Ghassemi Mohammad M
Annu Int Conf IEEE Eng Med Biol Soc. 2016 Aug;2016:2602-2605. doi: 10.1109/EMBC.2016.7591263.
Deep learning has achieved remarkable results in the areas of computer vision, speech recognition, natural language processing and most recently, even playing Go. The application of deep-learning to problems in healthcare, however, has gained attention only in recent years, and it's ultimate place at the bedside remains a topic of skeptical discussion. While there is a growing academic interest in the application of Machine Learning (ML) techniques to clinical problems, many in the clinical community see little incentive to upgrade from simpler methods, such as logistic regression, to deep learning. Logistic regression, after all, provides odds ratios, p-values and confidence intervals that allow for ease of interpretation, while deep nets are often seen as `black-boxes' which are difficult to understand and, as of yet, have not demonstrated performance levels far exceeding their simpler counterparts. If deep learning is to ever take a place at the bedside, it will require studies which (1) showcase the performance of deep-learning methods relative to other approaches and (2) interpret the relationships between network structure, model performance, features and outcomes. We have chosen these two requirements as the goal of this study. In our investigation, we utilized a publicly available EMR dataset of over 32,000 intensive care unit patients and trained a Deep Belief Network (DBN) to predict patient mortality at discharge. Utilizing an evolutionary algorithm, we demonstrate automated topology selection for DBNs. We demonstrate that with the correct topology selection, DBNs can achieve better prediction performance compared to several bench-marking methods.
深度学习在计算机视觉、语音识别、自然语言处理领域,以及最近在围棋对弈方面都取得了显著成果。然而,深度学习在医疗保健问题上的应用只是近年来才受到关注,其在床边的最终应用仍然是一个备受质疑的话题。虽然学术界对将机器学习(ML)技术应用于临床问题的兴趣日益浓厚,但临床界的许多人认为,从逻辑回归等更简单的方法升级到深度学习并没有太大的动力。毕竟,逻辑回归提供了比值比、p值和置信区间,便于解释,而深度网络通常被视为难以理解的“黑匣子”,而且到目前为止,其性能水平尚未证明远远超过更简单的方法。如果深度学习要在床边占据一席之地,就需要开展一些研究,这些研究要(1)展示深度学习方法相对于其他方法的性能,(2)解释网络结构、模型性能、特征和结果之间的关系。我们选择这两个要求作为本研究的目标。在我们的调查中,我们使用了一个公开可用的电子病历数据集,该数据集包含超过32000名重症监护病房患者的数据,并训练了一个深度信念网络(DBN)来预测患者出院时的死亡率。利用进化算法,我们展示了DBN的自动拓扑选择。我们证明,通过正确的拓扑选择,DBN与几种基准方法相比,可以实现更好的预测性能。