用于重症监护病房住院时间预测的时间点卷积网络

Emma Rocheteau, P. Lio’, Stephanie L. Hyland
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引用次数: 33

摘要

不断增加的病人需求和预算限制的压力使医院病床管理成为临床工作人员的日常挑战。最关键的是有效地将资源繁重的重症监护病房(ICU)床位分配给需要生命支持的患者。解决这一问题的核心是了解当前ICU患者可能在病房待多久。在这项工作中,我们提出了一种新的基于时间卷积和点向(1x1)卷积相结合的深度学习模型,以解决eICU和MIMIC-IV重症监护数据集的住院时间预测任务。该模型——我们称之为时间点卷积(TPC)——是专门为减轻电子健康记录的常见挑战而设计的,比如偏度、不规则采样和数据缺失。在这样做的过程中,我们已经取得了18-68%的显著性能优势(指标和数据集依赖),超过了常用的长短期记忆(LSTM)网络,以及被称为Transformer的多头自关注网络。通过增加死亡率预测作为副任务,我们可以进一步提高性能,导致预测剩余住院时间的平均绝对偏差为1.55天(eICU)和2.28天(MIMIC-IV)。
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Temporal pointwise convolutional networks for length of stay prediction in the intensive care unit
The pressure of ever-increasing patient demand and budget restrictions make hospital bed management a daily challenge for clinical staff. Most critical is the efficient allocation of resource-heavy Intensive Care Unit (ICU) beds to the patients who need life support. Central to solving this problem is knowing for how long the current set of ICU patients are likely to stay in the unit. In this work, we propose a new deep learning model based on the combination of temporal convolution and pointwise (1x1) convolution, to solve the length of stay prediction task on the eICU and MIMIC-IV critical care datasets. The model - which we refer to as Temporal Pointwise Convolution (TPC) - is specifically designed to mitigate common challenges with Electronic Health Records, such as skewness, irregular sampling and missing data. In doing so, we have achieved significant performance benefits of 18-68% (metric and dataset dependent) over the commonly used Long-Short Term Memory (LSTM) network, and the multi-head self-attention network known as the Transformer. By adding mortality prediction as a side-task, we can improve performance further still, resulting in a mean absolute deviation of 1.55 days (eICU) and 2.28 days (MIMIC-IV) on predicting remaining length of stay.
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