Chaohe Zhang

Chaohe Zhang, Xu Chu, Liantao Ma et al.

Multimodal electronic health record (EHR) data are widely used in clinical applications. Conventional methods usually assume that each sample (patient) is associated with the unified observed modalities, and all modalities are available for each sample. However, missing modality caused by various clinical and social reasons is a common issue in real-world clinical scenarios. Existing methods mostly rely on solving a generative model that learns a mapping from the latent space to the original input space, which is an unstable ill-posed inverse problem. To relieve the underdetermined system, we propose a model solving a direct problem, dubbed learning with Missing Modalities in Multimodal healthcare data (M3Care). M3Care is an end-to-end model compensating the missing information of the patients with missing modalities to perform clinical analysis. Instead of generating raw missing data, M3Care imputes the task-related information of the missing modalities in the latent space by the auxiliary information from each patient's similar neighbors, measured by a task-guided modality-adaptive similarity metric, and thence conducts the clinical tasks. The task-guided modality-adaptive similarity metric utilizes the uncensored modalities of the patient and the other patients who also have the same uncensored modalities to find similar patients. Experiments on real-world datasets show that M3Care outperforms the state-of-the-art baselines. Moreover, the findings discovered by M3Care are consistent with experts and medical knowledge, demonstrating the capability and the potential of providing useful insights and explanations.

Liantao Ma, Chaohe Zhang, Junyi Gao et al.

Objective: Peritoneal Dialysis (PD) is one of the most widely used life-supporting therapies for patients with End-Stage Renal Disease (ESRD). Predicting mortality risk and identifying modifiable risk factors based on the Electronic Medical Records (EMR) collected along with the follow-up visits are of great importance for personalized medicine and early intervention. Here, our objective is to develop a deep learning model for a real-time, individualized, and interpretable mortality prediction model - AICare. Method and Materials: Our proposed model consists of a multi-channel feature extraction module and an adaptive feature importance recalibration module. AICare explicitly identifies the key features that strongly indicate the outcome prediction for each patient to build the health status embedding individually. This study has collected 13,091 clinical follow-up visits and demographic data of 656 PD patients. To verify the application universality, this study has also collected 4,789 visits of 1,363 hemodialysis dialysis (HD) as an additional experiment dataset to test the prediction performance, which will be discussed in the Appendix. Results: 1) Experiment results show that AICare achieves 81.6%/74.3% AUROC and 47.2%/32.5% AUPRC for the 1-year mortality prediction task on PD/HD dataset respectively, which outperforms the state-of-the-art comparative deep learning models. 2) This study first provides a comprehensive elucidation of the relationship between the causes of mortality in patients with PD and clinical features based on an end-to-end deep learning model. 3) This study first reveals the pattern of variation in the importance of each feature in the mortality prediction based on built-in interpretability. 4) We develop a practical AI-Doctor interaction system to visualize the trajectory of patients' health status and risk indicators.

Zhihao Yu, Chaohe Zhang, Yasha Wang et al.

Predicting health risks from electronic health records (EHR) is a topic of recent interest. Deep learning models have achieved success by modeling temporal and feature interaction. However, these methods learn insufficient representations and lead to poor performance when it comes to patients with few visits or sparse records. Inspired by the fact that doctors may compare the patient with typical patients and make decisions from similar cases, we propose a Progressive Prototypical Network (PPN) to select typical patients as prototypes and utilize their information to enhance the representation of the given patient. In particular, a progressive prototype memory and two prototype separation losses are proposed to update prototypes. Besides, a novel integration is introduced for better fusing information from patients and prototypes. Experiments on three real-world datasets demonstrate that our model brings improvement on all metrics. To make our results better understood by physicians, we developed an application at http://ppn.ai-care.top. Our code is released at https://github.com/yzhHoward/PPN.

Liantao Ma, Chaohe Zhang, Yasha Wang et al.

Predicting the patient's clinical outcome from the historical electronic medical records (EMR) is a fundamental research problem in medical informatics. Most deep learning-based solutions for EMR analysis concentrate on learning the clinical visit embedding and exploring the relations between visits. Although those works have shown superior performances in healthcare prediction, they fail to explore the personal characteristics during the clinical visits thoroughly. Moreover, existing works usually assume that the more recent record weights more in the prediction, but this assumption is not suitable for all conditions. In this paper, we propose ConCare to handle the irregular EMR data and extract feature interrelationship to perform individualized healthcare prediction. Our solution can embed the feature sequences separately by modeling the time-aware distribution. ConCare further improves the multi-head self-attention via the cross-head decorrelation, so that the inter-dependencies among dynamic features and static baseline information can be effectively captured to form the personal health context. Experimental results on two real-world EMR datasets demonstrate the effectiveness of ConCare. The medical findings extracted by ConCare are also empirically confirmed by human experts and medical literature.