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
