Global Contrastive Training for Multimodal Electronic Health Records with Language Supervision

Fuente: arXiv
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Main Authors: Ma, Yingbo, Kolla, Suraj, Hu, Zhenhong, Kaliraman, Dhruv, Nolan, Victoria, Guan, Ziyuan, Ren, Yuanfang, Armfield, Brooke, Ozrazgat-Baslanti, Tezcan, Balch, Jeremy A., Loftus, Tyler J., Rashidi, Parisa, Bihorac, Azra, Shickel, Benjamin
Format: Preprint
Published: 2024
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author Ma, Yingbo
Kolla, Suraj
Hu, Zhenhong
Kaliraman, Dhruv
Nolan, Victoria
Guan, Ziyuan
Ren, Yuanfang
Armfield, Brooke
Ozrazgat-Baslanti, Tezcan
Balch, Jeremy A.
Loftus, Tyler J.
Rashidi, Parisa
Bihorac, Azra
Shickel, Benjamin
author_facet Ma, Yingbo
Kolla, Suraj
Hu, Zhenhong
Kaliraman, Dhruv
Nolan, Victoria
Guan, Ziyuan
Ren, Yuanfang
Armfield, Brooke
Ozrazgat-Baslanti, Tezcan
Balch, Jeremy A.
Loftus, Tyler J.
Rashidi, Parisa
Bihorac, Azra
Shickel, Benjamin
contents Modern electronic health records (EHRs) hold immense promise in tracking personalized patient health trajectories through sequential deep learning, owing to their extensive breadth, scale, and temporal granularity. Nonetheless, how to effectively leverage multiple modalities from EHRs poses significant challenges, given its complex characteristics such as high dimensionality, multimodality, sparsity, varied recording frequencies, and temporal irregularities. To this end, this paper introduces a novel multimodal contrastive learning framework, specifically focusing on medical time series and clinical notes. To tackle the challenge of sparsity and irregular time intervals in medical time series, the framework integrates temporal cross-attention transformers with a dynamic embedding and tokenization scheme for learning multimodal feature representations. To harness the interconnected relationships between medical time series and clinical notes, the framework equips a global contrastive loss, aligning a patient's multimodal feature representations with the corresponding discharge summaries. Since discharge summaries uniquely pertain to individual patients and represent a holistic view of the patient's hospital stay, machine learning models are led to learn discriminative multimodal features via global contrasting. Extensive experiments with a real-world EHR dataset demonstrated that our framework outperformed state-of-the-art approaches on the exemplar task of predicting the occurrence of nine postoperative complications for more than 120,000 major inpatient surgeries using multimodal data from UF health system split among three hospitals (UF Health Gainesville, UF Health Jacksonville, and UF Health Jacksonville-North).
format Preprint
id arxiv_https___arxiv_org_abs_2404_06723
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Global Contrastive Training for Multimodal Electronic Health Records with Language Supervision
Ma, Yingbo
Kolla, Suraj
Hu, Zhenhong
Kaliraman, Dhruv
Nolan, Victoria
Guan, Ziyuan
Ren, Yuanfang
Armfield, Brooke
Ozrazgat-Baslanti, Tezcan
Balch, Jeremy A.
Loftus, Tyler J.
Rashidi, Parisa
Bihorac, Azra
Shickel, Benjamin
Machine Learning
Computation and Language
Modern electronic health records (EHRs) hold immense promise in tracking personalized patient health trajectories through sequential deep learning, owing to their extensive breadth, scale, and temporal granularity. Nonetheless, how to effectively leverage multiple modalities from EHRs poses significant challenges, given its complex characteristics such as high dimensionality, multimodality, sparsity, varied recording frequencies, and temporal irregularities. To this end, this paper introduces a novel multimodal contrastive learning framework, specifically focusing on medical time series and clinical notes. To tackle the challenge of sparsity and irregular time intervals in medical time series, the framework integrates temporal cross-attention transformers with a dynamic embedding and tokenization scheme for learning multimodal feature representations. To harness the interconnected relationships between medical time series and clinical notes, the framework equips a global contrastive loss, aligning a patient's multimodal feature representations with the corresponding discharge summaries. Since discharge summaries uniquely pertain to individual patients and represent a holistic view of the patient's hospital stay, machine learning models are led to learn discriminative multimodal features via global contrasting. Extensive experiments with a real-world EHR dataset demonstrated that our framework outperformed state-of-the-art approaches on the exemplar task of predicting the occurrence of nine postoperative complications for more than 120,000 major inpatient surgeries using multimodal data from UF health system split among three hospitals (UF Health Gainesville, UF Health Jacksonville, and UF Health Jacksonville-North).
title Global Contrastive Training for Multimodal Electronic Health Records with Language Supervision
topic Machine Learning
Computation and Language
url https://arxiv.org/abs/2404.06723