Leveraging Deep Representations of Radiology Reports in Survival Analysis for Predicting Heart Failure Patient MortalityHyun Gi Lee, Evan Sholle, Ashley Beecy et al.
Utilizing clinical texts in survival analysis is difficult because they are largely unstructured. Current automatic extraction models fail to capture textual information comprehensively since their labels are limited in scope. Furthermore, they typically require a large amount of data and high-quality expert annotations for training. In this work, we present a novel method of using BERT-based hidden layer representations of clinical texts as covariates for proportional hazards models to predict patient survival outcomes. We show that hidden layers yield notably more accurate predictions than predefined features, outperforming the previous baseline model by 5.7% on average across C-index and time-dependent AUC. We make our work publicly available at https://github.com/bionlplab/heart_failure_mortality.
2.5CLMay 10, 2023
A Method to Automate the Discharge Summary Hospital Course for Neurology PatientsVince C. Hartman, Sanika S. Bapat, Mark G. Weiner et al.
Generation of automated clinical notes have been posited as a strategy to mitigate physician burnout. In particular, an automated narrative summary of a patient's hospital stay could supplement the hospital course section of the discharge summary that inpatient physicians document in electronic health record (EHR) systems. In the current study, we developed and evaluated an automated method for summarizing the hospital course section using encoder-decoder sequence-to-sequence transformer models. We fine tuned BERT and BART models and optimized for factuality through constraining beam search, which we trained and tested using EHR data from patients admitted to the neurology unit of an academic medical center. The approach demonstrated good ROUGE scores with an R-2 of 13.76. In a blind evaluation, two board-certified physicians rated 62% of the automated summaries as meeting the standard of care, which suggests the method may be useful clinically. To our knowledge, this study is among the first to demonstrate an automated method for generating a discharge summary hospital course that approaches a quality level of what a physician would write.