Department of Signal Theory and Communications, Telematics and Computing Systems, Rey Juan Carlos University, Fuenlabrada 28943, Spain.
University Hospital of Fuenlabrada, Fuenlabrada 28943, Spain.
Artif Intell Med. 2021 Dec;122:102211. doi: 10.1016/j.artmed.2021.102211. Epub 2021 Nov 9.
Electronic health records (EHRs) are a valuable data source that, in conjunction with deep learning (DL) methods, have provided important outcomes in different domains, contributing to supporting decision-making. Owing to the remarkable advancements achieved by DL-based models, autoencoders (AE) are becoming extensively used in health care. Nevertheless, AE-based models are based on nonlinear transformations, resulting in black-box models leading to a lack of interpretability, which is vital in the clinical setting. To obtain insights from AE latent representations, we propose a methodology by combining probabilistic models based on Gaussian mixture models and hierarchical clustering supported by Kullback-Leibler divergence. To validate the methodology from a clinical viewpoint, we used real-world data extracted from EHRs of the University Hospital of Fuenlabrada (Spain). Records were associated with healthy and chronic hypertensive and diabetic patients. Experimental outcomes showed that our approach can find groups of patients with similar health conditions by identifying patterns associated with diagnosis and drug codes. This work opens up promising opportunities for interpreting representations obtained by the AE-based model, bringing some light to the decision-making process made by clinical experts in daily practice.
电子健康记录 (EHR) 是一种有价值的数据来源,与深度学习 (DL) 方法结合使用,可以在不同领域提供重要结果,有助于支持决策。由于基于深度学习的模型取得了显著进展,自动编码器 (AE) 在医疗保健中得到了广泛应用。然而,基于 AE 的模型基于非线性变换,导致黑盒模型缺乏可解释性,这在临床环境中至关重要。为了从 AE 潜在表示中获得见解,我们提出了一种结合基于高斯混合模型和层次聚类的概率模型的方法,并辅以 Kullback-Leibler 散度支持。为了从临床角度验证该方法,我们使用了从西班牙富恩拉夫拉达大学医院 (University Hospital of Fuenlabrada) 的 EHR 中提取的真实世界数据。记录与健康和慢性高血压及糖尿病患者相关联。实验结果表明,我们的方法可以通过识别与诊断和药物代码相关的模式,找到具有相似健康状况的患者群体。这项工作为解释基于 AE 的模型获得的表示提供了有前途的机会,为临床专家在日常实践中的决策过程带来了一些启示。