Explainable Prediction of Adverse Outcomes Using Clinical Notes
This addresses the need for explainable AI in clinical decision support, though it is incremental as it builds on existing deep learning methods.
The paper tackled the problem of predicting ICU readmission and mortality from clinical notes by augmenting a convolutional model with an attention mechanism, achieving competitive performance while enabling interpretable predictions through visualizations of important text spans.
Clinical notes contain a large amount of clinically valuable information that is ignored in many clinical decision support systems due to the difficulty that comes with mining that information. Recent work has found success leveraging deep learning models for the prediction of clinical outcomes using clinical notes. However, these models fail to provide clinically relevant and interpretable information that clinicians can utilize for informed clinical care. In this work, we augment a popular convolutional model with an attention mechanism and apply it to unstructured clinical notes for the prediction of ICU readmission and mortality. We find that the addition of the attention mechanism leads to competitive performance while allowing for the straightforward interpretation of predictions. We develop clear visualizations to present important spans of text for both individual predictions and high-risk cohorts. We then conduct a qualitative analysis and demonstrate that our model is consistently attending to clinically meaningful portions of the narrative for all of the outcomes that we explore.