DeepCare: A Deep Dynamic Memory Model for Predictive Medicine

Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, recorded in electronic medical records, are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors in space, models patient health state trajectories through explicit memory of historical records. Built on Long Short-Term Memory (LSTM), DeepCare introduces time parameterizations to handle irregular timed events by moderating the forgetting and consolidation of memory cells. DeepCare also incorporates medical interventions that change the course of illness and shape future medical risk. Moving up to the health state level, historical and present health states are then aggregated through multiscale temporal pooling, before passing through a neural network that estimates future outcomes. We demonstrate the efficacy of DeepCare for disease progression modeling, intervention recommendation, and future risk prediction. On two important cohorts with heavy social and economic burden -- diabetes and mental health -- the results show improved modeling and risk prediction accuracy.Comment: Accepted at JBI under the new name: "Predicting healthcare trajectories from medical records: A deep learning approach

Privacy-preserving scoring of tree ensembles : a novel framework for AI in healthcare

Machine Learning (ML) techniques now impact a wide variety of domains. Highly regulated industries such as healthcare and finance have stringent compliance and data governance policies around data sharing. Advances in secure multiparty computation (SMC) for privacy-preserving machine learning (PPML) can help transform these regulated industries by allowing ML computations over encrypted data with personally identifiable information (PII). Yet very little of SMC-based PPML has been put into practice so far. In this paper we present the very first framework for privacy-preserving classification of tree ensembles with application in healthcare. We first describe the underlying cryptographic protocols that enable a healthcare organization to send encrypted data securely to a ML scoring service and obtain encrypted class labels without the scoring service actually seeing that input in the clear. We then describe the deployment challenges we solved to integrate these protocols in a cloud based scalable risk-prediction platform with multiple ML models for healthcare AI. Included are system internals, and evaluations of our deployment for supporting physicians to drive better clinical outcomes in an accurate, scalable, and provably secure manner. To the best of our knowledge, this is the first such applied framework with SMC-based privacy-preserving machine learning for healthcare

A theoretical framework for research on readmission risk prediction

On the one hand, predictive analytics is an important field of research in Information Systems (IS); however, research on predictive analytics in healthcare is still scarce in IS literature. One area where predictive analytics can be of great benefit is with regard to unplanned readmissions. While a number of studies on readmission prediction already exists in related research areas, there are few guidelines to date on how to conduct such analytics projects. To address this gap the paper presents the general process to develop empirical models by Shmueli and Koppius (2011) and extends this to the specific requirements of readmission risk prediction. Based on a systematic literature review, the resulting process defines important aspects of readmission prediction. It also structures relevant questions and tasks that need to be taken care of in this context. This extension of the guidelines by Shmueli and Koppius (2011) provides a best practice as well as a template that can be used in future studies on readmission risk prediction, thus allowing for more comparable results across various research fields

Improving Palliative Care with Deep Learning

Improving the quality of end-of-life care for hospitalized patients is a priority for healthcare organizations. Studies have shown that physicians tend to over-estimate prognoses, which in combination with treatment inertia results in a mismatch between patients wishes and actual care at the end of life. We describe a method to address this problem using Deep Learning and Electronic Health Record (EHR) data, which is currently being piloted, with Institutional Review Board approval, at an academic medical center. The EHR data of admitted patients are automatically evaluated by an algorithm, which brings patients who are likely to benefit from palliative care services to the attention of the Palliative Care team. The algorithm is a Deep Neural Network trained on the EHR data from previous years, to predict all-cause 3-12 month mortality of patients as a proxy for patients that could benefit from palliative care. Our predictions enable the Palliative Care team to take a proactive approach in reaching out to such patients, rather than relying on referrals from treating physicians, or conduct time consuming chart reviews of all patients. We also present a novel interpretation technique which we use to provide explanations of the model's predictions.Comment: IEEE International Conference on Bioinformatics and Biomedicine 201