Learning Temporal Relevance in Longitudinal Medical Notes
2019 IEEE INTERNATIONAL CONFERENCE ON BIG DATA (BIG DATA)(2019)
摘要
Clinical notes correspond to sequences of reports about patients written over time by health-care professionals. With the availability of massive Electronic Health Record (EHR) datasets composed of such clinical notes, machine learning models on these rich text data series are being developed for patient outcome prediction from infection diagnosis to mortality. While current models focus on content in these unstructured clinical notes, we postulate that timing of the medical events that are explained in the notes are equally crucial. We thus propose a novel attention mechanism composed of dual-attention blocks based on a rich diversity of time representations. We then pair this mechanism with an LSTM, resulting in our proposed time-aware recurrent network TEND-LSTM. TEND-LSTM learns an integrated set of attention weights, with the first attention based on the content of the clinical notes and the second based on when the notes were taken. Together, they are combined using a deep-attention network layer. The proposed dual attention mechanism not only learns a function of time incorporating different aspects of the temporal nature of note instances but also automatically finds a balance between how much attention to put on content versus time. We evaluate our model on six medical tasks using data sets from the publicly-available MIMIC III database from the Beth Israel Deaconess Medical Center. Our results demonstrate that TEND-LSTM outperforms state-of-the-art methods by a large margin.
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关键词
Time Attention Mechanism, Time-aware Recurrent Neural Networks, Clinical Note Classification
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