that is typically collected from disparate sources and comprises of multiple likelihoods with noisy as well as missing values. In this work, we propose an unsupervised generative model that can learn a low-dimensional representation among the observations in a latent space, while making use of all available data in a heterogeneous data setting with missing values. We improve upon the existing Gaussian process latent variable model (GPLVM) by incorporating multiple likelihoods and deep neural network parameterised back-constraints to create a non-linear dimensionality reduction technique for heterogeneous data. In addition, we develop a variational inference method for our model that uses numerical quadrature. We establish the effectiveness of our model and compare against existing GPLVM methods on a standard benchmark dataset as well as on clinical data of Parkinson's disease patients treated at the HUS Helsinki University Hospital.