Enhancing healthcare decision support through explainable AI models for risk prediction

IF 6.7 1区 计算机科学 Q1 COMPUTER SCIENCE, ARTIFICIAL INTELLIGENCE Decision Support Systems Pub Date : 2024-04-18 DOI:10.1016/j.dss.2024.114228
Shuai Niu , Qing Yin , Jing Ma , Yunya Song , Yida Xu , Liang Bai , Wei Pan , Xian Yang
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Abstract

Electronic health records (EHRs) are a valuable source of information that can aid in understanding a patient’s health condition and making informed healthcare decisions. However, modelling longitudinal EHRs with heterogeneous information is a challenging task. Although recurrent neural networks (RNNs) are frequently utilized in artificial intelligence (AI) models for capturing longitudinal data, their explanatory capabilities are limited. Predictive clustering stands as the most recent advancement within this domain, offering interpretable indications at the cluster level for predicting disease risk. Nonetheless, the challenge of determining the optimal number of clusters has put a brake on the widespread application of predictive clustering for disease risk prediction. In this paper, we introduce a novel non-parametric predictive clustering-based risk prediction model that integrates the Dirichlet Process Mixture Model (DPMM) with predictive clustering via neural networks. To enhance the model’s interpretability, we integrate attention mechanisms that enable the capture of local-level evidence in addition to the cluster-level evidence provided by predictive clustering. The outcome of this research is the development of a multi-level explainable artificial intelligence (AI) model. We evaluated the proposed model on two real-world datasets and demonstrated its effectiveness in capturing longitudinal EHR information for disease risk prediction. Moreover, the model successfully produced interpretable evidence to bolster its predictions.

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通过可解释的人工智能风险预测模型加强医疗决策支持
电子健康记录(EHR)是一种宝贵的信息来源,有助于了解病人的健康状况并做出明智的医疗决策。然而,为具有异构信息的纵向电子健康记录建模是一项具有挑战性的任务。虽然人工智能(AI)模型中经常使用递归神经网络(RNN)来捕捉纵向数据,但其解释能力有限。预测性聚类是这一领域的最新进展,可在聚类水平上提供可解释的指标,用于预测疾病风险。然而,确定最佳聚类数量的难题阻碍了预测性聚类在疾病风险预测中的广泛应用。在本文中,我们介绍了一种基于非参数预测聚类的新型风险预测模型,该模型通过神经网络将狄利克特过程混杂模型(DPMM)与预测聚类整合在一起。为了增强模型的可解释性,我们整合了注意力机制,除了预测聚类提供的聚类证据外,还能捕捉局部证据。这项研究的成果是开发了一个多级可解释人工智能(AI)模型。我们在两个真实世界的数据集上对所提出的模型进行了评估,并证明了它在捕捉纵向电子病历信息进行疾病风险预测方面的有效性。此外,该模型还成功地产生了可解释的证据来支持其预测。
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来源期刊
Decision Support Systems
Decision Support Systems 工程技术-计算机:人工智能
CiteScore
14.70
自引率
6.70%
发文量
119
审稿时长
13 months
期刊介绍: The common thread of articles published in Decision Support Systems is their relevance to theoretical and technical issues in the support of enhanced decision making. The areas addressed may include foundations, functionality, interfaces, implementation, impacts, and evaluation of decision support systems (DSSs).
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