TransformEHR:基于变压器的编码解码器生成模型,以提高使用电子健康记录预测疾病结果
Zhichao Yang1, Avijit Mitra1, Weisong Liu2,3
1College of Information and Computer Science, University of Massachusetts Amherst, Amherst, MA, USA.
Nature communications
|November 29, 2023
概括
使用电子健康记录 (EHR) 的深度学习模型TransformEHR实现了最先进的临床预测. 它的新预训练方法提高了疾病和结果的预测,特别是在故意自我伤害和胰腺癌方面.
科学领域:
- 人工智能在医学中的应用
- 临床信息学 临床信息学
- 机器学习用于医疗保健
背景情况:
- 基于变压器的深度学习模型擅长使用纵向电子健康记录 (EHR) 预测临床结果.
- 在大型数据集上进行预训练可以提高下游任务中的模型性能,特别是当使用有限数据进行微调时.
研究的目的:
- 推出TransformEHR,一个用于临床预测的生成式编码解码器变压器模型.
- 为TransformEHR提出一个新的预培训目标:根据过去的EHR数据预测未来的患者疾病和结果.
主要方法:
- 开发了TransformEHR,这是一个利用变压器架构的生成编码器解码器模型.
- 实施了一项新的预培训策略,重点是预测所有未来的疾病和历史患者访问的结果.
- 在多个临床预测任务中对TransformEHR进行评估,并将其性能与现有模型进行比较.
主要成果:
- 在各种临床预测任务中,TransformEHR实现了最先进的性能.
- 显著提高了胰腺癌发病 (2%AUC增加,p < 0.001) 和PTSD患者的故意自我伤害 (24%AUC增加,p = 0.007) 的预测准确度.
- 证明了对具有有限数据的任务的概括性和微调性.
结论:
- 通过其新的预训练,TransformEHR在使用EHR的临床预测中提供了卓越的性能.
- 该模型特别有望预测高风险事件,如故意自伤,从而使临床干预系统成为可能.
- TransformEHR的适应性使其成为一个有价值的工具,可以应对缺乏数据的各种临床预测挑战.
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