Summary
Electronic health record (EHR) data is irregular, sparse, heterogeneous and opaque. There are several challenges associated with analysing EHR data. The EHR data is collected irregularly and lacks temporal alignment which makes it difficult for traditional machine learning models to analyse the data. There are some approaches that can be used to handle irregular EHR data. One approach is imputation strategies which produce a time series without missing values that can then be input into a predictive model. Developing predictive models that can handle irregular time series with minimal pre-processing is another approach. These models utilize human knowledge of the aspects to be measured and the timing of measurements. An example is the multi-integration attention module which extracts complex information from irregular time-series data. A missing value imputer can also be used to improve representation learning and prediction tasks. Warped time is another technique that can handle irregular EHR data. Warped time with an exponent of 1/3 is intermediate between clock time (exponent of 1) and sequence time (exponent of 0). If clock time is required, for example to link to a mechanistic model or for interpretation of predictions, clock time can be used but sequence time incorporated as an additional input. There are various clinical summarization applications that have been developed to handle irregular EHR data. For example, the NUCRSS summarization approach uses extraction of clinical variables to produce an eight page summary including problem lists, vital signs, diagnoses and treatment suggestions. Evaluation showed significant time savings and increased accuracy for physicians. Multivariate clinical event time-series represent patient records as multiple event time-series, one for each clinical event type like medication, lab tests, physiology and procedures. This can be used to analyse irregular sequential EHR data.
LSTM and GRU models have shown impressive results in modeling sequence data, outperforming statistical techniques. There are two approaches for handling irregular datasets: imputation strategies or developing predictive models that can handle irregular time series.
Published By:
PB Weerakody, KW Wong, G Wang, W Ela - Neurocomputing, 2021 - Elsevier
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The text discusses challenges with analyzing electronic health record (EHR) data and proposes a method utilizing human knowledge and attention modules to extract complex information. The method outperforms other approaches in downstream tasks and is effective in handling the irregularities of EHR data.
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Y Lee, E Jun, J Choi, HI Suk - IEEE Journal of Biomedical and …, 2022 - ieeexplore.ieee.org
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Temporal EHR data analysis faces challenges including irregularity, sparsity, heterogeneity, and opacity. Limited data is common in medical settings due to costs and data sensitivity.
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F Xie, H Yuan, Y Ning, MEH Ong, M Feng… - Journal of biomedical …, 2022 - Elsevier
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The silhouette value measures the similarity between a sequence and its own cluster compared to other clusters. It is calculated using the average pair-wise distance between the sequence and others in the same cluster. Different models use different features such as original sequence, sequence cluster, or random subsequence.
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J Zhao, P Papapetrou, L Asker, H Boström - Journal of biomedical …, 2017 - Elsevier
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A risk prediction model for chronic kidney disease (CKD) progression from stage III to IV was developed using clinical data. Incorporating laboratory test results improved the accuracy of the model.
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A Perotte, R Ranganath, JS Hirsch… - Journal of the …, 2015 - academic.oup.com
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Clock time and sequence time can be seen as different perspectives of warped time. When conducting experiments that require clock time, it is recommended to parameterize by clock time but consider stratifying or incorporating sequence time as well.
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G Hripcsak, DJ Albers, A Perotte - Journal of the American …, 2015 - academic.oup.com
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In EHR-derived sequential data, multivariate clinical event time-series represents patient records projected to multiple event time-series, each representing a specific clinical event type. These events include medication administration, lab test results, physiological results, and procedures.
Published By:
JM Lee, M Hauskrecht - Artificial intelligence in medicine, 2021 - Elsevier
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A clinical summarization application called NUCRSS extracts clinical variables from structured EHR data and produces an eight-page summary of vital signs, diagnoses, treatments, and more. Evaluation studies have shown time savings, increased accuracy, and potential improvements in patient care. Previous research in various fields can inform the development of summarization systems.
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R Pivovarov, N Elhadad - Journal of the American Medical …, 2015 - academic.oup.com
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A framework proposes mining techniques to handle complex clinical data and improve classification. On Hepatitis and Thrombosis data,the framework selects relevant attributes,imputes values and extracts patterns to build an accurate neuro-fuzzy model.
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NY Jane, KH Nehemiah… - Applied clinical …, 2016 - thieme-connect.com
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