Lucas J. Liu

Sihang Zeng, Lucas Jing Liu, Jun Wen et al.

Trustworthy survival prediction is essential for clinical decision making. Longitudinal electronic health records (EHRs) provide a uniquely powerful opportunity for the prediction. However, it is challenging to accurately model the continuous clinical progression of patients underlying the irregularly sampled clinical features and to transparently link the progression to survival outcomes. To address these challenges, we develop TrajSurv, a model that learns continuous latent trajectories from longitudinal EHR data for trustworthy survival prediction. TrajSurv employs a neural controlled differential equation (NCDE) to extract continuous-time latent states from the irregularly sampled data, forming continuous latent trajectories. To ensure the latent trajectories reflect the clinical progression, TrajSurv aligns the latent state space with patient state space through a time-aware contrastive learning approach. To transparently link clinical progression to the survival outcome, TrajSurv uses latent trajectories in a two-step divide-and-conquer interpretation process. First, it explains how the changes in clinical features translate into the latent trajectory's evolution using a learned vector field. Second, it clusters these latent trajectories to identify key clinical progression patterns associated with different survival outcomes. Evaluations on two real-world medical datasets, MIMIC-III and eICU, show TrajSurv's competitive accuracy and superior transparency over existing deep learning methods.

Lucas J. Liu, Hongwei Zhang, Jianzhong Di et al.

Many real-world Electronic Health Record (EHR) data contains a large proportion of missing values. Leaving substantial portion of missing information unaddressed usually causes significant bias, which leads to invalid conclusion to be drawn. On the other hand, training a machine learning model with a much smaller nearly-complete subset can drastically impact the reliability and accuracy of model inference. Data imputation algorithms that attempt to replace missing data with meaningful values inevitably increase the variability of effect estimates with increased missingness, making it unreliable for hypothesis validation. We propose a novel Ensemble-Learning for Missing Value (ELMV) framework, which introduces an effective approach to construct multiple subsets of the original EHR data with a much lower missing rate, as well as mobilizing a dedicated support set for the ensemble learning in the purpose of reducing the bias caused by substantial missing values. ELMV has been evaluated on a real-world healthcare data for critical feature identification as well as a batch of simulation data with different missing rates for outcome prediction. On both experiments, ELMV clearly outperforms conventional missing value imputation methods and ensemble learning models.