Zhenhao Zhang

Yuxi Liu, Zhenhao Zhang, Antonio Jimeno Yepes et al.

Building models for health prediction based on Electronic Health Records (EHR) has become an active research area. EHR patient journey data consists of patient time-ordered clinical events/visits from patients. Most existing studies focus on modeling long-term dependencies between visits, without explicitly taking short-term correlations between consecutive visits into account, where irregular time intervals, incorporated as auxiliary information, are fed into health prediction models to capture latent progressive patterns of patient journeys. We present a novel deep neural network with four modules to take into account the contributions of various variables for health prediction: i) the Stacked Attention module strengthens the deep semantics in clinical events within each patient journey and generates visit embeddings, ii) the Short-Term Temporal Attention module models short-term correlations between consecutive visit embeddings while capturing the impact of time intervals within those visit embeddings, iii) the Long-Term Temporal Attention module models long-term dependencies between visit embeddings while capturing the impact of time intervals within those visit embeddings, iv) and finally, the Coupled Attention module adaptively aggregates the outputs of Short-Term Temporal Attention and Long-Term Temporal Attention modules to make health predictions. Experimental results on MIMIC-III demonstrate superior predictive accuracy of our model compared to existing state-of-the-art methods, as well as the interpretability and robustness of this approach. Furthermore, we found that modeling short-term correlations contributes to local priors generation, leading to improved predictive modeling of patient journeys.

Yuxi Liu, Zhenhao Zhang, Shaowen Qin et al.

Predicting the risk of in-hospital mortality from electronic health records (EHRs) has received considerable attention. Such predictions will provide early warning of a patient's health condition to healthcare professionals so that timely interventions can be taken. This prediction task is challenging since EHR data are intrinsically irregular, with not only many missing values but also varying time intervals between medical records. Existing approaches focus on exploiting the variable correlations in patient medical records to impute missing values and establishing time-decay mechanisms to deal with such irregularity. This paper presents a novel contrastive learning-based imputation-prediction network for predicting in-hospital mortality risks using EHR data. Our approach introduces graph analysis-based patient stratification modeling in the imputation process to group similar patients. This allows information of similar patients only to be used, in addition to personal contextual information, for missing value imputation. Moreover, our approach can integrate contrastive learning into the proposed network architecture to enhance patient representation learning and predictive performance on the classification task. Experiments on two real-world EHR datasets show that our approach outperforms the state-of-the-art approaches in both imputation and prediction tasks.

Yuxi Liu, Zhenhao Zhang, Shaowen Qin et al.

The Intensive Care Unit (ICU) is one of the most important parts of a hospital, which admits critically ill patients and provides continuous monitoring and treatment. Various patient outcome prediction methods have been attempted to assist healthcare professionals in clinical decision-making. Existing methods focus on measuring the similarity between patients using deep neural networks to capture the hidden feature structures. However, the higher-order relationships are ignored, such as patient characteristics (e.g., diagnosis codes) and their causal effects on downstream clinical predictions. In this paper, we propose a novel Hypergraph Convolutional Network that allows the representation of non-pairwise relationships among diagnosis codes in a hypergraph to capture the hidden feature structures so that fine-grained patient similarity can be calculated for personalized mortality risk prediction. Evaluation using a publicly available eICU Collaborative Research Database indicates that our method achieves superior performance over the state-of-the-art models on mortality risk prediction. Moreover, the results of several case studies demonstrated the effectiveness and robustness of the model decisions.

Yuxi Liu, Shaowen Qin, Antonio Jimeno Yepes et al.

Predicting the health risks of patients using Electronic Health Records (EHR) has attracted considerable attention in recent years, especially with the development of deep learning techniques. Health risk refers to the probability of the occurrence of a specific health outcome for a specific patient. The predicted risks can be used to support decision-making by healthcare professionals. EHRs are structured patient journey data. Each patient journey contains a chronological set of clinical events, and within each clinical event, there is a set of clinical/medical activities. Due to variations of patient conditions and treatment needs, EHR patient journey data has an inherently high degree of missingness that contains important information affecting relationships among variables, including time. Existing deep learning-based models generate imputed values for missing values when learning the relationships. However, imputed data in EHR patient journey data may distort the clinical meaning of the original EHR patient journey data, resulting in classification bias. This paper proposes a novel end-to-end approach to modeling EHR patient journey data with Integrated Convolutional and Recurrent Neural Networks. Our model can capture both long- and short-term temporal patterns within each patient journey and effectively handle the high degree of missingness in EHR data without any imputation data generation. Extensive experimental results using the proposed model on two real-world datasets demonstrate robust performance as well as superior prediction accuracy compared to existing state-of-the-art imputation-based prediction methods.

