arXiv:2504.04120cs.LG2025-04被引 1

用Transformer学习多模态生理数据,提升术后谵妄早期诊断准确率

Transformer representation learning is necessary for dynamic multi-modal physiological data on small-cohort patients

  • 采用Transformer提取多模态生理信号表征,融合aEEG、生命体征等数据
  • 在类型I患者中敏感性和约登指数显著提升,路径融合的Pathformer效果最佳
  • 适合临床医生和医疗AI研究者,为小样本患者诊断提供新思路

术后谵妄(POD)是影响近50%高风险手术患者的严重神经精神并发症,表现为注意力与认知的急性障碍。由于依赖主观监测,其在重症监护室中仍被严重漏诊。早期精准诊断至关重要且可行。本文提出一种结合Transformer表示学习与传统机器学习的POD预测框架,利用多模态生理数据,包括振幅整合脑电图(aEEG)、生命体征、心电监护数据及血流动力学参数。我们构建了首个包含两类患者的多模态POD数据集,并评估多种Transformer架构在表示学习中的表现。实验证明,使用Transformer表征后,在类型I患者中敏感性与约登指数均持续提升,尤其以路径融合的Pathformer表现最优。该方法可实现术后第1至3天的有效谵妄诊断,充分展现多模态生理数据的潜力,强调在临床诊断中采用多模态Transformer进行表示学习的必要性。

原文摘要 · Abstract (English)

Postoperative delirium (POD), a severe neuropsychiatric complication affecting nearly 50% of high-risk surgical patients, is defined as an acute disorder of attention and cognition, It remains significantly underdiagnosed in the intensive care units (ICUs) due to subjective monitoring methods. Early and accurate diagnosis of POD is critical and achievable. Here, we propose a POD prediction framework comprising a Transformer representation model followed by traditional machine learning algorithms. Our approaches utilizes multi-modal physiological data, including amplitude-integrated electroencephalography (aEEG), vital signs, electrocardiographic monitor data as well as hemodynamic parameters. We curated the first multi-modal POD dataset encompassing two patient types and evaluated the various Transformer architectures for representation learning. Empirical results indicate a consistent improvements of sensitivity and Youden index in patient TYPE I using Transformer representations, particularly our fusion adaptation of Pathformer. By enabling effective delirium diagnosis from postoperative day 1 to 3, our extensive experimental findings emphasize the potential of multi-modal physiological data and highlight the necessity of representation learning via multi-modal Transformer architecture in clinical diagnosis.

术后谵妄多模态Transformer临床诊断

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