Cited by 269Machine Learning in HealthcareNursing Diagnosis and DocumentationElectronic Health Records Systems

Combining structured and unstructured data for predictive models: a deep learning approach

Open access
Zhang, Dongdong, Yin, Changchang, Zeng, Jucheng, Yuan, Xiaohui, Zhang, Ping·2020·BMC Medical Informatics and Decision Making

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Abstract

BACKGROUND: The broad adoption of electronic health records (EHRs) provides great opportunities to conduct health care research and solve various clinical problems in medicine. With recent advances and success, methods based on machine learning and deep learning have become increasingly popular in medical informatics. However, while many research studies utilize temporal structured data on predictive modeling, they typically neglect potentially valuable information in unstructured clinical notes. Integrating heterogeneous data types across EHRs through deep learning techniques may help improve the performance of prediction models. METHODS: In this research, we proposed 2 general-purpose multi-modal neural network architectures to enhance patient representation learning by combining sequential unstructured notes with structured data. The proposed fusion models leverage document embeddings for the representation of long clinical note documents and either convolutional neural network or long short-term memory networks to model the sequential clinical notes and temporal signals, and one-hot encoding for static information representation. The concatenated representation is the final patient representation which is used to make predictions. RESULTS: We evaluate the performance of proposed models on 3 risk prediction tasks (i.e. in-hospital mortality, 30-day hospital readmission, and long length of stay prediction) using derived data from the publicly available Medical Information Mart for Intensive Care III dataset. Our results show that by combining unstructured clinical notes with structured data, the proposed models outperform other models that utilize either unstructured notes or structured data only. CONCLUSIONS: The proposed fusion models learn better patient representation by combining structured and unstructured data. Integrating heterogeneous data types across EHRs helps improve the performance of prediction models and reduce errors.

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Crossref · 10.1186/s12911-020-01297-6

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  • The dataset is split into 0.70-0.15-0.15 train-validation-test sets with no overlap between sets by patient ID and admission ID.

    “For evaluation, we use a 0.70-0.15-0.15 train-validation-test split following the previous work [13]. However, we equalized the size of the validation set and the test set to get a better estimation of test performance on the validation set. We split the dataset according to patient ID and admission ID so that there's no overlap between training, validation, and test sets.”

    From Multimodal risk prediction with physiological signals, medical images and clinical notes (2024) · cites this paper as [13]

    The cited paper’s Results and discussion > Experiment setup says it used 70% of the data for training, 10% for validation, and 20% for testing—not the cited 70%-15%-15% split. The citing sentence presents equal validation and test sizes and the patient-ID/admission-ID separation as its own procedures; the cited paper’s passage does not establish those procedures. (LLM, conf=0.91)

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  • Machine learning and deep learning techniques hold great promise in deriving meaningful insights from EHR, which can aid in accurately predicting clinical outcomes, such as mortality and readmission.

    “They hold great promise in deriving meaningful insights from EHR, which can aid in accurately predicting clinical outcomes, such as mortality [13] and readmission [13], [14].”

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1 of the 35 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [1]Henry J Pylypchuk Y Searcy T Patel V Adoption of electronic health record systems among US non-federal acute care hospitals: 2008–2015 ONC Data Brief 2016 35 1 9 40127322
  2. [13]Ghassemi M, Naumann T, Joshi R, Rumshisky A. Topic models for mortality modeling in intensive care units. In: ICML machine learning for clinical data analysis workshop; 2012. p. 1–4.

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Authors
Zhang, D., Yin, C., Zeng, J., Yuan, X., & Zhang, P.
Affiliations
  • Wuhan University of Technology (CN)
  • The Ohio State University (US)
Corresponding author
Zhang, Ping
Venue
BMC Medical Informatics and Decision Making
Published
2020-10-29
Volume
20
Issue
1
Pages
280-280
ISSN
1472-6947 (ISSN-L)
OpenAlex
W3095791468
Cited by
269
References
35
Citations by year
2026: 41 · 2025: 72 · 2024: 52 · 2023: 52 · 2022: 34 · 2021: 18
FWCI
10.13
Type
journal article
Language
en
Open access
Locations
  • BMC Medical Informatics and Decision Making (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
  • Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Keywords
electronic health records, unstructured clinical notes, multimodal neural networks, patient representation learning, in-hospital mortality prediction, hospital readmission prediction, length of stay prediction, MIMIC-III, clinical risk prediction
MeSH terms
Machine Learning, Deep Learning, Humans, Patient Readmission, Neural Networks, Computer, Electronic Health Records

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