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| Main Authors: | , |
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| Format: | Preprint |
| Published: |
2023
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| Subjects: | |
| Online Access: | https://arxiv.org/abs/2306.05779 |
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| _version_ | 1866913338454179840 |
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| author | Zisser, Moshe Aran, Dvir |
| author_facet | Zisser, Moshe Aran, Dvir |
| contents | Deep-learning techniques, particularly the transformer model, have shown great potential in enhancing the prediction performance of longitudinal health records. While previous methods have mainly focused on fixed-time risk prediction, time-to-event prediction (also known as survival analysis) is often more appropriate for clinical scenarios. Here, we present a novel deep-learning architecture we named STRAFE, a generalizable survival analysis transformer-based architecture for electronic health records. The performance of STRAFE was evaluated using a real-world claim dataset of over 130,000 individuals with stage 3 chronic kidney disease (CKD) and was found to outperform other time-to-event prediction algorithms in predicting the exact time of deterioration to stage 5. Additionally, STRAFE was found to outperform binary outcome algorithms in predicting fixed-time risk, possibly due to its ability to train on censored data. We show that STRAFE predictions can improve the positive predictive value of high-risk patients by 3-fold, demonstrating possible usage to improve targeting for intervention programs. Finally, we suggest a novel visualization approach to predictions on a per-patient basis. In conclusion, STRAFE is a cutting-edge time-to-event prediction algorithm that has the potential to enhance risk predictions in large claims datasets. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2306_05779 |
| institution | arXiv |
| publishDate | 2023 |
| record_format | arxiv |
| spellingShingle | Transformer-based Time-to-Event Prediction for Chronic Kidney Disease Deterioration Zisser, Moshe Aran, Dvir Machine Learning Computation and Language Deep-learning techniques, particularly the transformer model, have shown great potential in enhancing the prediction performance of longitudinal health records. While previous methods have mainly focused on fixed-time risk prediction, time-to-event prediction (also known as survival analysis) is often more appropriate for clinical scenarios. Here, we present a novel deep-learning architecture we named STRAFE, a generalizable survival analysis transformer-based architecture for electronic health records. The performance of STRAFE was evaluated using a real-world claim dataset of over 130,000 individuals with stage 3 chronic kidney disease (CKD) and was found to outperform other time-to-event prediction algorithms in predicting the exact time of deterioration to stage 5. Additionally, STRAFE was found to outperform binary outcome algorithms in predicting fixed-time risk, possibly due to its ability to train on censored data. We show that STRAFE predictions can improve the positive predictive value of high-risk patients by 3-fold, demonstrating possible usage to improve targeting for intervention programs. Finally, we suggest a novel visualization approach to predictions on a per-patient basis. In conclusion, STRAFE is a cutting-edge time-to-event prediction algorithm that has the potential to enhance risk predictions in large claims datasets. |
| title | Transformer-based Time-to-Event Prediction for Chronic Kidney Disease Deterioration |
| topic | Machine Learning Computation and Language |
| url | https://arxiv.org/abs/2306.05779 |