Temporal Cross-Attention for Dynamic Embedding and Tokenization of Multimodal Electronic Health Records

Fuente: arXiv
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Auteurs principaux: Ma, Yingbo, Kolla, Suraj, Kaliraman, Dhruv, Nolan, Victoria, Hu, Zhenhong, Guan, Ziyuan, Ren, Yuanfang, Armfield, Brooke, Ozrazgat-Baslanti, Tezcan, Loftus, Tyler J., Rashidi, Parisa, Bihorac, Azra, Shickel, Benjamin
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Publié: 2024
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author Ma, Yingbo
Kolla, Suraj
Kaliraman, Dhruv
Nolan, Victoria
Hu, Zhenhong
Guan, Ziyuan
Ren, Yuanfang
Armfield, Brooke
Ozrazgat-Baslanti, Tezcan
Loftus, Tyler J.
Rashidi, Parisa
Bihorac, Azra
Shickel, Benjamin
author_facet Ma, Yingbo
Kolla, Suraj
Kaliraman, Dhruv
Nolan, Victoria
Hu, Zhenhong
Guan, Ziyuan
Ren, Yuanfang
Armfield, Brooke
Ozrazgat-Baslanti, Tezcan
Loftus, Tyler J.
Rashidi, Parisa
Bihorac, Azra
Shickel, Benjamin
contents The breadth, scale, and temporal granularity of modern electronic health records (EHR) systems offers great potential for estimating personalized and contextual patient health trajectories using sequential deep learning. However, learning useful representations of EHR data is challenging due to its high dimensionality, sparsity, multimodality, irregular and variable-specific recording frequency, and timestamp duplication when multiple measurements are recorded simultaneously. Although recent efforts to fuse structured EHR and unstructured clinical notes suggest the potential for more accurate prediction of clinical outcomes, less focus has been placed on EHR embedding approaches that directly address temporal EHR challenges by learning time-aware representations from multimodal patient time series. In this paper, we introduce a dynamic embedding and tokenization framework for precise representation of multimodal clinical time series that combines novel methods for encoding time and sequential position with temporal cross-attention. Our embedding and tokenization framework, when integrated into a multitask transformer classifier with sliding window attention, outperformed baseline approaches on the exemplar task of predicting the occurrence of nine postoperative complications of more than 120,000 major inpatient surgeries using multimodal data from three hospitals and two academic health centers in the United States.
format Preprint
id arxiv_https___arxiv_org_abs_2403_04012
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Temporal Cross-Attention for Dynamic Embedding and Tokenization of Multimodal Electronic Health Records
Ma, Yingbo
Kolla, Suraj
Kaliraman, Dhruv
Nolan, Victoria
Hu, Zhenhong
Guan, Ziyuan
Ren, Yuanfang
Armfield, Brooke
Ozrazgat-Baslanti, Tezcan
Loftus, Tyler J.
Rashidi, Parisa
Bihorac, Azra
Shickel, Benjamin
Machine Learning
The breadth, scale, and temporal granularity of modern electronic health records (EHR) systems offers great potential for estimating personalized and contextual patient health trajectories using sequential deep learning. However, learning useful representations of EHR data is challenging due to its high dimensionality, sparsity, multimodality, irregular and variable-specific recording frequency, and timestamp duplication when multiple measurements are recorded simultaneously. Although recent efforts to fuse structured EHR and unstructured clinical notes suggest the potential for more accurate prediction of clinical outcomes, less focus has been placed on EHR embedding approaches that directly address temporal EHR challenges by learning time-aware representations from multimodal patient time series. In this paper, we introduce a dynamic embedding and tokenization framework for precise representation of multimodal clinical time series that combines novel methods for encoding time and sequential position with temporal cross-attention. Our embedding and tokenization framework, when integrated into a multitask transformer classifier with sliding window attention, outperformed baseline approaches on the exemplar task of predicting the occurrence of nine postoperative complications of more than 120,000 major inpatient surgeries using multimodal data from three hospitals and two academic health centers in the United States.
title Temporal Cross-Attention for Dynamic Embedding and Tokenization of Multimodal Electronic Health Records
topic Machine Learning
url https://arxiv.org/abs/2403.04012