论文标题
通过HIV患者的联合表型学习迈向患者记录摘要
Towards Patient Record Summarization Through Joint Phenotype Learning in HIV Patients
论文作者
论文摘要
对于当前的电力健康记录,确定患者的关键问题是随着时间的推移而言,这是提供者的常见任务,但既复杂又耗时的活动。为了使面向问题的摘要能够确定患者的全面问题及其显着性清单,我们提出了一种无监督的表型方法,该方法共同学习了在结构化和非结构化数据中的大量表型/问题。为了确定学习表型的适当粒度,该模型是在同一诊所的目标患者人群中训练的。为了使面向问题的摘要的内容组织也可以确定表型相关性。该模型利用了一种相关的混合成员方法,其变异推断应用于异源临床数据。在本文中,我们将实验重点放在评估从特定患者人群中学到的学习表型及其相关性上。我们在大型城市护理机构(n = 7,523)的艾滋病毒诊所的表型患者中进行实验,该患者有大量的纵向文件,以及提供者将从这些患者病史的摘要中受益,无论是关于他们的HIV还是有关其HIV或任何合并症。我们发现,当通过临床专家定性评估时,学到的表型及其相关性在临床上是有效的,并且与现有专家策划的条件分组相比,该模型在推断表型相关性时超过了基线。
Identifying a patient's key problems over time is a common task for providers at the point care, yet a complex and time-consuming activity given current electric health records. To enable a problem-oriented summarizer to identify a patient's comprehensive list of problems and their salience, we propose an unsupervised phenotyping approach that jointly learns a large number of phenotypes/problems across structured and unstructured data. To identify the appropriate granularity of the learned phenotypes, the model is trained on a target patient population of the same clinic. To enable the content organization of a problem-oriented summarizer, the model identifies phenotype relatedness as well. The model leverages a correlated-mixed membership approach with variational inference applied to heterogenous clinical data. In this paper, we focus our experiments on assessing the learned phenotypes and their relatedness as learned from a specific patient population. We ground our experiments in phenotyping patients from an HIV clinic in a large urban care institution (n=7,523), where patients have voluminous, longitudinal documentation, and where providers would benefit from summaries of these patient's medical histories, whether about their HIV or any comorbidities. We find that the learned phenotypes and their relatedness are clinically valid when assessed qualitatively by clinical experts, and that the model surpasses baseline in inferring phenotype-relatedness when comparing to existing expert-curated condition groupings.