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数据分析与知识发现  2020, Vol. 4 Issue (11): 63-73     https://doi.org/10.11925/infotech.2096-3467.2020.0469
  研究论文 本期目录 | 过刊浏览 | 高级检索 |
基于深度学习的重复住院预测模型研究——以心脏病为例*
达婧玮1,颜嘉麒1(),邓三鸿1,2,王忠民3
1南京大学信息管理学院 南京 210023
2江苏省数据工程与知识服务重点实验室 南京 210023
3江苏省人民医院(南京医科大学第一附属医院)南京 210029
Predicting Hospital Readmissions with Deep Learning: Case Study of Heart Diseases
Da Jingwei1,Yan Jiaqi1(),Deng Sanhong1,2,Wang Zhongmin3
1School of Information Management, Nanjing University, Nanjing 210023, China
2Jiangsu Key Laboratory of Data Engineering and Knowledge Service, Nanjing 210023, China
3Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University), Nanjing 210029, China
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摘要 

【目的】 基于电子病历,运用深度学习方法提高重复住院预测准确率,为医院管理提供参考。【方法】 提出一种融合结构化和非结构化数据的模型。该模型基于字符级卷积神经网络对非结构化文本数据进行学习,并结合结构化数据(人口统计学数据、临床数据和行政数据)对重复住院进行预测。【结果】 融合结构化和非结构化数据的深度学习模型表现最好,F1值为0.735,超出单独使用结构化数据的模型12.9%,超出单独使用非结构化数据的模型约2.1%,预测性能有较大提升。【局限】 实验数据集仅包括来自一家医院患者的部分病历数据,对模型预测结果有一定影响。【结论】 本文模型实现了较好的预测效果,可为相关研究者和医院管理者提供参考。

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达婧玮
颜嘉麒
邓三鸿
王忠民
关键词 重复住院深度学习心脏病预测分析    
Abstract

[Objective] This paper uses the deep learning method to predict possible readmissions of patients based on their electronic medical records, aiming to improve hospital management. [Methods] We proposed a model based on character-level convolution neural network to process the unstructured texts. Then, with the help of structured data (demographics, clinical records and administrative data) to predict the hospital readmission cases. [Results] The deep learning model combining structured and unstructured data yielded better prediction results at F1-score of 0.735. Compared with the models only using structured or unstructured data, the F1-score was increased by 12.9% and 2.1%, respectively. [Limitations] The experimental medical records were collected from one hospital, which has some impacts on prediction results. [Conclusions] The proposed model provides references for researchers of hospital readmission prediction and hospital administrators.

