Chang Lü

Chang Lu, Chandan K. Reddy, Ping Wang et al.

In recent years, deep learning has been successfully adopted in a wide range of applications related to electronic health records (EHRs) such as representation learning and clinical event prediction. However, due to privacy constraints, limited access to EHR becomes a bottleneck for deep learning research. To mitigate these concerns, generative adversarial networks (GANs) have been successfully used for generating EHR data. However, there are still challenges in high-quality EHR generation, including generating time-series EHR data and imbalanced uncommon diseases. In this work, we propose a Multi-label Time-series GAN (MTGAN) to generate EHR and simultaneously improve the quality of uncommon disease generation. The generator of MTGAN uses a gated recurrent unit (GRU) with a smooth conditional matrix to generate sequences and uncommon diseases. The critic gives scores using Wasserstein distance to recognize real samples from synthetic samples by considering both data and temporal features. We also propose a training strategy to calculate temporal features for real data and stabilize GAN training. Furthermore, we design multiple statistical metrics and prediction tasks to evaluate the generated data. Experimental results demonstrate the quality of the synthetic data and the effectiveness of MTGAN in generating realistic sequential EHR data, especially for uncommon diseases.

Chang Lu, Chandan K. Reddy, Ping Wang et al.

Automatic coding of International Classification of Diseases (ICD) is a multi-label text categorization task that involves extracting disease or procedure codes from clinical notes. Despite the application of state-of-the-art natural language processing (NLP) techniques, there are still challenges including limited availability of data due to privacy constraints and the high variability of clinical notes caused by different writing habits of medical professionals and various pathological features of patients. In this work, we investigate the semi-structured nature of clinical notes and propose an automatic algorithm to segment them into sections. To address the variability issues in existing ICD coding models with limited data, we introduce a contrastive pre-training approach on sections using a soft multi-label similarity metric based on tree edit distance. Additionally, we design a masked section training strategy to enable ICD coding models to locate sections related to ICD codes. Extensive experimental results demonstrate that our proposed training strategies effectively enhance the performance of existing ICD coding methods.

Chang Lu, Tian Han, Yue Ning

With the wide application of electronic health records (EHR) in healthcare facilities, health event prediction with deep learning has gained more and more attention. A common feature of EHR data used for deep-learning-based predictions is historical diagnoses. Existing work mainly regards a diagnosis as an independent disease and does not consider clinical relations among diseases in a visit. Many machine learning approaches assume disease representations are static in different visits of a patient. However, in real practice, multiple diseases that are frequently diagnosed at the same time reflect hidden patterns that are conducive to prognosis. Moreover, the development of a disease is not static since some diseases can emerge or disappear and show various symptoms in different visits of a patient. To effectively utilize this combinational disease information and explore the dynamics of diseases, we propose a novel context-aware learning framework using transition functions on dynamic disease graphs. Specifically, we construct a global disease co-occurrence graph with multiple node properties for disease combinations. We design dynamic subgraphs for each patient's visit to leverage global and local contexts. We further define three diagnosis roles in each visit based on the variation of node properties to model disease transition processes. Experimental results on two real-world EHR datasets show that the proposed model outperforms state of the art in predicting health events.

Chang Lu, Chandan K. Reddy, Yue Ning

Electronic Health Records (EHR) have been heavily used in modern healthcare systems for recording patients' admission information to hospitals. Many data-driven approaches employ temporal features in EHR for predicting specific diseases, readmission times, or diagnoses of patients. However, most existing predictive models cannot fully utilize EHR data, due to an inherent lack of labels in supervised training for some temporal events. Moreover, it is hard for existing works to simultaneously provide generic and personalized interpretability. To address these challenges, we first propose a hyperbolic embedding method with information flow to pre-train medical code representations in a hierarchical structure. We incorporate these pre-trained representations into a graph neural network to detect disease complications, and design a multi-level attention method to compute the contributions of particular diseases and admissions, thus enhancing personalized interpretability. We present a new hierarchy-enhanced historical prediction proxy task in our self-supervised learning framework to fully utilize EHR data and exploit medical domain knowledge. We conduct a comprehensive set of experiments and case studies on widely used publicly available EHR datasets to verify the effectiveness of our model. The results demonstrate our model's strengths in both predictive tasks and interpretable abilities.

Chang Lu, Chandan K. Reddy, Prithwish Chakraborty et al.

Accurate and explainable health event predictions are becoming crucial for healthcare providers to develop care plans for patients. The availability of electronic health records (EHR) has enabled machine learning advances in providing these predictions. However, many deep learning based methods are not satisfactory in solving several key challenges: 1) effectively utilizing disease domain knowledge; 2) collaboratively learning representations of patients and diseases; and 3) incorporating unstructured text. To address these issues, we propose a collaborative graph learning model to explore patient-disease interactions and medical domain knowledge. Our solution is able to capture structural features of both patients and diseases. The proposed model also utilizes unstructured text data by employing an attention regulation strategy and then integrates attentive text features into a sequential learning process. We conduct extensive experiments on two important healthcare problems to show the competitive prediction performance of the proposed method compared with various state-of-the-art models. We also confirm the effectiveness of learned representations and model interpretability by a set of ablation and case studies.