用电子病历预测患者胸片随时间变化,提升临床决策支持能力
Towards Predicting Temporal Changes in a Patient's Chest X-ray Images based on Electronic Health Records
- 结合历史胸片与用药、化验等医疗事件,动态建模疾病进展
- 生成的未来胸片在临床一致性、人群特征一致性上表现优异
- 适合医疗影像生成、个性化诊疗规划等临床场景应用
胸部X光(CXR)是医院评估患者状况和监测病情变化的重要工具。近年来,基于扩散的生成模型在生成逼真合成胸片方面展现出潜力,但主要依赖单时间点数据进行条件生成,难以捕捉时间演变。为此,我们提出EHRXDiff框架,通过融合先前胸片与后续医疗事件(如处方、检验指标等),预测未来胸片图像。该框架基于潜变量扩散模型,以历史胸片和医疗事件序列为条件,动态追踪疾病发展。我们在临床一致性、人口统计一致性及视觉真实感三个维度进行全面评估,结果表明生成图像质量高,能有效反映潜在的时间变化。这表明该框架可进一步用于支持临床决策、辅助患者监测与治疗规划。代码已开源:https://github.com/dek924/EHRXDiff。
原文摘要 · Abstract (English)
Chest X-ray (CXR) is an important diagnostic tool widely used in hospitals to assess patient conditions and monitor changes over time. Recently, generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic CXRs. However, these models mainly focus on conditional generation using single-time-point data, i.e., generating CXRs conditioned on their corresponding reports from a specific time. This limits their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. Results show that our framework generates high-quality, realistic future images that effectively capture potential temporal changes. This suggests that our framework could be further developed to support clinical decision-making and provide valuable insights for patient monitoring and treatment planning in the medical field. The code is available at https://github.com/dek924/EHRXDiff.
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