Key wordsHospital Readmission    Deep Learning    Heart Disease    Predictive Analysis
收稿日期: 2020-05-27      出版日期: 2020-09-02
ZTFLH:  TP391  
基金资助:*本文系国家自然科学基金青年项目“供应链质量管理中基于区块链的智能系统模型研究”(71701091);教育部人文社会科学青年项目“区块链虚拟组织信息资源的知识表示方法研究”的研究成果之一(17YJC870020)
通讯作者: 颜嘉麒     E-mail: jiaqiyan@nju.edu.cn
引用本文:   
达婧玮,颜嘉麒,邓三鸿,王忠民. 基于深度学习的重复住院预测模型研究——以心脏病为例*[J]. 数据分析与知识发现, 2020, 4(11): 63-73.
Da Jingwei,Yan Jiaqi,Deng Sanhong,Wang Zhongmin. Predicting Hospital Readmissions with Deep Learning: Case Study of Heart Diseases. Data Analysis and Knowledge Discovery, 2020, 4(11): 63-73.
链接本文:  
https://manu44.magtech.com.cn/Jwk_infotech_wk3/CN/10.11925/infotech.2096-3467.2020.0469      或      https://manu44.magtech.com.cn/Jwk_infotech_wk3/CN/Y2020/V4/I11/63
Fig.1  研究框架
特征子集 特征名称 数据类型 数据描述
人口统计学数据 性别 分类变量 男(2 394, 65.4%); 女(1 266, 34.6%)
婚姻状态 分类变量 已婚(3 510, 95.9%); 未婚(150, 4.1%)
临床数据 收缩压 数值型变量 平均值=129.582; 方差=18.512
舒张压 数值型变量 平均值=72.314; 方差=12.130
行政数据 住院天数 数值型变量 平均值=14.879; 方差=10.311
ICD_10编码 分类变量 I25.101(57.6%); I25.105(29.3%);其他(13.1%)
美托洛尔使用 分类变量 是 (1 197, 32.7%); 否 (2 463, 67.3%)
厄贝沙坦使用 分类变量 是(215, 5.9%); 否(3 445, 94.1%)
是否手术 分类变量 是 (201, 5.5%); 否 (3 459, 94.5%)
Table 1  结构化数据描述
Fig.2  非结构化文本数据示例
变量 χ2 Spearman相关系数 p
性别 1.493 - 0.224
是否手术 34.905 - 0.000
ICD-10编码 81.145 - 0.000
婚姻状态 41.540 - 0.000
美托洛尔使用 88.998 - 0.000
厄贝沙坦使用 5.284 - 0.024
住院天数 - 0.391 0.000
收缩压 - -0.095 0.000
舒张压 - -0.163 0.000
Table 2  自变量与因变量的相关性分析
Fig.3  融合模型(SUCM)网络结构示意图
参数名称 参数值
词嵌入维度(Word Embedding) 64
句子维度(Sentences Dimension) 300
卷积核个数(Number of Filter) 32
卷积核长度(Filter Length) 5
学习率(Learning Rate) 0.001
Table 3  SUCM模型实验参数设置
模 型 ACC F1 P R AUC
结构化数据 NB 0.704 0.649 0.705 0.639 0.701
SVM 0.717 0.647 0.746 0.619 0.713
LR 0.711 0.650 0.730 0.633 0.708
MS(DL) 0.728 0.651 0.771 0.604 0.723
非结构化数据 NB 0.718 0.624 0.802 0.578 0.712
SVM 0.743 0.704 0.771 0.701 0.742
LR 0.731 0.687 0.762 0.685 0.729
MU(DL) 0.743 0.720 0.751 0.728 0.743
结构化数据+
非结构化数据
NB 0.719 0.654 0.736 0.636 0.715
SVM 0.745 0.710 0.771 0.713 0.744
LR 0.734 0.687 0.760 0.689 0.732
SUCM(DL) 0.754 0.735 0.752 0.749 0.754
Table 4  各模型预测实验结果
Fig.4  结构化数据融合非结构化数据后模型的性能提升比较
Fig.5  非结构化数据融合结构化数据后模型的性能提升比较
激活函数 ACC F1 P R AUC
ReLU 0.754 0.735 0.752 0.749 0.754
ELU 0.750 0.728 0.767 0.724 0.749
Swish 0.748 0.727 0.752 0.736 0.747
Table 5  不同激活函数对应预测实验结果
全连接层数 ACC F1 P R AUC 运行时间/min
(3, 1) 0.750 0.732 0.760 0.738 0.750 1.3
(3, 2) 0.750 0.734 0.744 0.748 0.750 1.8
(4, 1) 0.754 0.735 0.752 0.749 0.754 1.2
(4, 2) 0.738 0.725 0.732 0.754 0.739 1.9
(5, 1) 0.741 0.725 0.739 0.740 0.741 1.4
(5, 2) 0.749 0.730 0.750 0.743 0.749 1.7
Table 6  不同全连接层数设置对应预测实验结果
模 型 ACC F1 P R AUC 运行时间/min
MU(Char-CNN) 0.743 0.720 0.751 0.728 0.743 1.0
MU(Word2Vec) 0.728 0.715 0.720 0.732 0.728 2.3
SUCM(Char-CNN) 0.754 0.735 0.752 0.749 0.754 1.2
SUCM(Word2Vec) 0.729 0.713 0.733 0.718 0.729 4.3
Table 7  不同文本处理方法效果
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