Utilizing dynamic treatment information for MACE prediction of acute coronary syndrome

Main adverse cardiac events (MACE) are essentially composite endpoints for assessing safety and efficacy of treatment processes of acute coronary syndrome (ACS) patients. Timely prediction of MACE is highly valuable for improving the effects of ACS treatments. Most existing tools are specific to predict MACE by mainly using static patient features and neglecting dynamic treatment information during learning.

We address this challenge by developing a deep learning-based approach to utilize a large volume of heterogeneous electronic health record (EHR) for predicting MACE after ACS. Specifically, we obtain the deep representation of dynamic treatment features from EHR data, using the bidirectional recurrent neural network. And then, the extracted latent representation of treatment features can be utilized to predict whether a patient occurs MACE in his or her hospitalization.

We validate the effectiveness of our approach on a clinical dataset containing 2930 ACS patient samples with 232 static feature types and 2194 dynamic feature types. The performance of our best model for predicting MACE after ACS remains robust and reaches 0.713 and 0.764 in terms of AUC and Accuracy, respectively, and has over 11.9% (1.2%) and 1.9% (7.5%) performance gain of AUC (Accuracy) in comparison with both logistic regression and a boosted resampling model presented in our previous work, respectively. The results are statistically significant.

We hypothesize that our proposed model adapted to leverage dynamic treatment information in EHR data appears to boost the performance of MACE prediction for ACS, and can readily meet the demand clinical prediction of other diseases, from a large volume of EHR in an open-ended fashion.