Zhou Sicheng, Blaes Anne, Shenoy Chetan, Sun Ju, Zhang Rui
Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA.
iScience. 2024 Jun 20;27(7):110329. doi: 10.1016/j.isci.2024.110329. eCollection 2024 Jul 19.
Accurately predicting heart disease risks in patients with breast cancer is crucial for clinical decision support and patient safety. This study developed and evaluated predictive models for six heart diseases using real-world electronic health records (EHRs) data. We incorporated a trainable decay mechanism to handle missing values in the long short-term memory (LSTM) model, creating LSTM-D models to predict heart disease risk based on longitudinal EHRs data. Additionally, we deployed NLP methods to extract breast cancer phenotypes from clinical texts, integrating unstructured and structured data to enhance predictions. Our LSTM-D models outperformed baseline models in predicting congestive heart failure, coronary artery disease, cardiomyopathy, myocardial infarction, transient ischemic attack, and aortic regurgitation, with AUC scores ranging from 0.7189 to 0.9548. Observation windows of 12-24 months were found optimal for model performance. This research advances precise, personalized care strategies, enabling early intervention and improved management of cardiovascular risks in breast cancer survivors.
准确预测乳腺癌患者的心脏病风险对于临床决策支持和患者安全至关重要。本研究利用真实世界电子健康记录(EHR)数据开发并评估了六种心脏病的预测模型。我们在长短期记忆(LSTM)模型中纳入了一种可训练的衰减机制来处理缺失值,创建了LSTM-D模型,以基于纵向EHR数据预测心脏病风险。此外,我们部署了自然语言处理(NLP)方法从临床文本中提取乳腺癌表型,整合非结构化和结构化数据以增强预测。我们的LSTM-D模型在预测充血性心力衰竭、冠状动脉疾病、心肌病、心肌梗死、短暂性脑缺血发作和主动脉瓣反流方面优于基线模型,AUC分数范围为0.7189至0.9548。发现12至24个月的观察窗口对模型性能最为理想。这项研究推进了精确的个性化护理策略,能够在乳腺癌幸存者中实现早期干预并改善心血管风险的管理。