Probabilistic Prognostic Estimates of Survival in Metastatic Cancer Patients (PPES-Met) Utilizing Free-Text Clinical Narratives.

Probabilistic Prognostic Estimates of Survival in Metastatic Cancer Patients (PPES-Met) Utilizing Free-Text Clinical Narratives.
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DOI:
10.1038/s41598-018-27946-5
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发表时间:
2018-07-03
期刊:
影响因子:
4.6
通讯作者:
Rubin DL
Rubin DL
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Banerjee I;Gensheimer MF;Wood DJ;Henry S;Aggarwal S;Chang DT;Rubin DL

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我们提出了一种深度学习模型-转移性癌症患者生存概率预后估计(PPES-Met),通过分析电子病历中的自由文本临床记录,同时保持时间访问序列,来估计患者的短期预期寿命(>3个月)。在一个框架中,我们集成了语义数据映射和神经嵌入技术,产生了一种文本处理方法,以无监督的方式从不同类型的临床病历中提取相关信息,并设计了一个递归神经网络来建模患者就诊的时间依赖性。该模型在一个大型数据集(10,293名患者)上进行了训练,并在一个独立的数据集(1818名患者)上进行了验证。我们的方法在ROC曲线下的面积(AUC)为0.89。为了提供解释能力,我们开发了一种交互式图形工具,可以提高医生对模型预测基础的理解。PPEs-Met模型的高精确度和可解释性使我们的模型可以作为个性化转移癌治疗的决策支持工具,并为医生提供有价值的帮助。
We propose a deep learning model - Probabilistic Prognostic Estimates of Survival in Metastatic Cancer Patients (PPES-Met) for estimating short-term life expectancy (>3 months) of the patients by analyzing free-text clinical notes in the electronic medical record, while maintaining the temporal visit sequence. In a single framework, we integrated semantic data mapping and neural embedding technique to produce a text processing method that extracts relevant information from heterogeneous types of clinical notes in an unsupervised manner, and we designed a recurrent neural network to model the temporal dependency of the patient visits. The model was trained on a large dataset (10,293 patients) and validated on a separated dataset (1818 patients). Our method achieved an area under the ROC curve (AUC) of 0.89. To provide explain-ability, we developed an interactive graphical tool that may improve physician understanding of the basis for the model’s predictions. The high accuracy and explain-ability of the PPES-Met model may enable our model to be used as a decision support tool to personalize metastatic cancer treatment and provide valuable assistance to the physicians.
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