Cited by 49Machine Learning in HealthcareTime Series Analysis and ForecastingArtificial Intelligence in Healthcare

Learning hidden patterns from patient multivariate time series data using convolutional neural networks: A case study of healthcare cost prediction

Open access
Morid, Mohammad Amin, Sheng, Olivia R. Liu, Kawamoto, Kensaku, Abdelrahman, Samir·2020·Journal of Biomedical Informatics

Abstract

Objective To develop an effective and scalable individual-level patient cost prediction method by automatically learning hidden temporal patterns from multivariate time series data in patient insurance claims using a convolutional neural network (CNN) architecture.Methods We used three years of medical and pharmacy claims data from 2013 to 2016 from a healthcare insurer, where data from the first two years were used to build the model to predict costs in the third year. The data consisted of the multivariate time series of cost, visit and medical features that were shaped as images of patients' health status (i.e., matrices with time windows on one dimension and the medical, visit and cost features on the other dimension). Patients' multivariate time series images were given to a CNN method with a proposed architecture. After hyper-parameter tuning, the proposed architecture consisted of three building blocks of convolution and pooling layers with an LReLU activation function and a customized kernel size at each layer for healthcare data. The proposed CNN learned temporal patterns became inputs to a fully connected layer. We benchmarked the proposed method against three other methods: (1) a spike temporal pattern detection method, as the most accurate method for healthcare cost prediction described to date in the literature; (2) a symbolic temporal pattern detection method, as the most common approach for leveraging healthcare temporal data; and (3) the most commonly used CNN architectures for image pattern detection (i.e., AlexNet, VGGNet and ResNet) (via transfer learning). Moreover, we assessed the contribution of each type of data (i.e., cost, visit and medical). Finally, we externally validated the proposed method against a separate cohort of patients. All prediction performances were measured in terms of mean absolute percentage error (MAPE).Results The proposed CNN configuration outperformed the spike temporal pattern detection and symbolic temporal pattern detection methods with a MAPE of 1.67 versus 2.02 and 3.66, respectively (p < 0.01). The proposed CNN outperformed ResNet, AlexNet and VGGNet with MAPEs of 4.59, 4.85 and 5.06, respectively (p < 0.01). Removing medical, visit and cost features resulted in MAPEs of 1.98, 1.91 and 2.04, respectively (p < 0.01).Conclusions Feature learning through the proposed CNN configuration significantly improved individual-level healthcare cost prediction. The proposed CNN was able to outperform temporal pattern detection methods that look for a pre-defined set of pattern shapes, since it is capable of extracting a variable number of patterns with various shapes. Temporal patterns learned from medical, visit and cost data made significant contributions to the prediction performance. Hyper-parameter tuning showed that considering three-month data patterns has the highest prediction accuracy. Our results showed that patients' images extracted from multivariate time series data are different from regular images, and hence require unique designs of CNN architectures. The proposed method for converting multivariate time series data of patients into images and tuning them for convolutional learning could be applied in many other healthcare applications with multivariate time series data.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jbi.2020.103565

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. M.A. Morid, K. Kawamoto, T. Ault, J. Dorius, S. Abdelrahman, Supervised Learning Methods for Predicting Healthcare Costs: Systematic Literature Review and Empirical Evaluation., in: Proceeding Am. Med. Informatics Assoc., 2017: pp. 1312-1321.
  2. G.K. Dziugaite, D.M. Roy, Z. Ghahramani, Deep Learning, MIT Press, 2016.
  3. R. Moskovitch, Y. Shahar, Medical Temporal-Knowledge Discovery via Temporal Abstraction, in: AMIA 2009 Symp. Proc., 2009: pp. 452-456.
  4. I. Batal, D. Fradkin, J. Harrison, F. Moerchen, M. Hauskrecht, Mining recent temporal patterns for event detection in multivariate time series data, in: Proc. 18th ACM SIGKDD Int. Conf. Knowl. Discov. Data Min. -KDD '12, 2012: pp. 280-288.
  5. D.P. Kingma, J. Ba, Adam: A Method for Stochastic Optimization, in: 3rd Int. Conf. Learn. Represent., 2015.

Cited by

Sorted by citations

Authors
Morid, M. A., Sheng, O. R. L., Kawamoto, K., & Abdelrahman, S.
Affiliations
  • Santa Clara University (US)
  • University of Utah (US)
  • Cairo University (EG)
Corresponding author
Abdelrahman, Samir
Venue
Journal of Biomedical Informatics
Publisher
Elsevier BV
Published
2020-11
Volume
111
Pages
103565
ISSN
1532-0464 (ISSN-L)
OpenAlex
W3085023160
Cited by
49
References
49
Citations by year
2026: 5 · 2025: 12 · 2024: 9 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 1
FWCI
2.26
Type
journal article
Language
en
Open access
Locations
  • Journal of Biomedical Informatics (publishedVersion)
  • PubMed (publishedVersion)
  • arXiv (Cornell University) (submittedVersion)
  • arXiv (Cornell University)
Funders
University of Utah
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
  • Physical Sciences › Computer Science › Signal Processing › Time Series Analysis and Forecasting
  • Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
Keywords
healthcare cost prediction, multivariate time series, convolutional neural networks, health insurance claims, temporal pattern detection, medical claims, pharmacy claims data, representation learning, transfer learning, external validation, temporal convolutional network, recurrent neural networks
MeSH terms
Humans, Cohort Studies, Neural Networks, Computer, Health Care Costs

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review