Kwangsoo Kim

Jaesung Yoo, Sunghyuk Choi, Ye Seul Yang et al.

When a deep learning model is trained sequentially on different datasets, it often forgets the knowledge learned from previous data, a problem known as catastrophic forgetting. This damages the model's performance on diverse datasets, which is critical in privacy-preserving deep learning (PPDL) applications based on transfer learning (TL). To overcome this, we introduce "review learning" (RevL), a low cost continual learning algorithm for diagnosis prediction using electronic health records (EHR) within a PPDL framework. RevL generates data samples from the model which are used to review knowledge from previous datasets. Six simulated institutional experiments and one real-world experiment involving three medical institutions were conducted to validate RevL, using three binary classification EHR data. In the real-world experiment with data from 106,508 patients, the mean global area under the receiver operating curve was 0.710 for RevL and 0.655 for TL. These results demonstrate RevL's ability to retain previously learned knowledge and its effectiveness in real-world PPDL scenarios. Our work establishes a realistic pipeline for PPDL research based on model transfers across institutions and highlights the practicality of continual learning in real-world medical settings using private EHR data.

Yohan Lee, DongGyun Kang, SeHoon Park et al.

Chronic Kidney Disease (CKD) affects nearly 10\% of the global population and often progresses to end-stage renal failure. Accurate prognosis prediction is vital for timely interventions and resource optimization. We present a transformer-based framework for predicting CKD progression using multi-modal electronic health records (EHR) from the Seoul National University Hospital OMOP Common Data Model. Our approach (\textbf{ProQ-BERT}) integrates demographic, clinical, and laboratory data, employing quantization-based tokenization for continuous lab values and attention mechanisms for interpretability. The model was pretrained with masked language modeling and fine-tuned for binary classification tasks predicting progression from stage 3a to stage 5 across varying follow-up and assessment periods. Evaluated on a cohort of 91,816 patients, our model consistently outperformed CEHR-BERT, achieving ROC-AUC up to 0.995 and PR-AUC up to 0.989 for short-term prediction. These results highlight the effectiveness of transformer architectures and temporal design choices in clinical prognosis modeling, offering a promising direction for personalized CKD care.

Junmo Kim, Namkyeong Lee, Jiwon Kim et al.

Electronic health record (EHR) foundation models have been an area ripe for exploration with their improved performance in various medical tasks. Despite the rapid advances, there exists a fundamental limitation: Processing unseen medical codes out of vocabulary. This problem limits the generalizability of EHR foundation models and the integration of models trained with different vocabularies. To alleviate this problem, we propose a set of novel medical concept representations (MedRep) for EHR foundation models based on the observational medical outcome partnership (OMOP) common data model (CDM). For concept representation learning, we enrich the information of each concept with a minimal definition through large language model (LLM) prompts and complement the text-based representations through the graph ontology of OMOP vocabulary. Our approach outperforms the vanilla EHR foundation model and the model with a previously introduced medical code tokenizer in diverse prediction tasks. We also demonstrate the generalizability of MedRep through external validation.

Joohyung Jeon, Junhui Kim, Joongheon Kim et al.

This paper proposes a distributed deep learning framework for privacy-preserving medical data training. In order to avoid patients' data leakage in medical platforms, the hidden layers in the deep learning framework are separated and where the first layer is kept in platform and others layers are kept in a centralized server. Whereas keeping the original patients' data in local platforms maintain their privacy, utilizing the server for subsequent layers improves learning performance by using all data from each platform during training.