IEEE J Biomed Health Inform. 2018 Sep;22(5):1589-1604. doi: 10.1109/JBHI.2017.2767063. Epub 2017 Oct 27.
The past decade has seen an explosion in the amount of digital information stored in electronic health records (EHRs). While primarily designed for archiving patient information and performing administrative healthcare tasks like billing, many researchers have found secondary use of these records for various clinical informatics applications. Over the same period, the machine learning community has seen widespread advances in the field of deep learning. In this review, we survey the current research on applying deep learning to clinical tasks based on EHR data, where we find a variety of deep learning techniques and frameworks being applied to several types of clinical applications including information extraction, representation learning, outcome prediction, phenotyping, and deidentification. We identify several limitations of current research involving topics such as model interpretability, data heterogeneity, and lack of universal benchmarks. We conclude by summarizing the state of the field and identifying avenues of future deep EHR research.
过去十年中,电子健康记录 (EHR) 中存储的数字信息量呈爆炸式增长。虽然 EHR 主要用于归档患者信息和执行计费等行政医疗保健任务,但许多研究人员发现可以将这些记录用于各种临床信息学应用。同期,机器学习领域在深度学习领域取得了广泛的进展。在本次综述中,我们调查了基于 EHR 数据应用深度学习进行临床任务的当前研究,发现各种深度学习技术和框架正在应用于包括信息提取、表示学习、结果预测、表型分析和去识别等几种类型的临床应用。我们确定了当前研究涉及模型可解释性、数据异质性和缺乏通用基准等主题的几个局限性。最后,我们总结了该领域的现状,并确定了未来深入研究 EHR 的方向。