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结合外部医学知识以改善产科智能诊断:模型开发与验证

Combining External Medical Knowledge for Improving Obstetric Intelligent Diagnosis: Model Development and Validation.

作者信息

Zhang Kunli, Cai Linkun, Song Yu, Liu Tao, Zhao Yueshu

机构信息

School of Information Engineering, Zhengzhou University, Zhengzhou, China.

The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

JMIR Med Inform. 2021 May 10;9(5):e25304. doi: 10.2196/25304.

Abstract

BACKGROUND

Data-driven medical health information processing has become a new development trend in obstetrics. Electronic medical records (EMRs) are the basis of evidence-based medicine and an important information source for intelligent diagnosis. To obtain diagnostic results, doctors combine clinical experience and medical knowledge in their diagnosis process. External medical knowledge provides strong support for diagnosis. Therefore, it is worth studying how to make full use of EMRs and medical knowledge in intelligent diagnosis.

OBJECTIVE

This study aims to improve the performance of intelligent diagnosis in EMRs by combining medical knowledge.

METHODS

As an EMR usually contains multiple types of diagnostic results, the intelligent diagnosis can be treated as a multilabel classification task. We propose a novel neural network knowledge-aware hierarchical diagnosis model (KHDM) in which Chinese obstetric EMRs and external medical knowledge can be synchronously and effectively used for intelligent diagnostics. In KHDM, EMRs and external knowledge documents are integrated by the attention mechanism contained in the hierarchical deep learning framework. In this way, we enrich the language model with curated knowledge documents, combining the advantages of both to make a knowledge-aware diagnosis.

RESULTS

We evaluate our model on a real-world Chinese obstetric EMR dataset and showed that KHDM achieves an accuracy of 0.8929, which exceeds that of the most advanced classification benchmark methods. We also verified the model's interpretability advantage.

CONCLUSIONS

In this paper, an improved model combining medical knowledge and an attention mechanism is proposed, based on the problem of diversity of diagnostic results in Chinese EMRs. KHDM can effectively integrate domain knowledge to greatly improve the accuracy of diagnosis.

摘要

背景

数据驱动的医疗健康信息处理已成为产科领域的新发展趋势。电子病历(EMR)是循证医学的基础,也是智能诊断的重要信息来源。为了获得诊断结果,医生在诊断过程中会结合临床经验和医学知识。外部医学知识为诊断提供了有力支持。因此,研究如何在智能诊断中充分利用电子病历和医学知识具有重要意义。

目的

本研究旨在通过结合医学知识提高电子病历智能诊断的性能。

方法

由于电子病历通常包含多种类型的诊断结果,智能诊断可视为多标签分类任务。我们提出了一种新颖的神经网络知识感知分层诊断模型(KHDM),该模型能够同步有效地利用中文产科电子病历和外部医学知识进行智能诊断。在KHDM中,电子病历和外部知识文档通过分层深度学习框架中包含的注意力机制进行整合。通过这种方式,我们用精心整理的知识文档丰富语言模型,结合两者的优势进行知识感知诊断。

结果

我们在一个真实世界的中文产科电子病历数据集上对模型进行了评估,结果表明KHDM的准确率达到了0.8929,超过了最先进的分类基准方法。我们还验证了该模型的可解释性优势。

结论

本文针对中文电子病历诊断结果多样性的问题,提出了一种结合医学知识和注意力机制的改进模型。KHDM能够有效整合领域知识,大幅提高诊断准确率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5958/8145091/b345d11bd11f/medinform_v9i5e25304_fig1.jpg

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