IEEE J Biomed Health Inform. 2021 Mar;25(3):850-861. doi: 10.1109/JBHI.2020.3006719. Epub 2021 Mar 5.
Forecasting patients' disease progressions with rich longitudinal clinical data has drawn much attention in recent years due to its impactful application in healthcare and the medical field. Researchers have tackled this problem by leveraging traditional machine learning, statistical techniques and deep learning based models. However, existing methods suffer from either deterministic internal structures or over-simplified stochastic components, failing to deal with complex uncertain scenarios such as progression uncertainty (i.e., multiple possible trajectories) and data uncertainty (i.e., imprecise observations and misdiagnosis). To overcome these major uncertainty issues, we propose a novel deep generative model, Stochastic Disease Forecasting Model (StoCast), along with an associated neural network architecture StoCastNet, that can be trained efficiently via stochastic optimization techniques. Our StoCast model uses internal stochastic components to deal with departures of observed data from patients' true health states, and more importantly, is able to produce a comprehensive estimate of future disease progression trajectories. Based on two public datasets related to Alzheimer's disease and Parkinson's disease, we demonstrate how our StoCast model achieves robust and superior performance than deterministic baseline approaches, and conveys richer information that can potentially assist doctors to make decisions with greater confidence in a complex uncertain scenario.
近年来,利用丰富的纵向临床数据预测患者的疾病进展引起了广泛关注,因为它在医疗保健和医学领域具有重要的应用价值。研究人员通过利用传统的机器学习、统计技术和基于深度学习的模型来解决这个问题。然而,现有的方法要么存在确定性的内部结构,要么存在过于简化的随机成分,无法处理复杂的不确定情况,如进展不确定性(即多个可能的轨迹)和数据不确定性(即不准确的观察和误诊)。为了克服这些主要的不确定性问题,我们提出了一种新的深度生成模型——随机疾病预测模型(StoCast),以及一个相关的神经网络架构 StoCastNet,它可以通过随机优化技术进行高效训练。我们的 StoCast 模型使用内部随机成分来处理观察数据与患者真实健康状态之间的偏差,更重要的是,它能够对未来疾病进展轨迹进行全面估计。基于两个与阿尔茨海默病和帕金森病相关的公共数据集,我们展示了我们的 StoCast 模型如何实现比确定性基线方法更稳健和优越的性能,并传达了更丰富的信息,这些信息有可能帮助医生在复杂的不确定情况下更有信心地做出决策。