Yuxi Liu, Shaowen Qin, Zhenhao Zhang et al.

Electronic Health Records (EHRs) exhibit a high amount of missing data due to variations of patient conditions and treatment needs. Imputation of missing values has been considered an effective approach to deal with this challenge. Existing work separates imputation method and prediction model as two independent parts of an EHR-based machine learning system. We propose an integrated end-to-end approach by utilizing a Compound Density Network (CDNet) that allows the imputation method and prediction model to be tuned together within a single framework. CDNet consists of a Gated recurrent unit (GRU), a Mixture Density Network (MDN), and a Regularized Attention Network (RAN). The GRU is used as a latent variable model to model EHR data. The MDN is designed to sample latent variables generated by GRU. The RAN serves as a regularizer for less reliable imputed values. The architecture of CDNet enables GRU and MDN to iteratively leverage the output of each other to impute missing values, leading to a more accurate and robust prediction. We validate CDNet on the mortality prediction task on the MIMIC-III dataset. Our model outperforms state-of-the-art models by significant margins. We also empirically show that regularizing imputed values is a key factor for superior prediction performance. Analysis of prediction uncertainty shows that our model can capture both aleatoric and epistemic uncertainties, which offers model users a better understanding of the model results.

Hanqing Wang, Yuan Tian, Mingyu Liu et al.

In the rapidly evolving landscape of Multimodal Large Language Models (MLLMs), the safety concerns of their outputs have earned significant attention. Although numerous datasets have been proposed, they may become outdated with MLLM advancements and are susceptible to data contamination issues. To address these problems, we propose \textbf{SDEval}, the \textit{first} safety dynamic evaluation framework to controllably adjust the distribution and complexity of safety benchmarks. Specifically, SDEval mainly adopts three dynamic strategies: text, image, and text-image dynamics to generate new samples from original benchmarks. We first explore the individual effects of text and image dynamics on model safety. Then, we find that injecting text dynamics into images can further impact safety, and conversely, injecting image dynamics into text also leads to safety risks. SDEval is general enough to be applied to various existing safety and even capability benchmarks. Experiments across safety benchmarks, MLLMGuard and VLSBench, and capability benchmarks, MMBench and MMVet, show that SDEval significantly influences safety evaluation, mitigates data contamination, and exposes safety limitations of MLLMs. Code is available at https://github.com/hq-King/SDEval

Peiqi He, Zhenhao Zhang, Yixiang Zhang et al.

Precise spatial modeling in the operating room (OR) is foundational to many clinical tasks, supporting intraoperative awareness, hazard avoidance, and surgical decision-making. While existing approaches leverage large-scale multimodal datasets for latent-space alignment to implicitly learn spatial relationships, they overlook the 3D capabilities of MLLMs. However, this approach raises two issues: (1) Operating rooms typically lack multiple video and audio sensors, making multimodal 3D data difficult to obtain; (2) Training solely on readily available 2D data fails to capture fine-grained details in complex scenes. To address this gap, we introduce Spatial-ORMLLM, the first large vision-language model for 3D spatial reasoning in operating rooms using only RGB modality to infer volumetric and semantic cues, enabling downstream medical tasks with detailed and holistic spatial context. Spatial-ORMLLM incorporates a Spatial-Enhanced Feature Fusion Block, which integrates 2D modality inputs with rich 3D spatial knowledge extracted by the estimation algorithm and then feeds the combined features into the visual tower. By employing a unified end-to-end MLLM framework, it combines powerful spatial features with textual features to deliver robust 3D scene reasoning without any additional expert annotations or sensor inputs. Experiments on multiple benchmark clinical datasets demonstrate that Spatial-ORMLLM achieves state-of-the-art performance and generalizes robustly to previously unseen surgical scenarios and downstream tasks.