论文标题
Covidcare:将知识从现有EMR转移到新兴的流行病,以进行可解释的预后
CovidCare: Transferring Knowledge from Existing EMR to Emerging Epidemic for Interpretable Prognosis
论文作者
论文摘要
由于Covid-19的特征,流行病发展迅速,并且压倒了全球的卫生服务系统。许多患者患有系统性威胁生命的问题,需要在ICU中仔细监测。因此,智能预后迫切需要协助医生进行早期干预,防止不良结果并优化医疗资源分配。但是,在流行病爆发的早期阶段,由于缺乏有效的诊断机制,案例稀有性和隐私问题,可用于分析的数据受到限制。在本文中,我们提出了一种基于深度学习的方法Covidcare,该方法利用现有的电子病历来增强对新兴传染病的住院患者的预后。它学会了通过转移学习嵌入基于大量现有EMR数据的与COVID相关的医疗功能。进一步培训了转移的参数,以模仿基于知识蒸馏的教师模型的表示行为,这将健康状况更全面地嵌入到源数据集中。我们在现实世界中的Covid-19数据集上为患者进行了住宿预测实验。实验结果表明,我们提出的模型始终优于比较基线方法。 Covidcare还表明,1)HS-CTNI,HS-CRP和血小板计数是最致命的生物标志物,其异常值通常表明紧急不良结果。 2)γ-GT,AP和EGFR的正常值表示健康的总体改善。 Covidcare提取的医学发现得到了人类专家和医学文献的经验证实。
Due to the characteristics of COVID-19, the epidemic develops rapidly and overwhelms health service systems worldwide. Many patients suffer from systemic life-threatening problems and need to be carefully monitored in ICUs. Thus the intelligent prognosis is in an urgent need to assist physicians to take an early intervention, prevent the adverse outcome, and optimize the medical resource allocation. However, in the early stage of the epidemic outbreak, the data available for analysis is limited due to the lack of effective diagnostic mechanisms, rarity of the cases, and privacy concerns. In this paper, we propose a deep-learning-based approach, CovidCare, which leverages the existing electronic medical records to enhance the prognosis for inpatients with emerging infectious diseases. It learns to embed the COVID-19-related medical features based on massive existing EMR data via transfer learning. The transferred parameters are further trained to imitate the teacher model's representation behavior based on knowledge distillation, which embeds the health status more comprehensively in the source dataset. We conduct the length of stay prediction experiments for patients on a real-world COVID-19 dataset. The experiment results indicate that our proposed model consistently outperforms the comparative baseline methods. CovidCare also reveals that, 1) hs-cTnI, hs-CRP and Platelet Counts are the most fatal biomarkers, whose abnormal values usually indicate emergency adverse outcome. 2) Normal values of gamma-GT, AP and eGFR indicate the overall improvement of health. The medical findings extracted by CovidCare are empirically confirmed by human experts and medical literatures.