arXiv:2504.05928cs.LG2025-04被引 1

用专家知识提升药物不良反应预测,患者中心转换是关键。

Evaluation of the impact of expert knowledge: How decision support scores impact the effectiveness of automatic knowledge-driven feature engineering (aKDFE)

  • 将医学专家风险评分融入EHR数据,进行患者中心特征转换
  • 患者历史信息与不良反应关联性强,AUROC表现优异
  • 适合医疗AI研究者和临床决策系统开发者参考

药物不良事件(ADE)对患者安全和医疗成本构成重大挑战。本研究评估了自动知识驱动特征工程(aKDFE)在电子健康记录(EHR)数据上改进ADE预测的效果,对比了基于事件的知识发现方法(KDD)。研究考察了从Janusmed临床决策支持系统(CDSS)中提取的延长心室复极化QT间期风险评分,以及用药途径信息,对模型预测性能的影响。结果显示,aKDFE第一步(基于事件的特征生成)未显著提升预测效果,但第二步(患者中心转换)显著增强预测能力。高受试者工作特征曲线下面积(AUROC)值表明特征与结局高度相关,符合患者既往医疗史对ADE的预测价值。统计分析未证实加入Janusmed风险评分及给药途径能提升模型表现。尽管如此,患者中心转换仍被证明是一种高效的特征工程策略。局限性包括单项目研究、机器学习流程潜在偏差及依赖AUROC指标。结论:aKDFE,尤其是患者中心转换,能有效提升EHR数据上的ADE预测能力。未来将探索注意力机制模型、事件特征序列及自动引入领域知识的方法。

原文摘要 · Abstract (English)

Adverse Drug Events (ADEs), harmful medication effects, pose significant healthcare challenges, impacting patient safety and costs. This study evaluates automatic Knowledge-Driven Feature Engineering (aKDFE) for improved ADE prediction from Electronic Health Record (EHR) data, comparing it with automated event-based Knowledge Discovery in Databases (KDD). We investigated how incorporating domain-specific ADE risk scores for prolonged heart QT interval, extracted from the Janusmed Riskprofile (Janusmed) Clinical Decision Support System (CDSS), affects prediction performance using EHR data and medication handling events. Results indicate that, while aKDFE step 1 (event-based feature generation) alone did not significantly improve ADE prediction performance, aKDFE step 2 (patient-centric transformation) enhances the prediction performance. High Area Under the Receiver Operating Characteristic curve (AUROC) values suggest strong feature correlations to the outcome, aligning with the predictive power of patients' prior healthcare history for ADEs. Statistical analysis did not confirm that incorporating the Janusmed information (i) risk scores and (ii) medication route of administration into the model's feature set enhanced predictive performance. However, the patient-centric transformation applied by aKDFE proved to be a highly effective feature engineering approach. Limitations include a single-project focus, potential bias from machine learning pipeline methods, and reliance on AUROC. In conclusion, aKDFE, particularly with patient-centric transformation, improves ADE prediction from EHR data. Future work will explore attention-based models, event feature sequences, and automatic methods for incorporating domain knowledge into the aKDFE framework.

药物不良反应特征工程医疗AIEHR数据

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