CATAN: Chart-aware temporal attention network for adverse outcome prediction.

Abstract

There is an increased adoption of electronic health record systems by a variety of hospitals and medical centers. This provides an opportunity to leverage automated computer systems in assisting healthcare workers. One of the least utilized but rich source of patient information is the unstructured clinical text. In this work, we develop CATAN, a chart-aware temporal attention network for learning patient representations from clinical notes. We introduce a novel representation where each note is considered a single unit, like a sentence, and composed of attention-weighted words. The notes in turn are aggregated into a patient representation using a second weighting unit, note attention. Unlike standard attention computations which focus only on the content of the note, we incorporate the chart-time for each note as a constraint for attention calculation. This allows our model to focus on notes closer to the prediction time. Using the MIMIC-III dataset, we empirically show that our patient representation and attention calculation achieves the best performance in comparison with various state-of-the-art baselines for one-year mortality prediction and 30-day hospital readmission. Moreover, the attention weights can be used to offer transparency into our model's predictions.