用注意力机制提升膀胱癌复发预测准确率并给出医生可读解释
Attention-enabled Explainable AI for Bladder Cancer Recurrence Prediction
- 引入向量嵌入与注意力机制,捕捉患者特征间复杂关系
- 在表格数据上达70%准确率,优于传统统计方法
- 揭示手术时长、住院天数等新关键因素,适合临床决策支持
非肌层浸润性膀胱癌(NMIBC)是肿瘤学中的重大挑战,复发率高达70%-80%。每次复发都会引发一系列侵入性操作、终身随访及医疗成本上升,影响全球46万患者。现有临床预测工具存在根本缺陷,常高估复发风险且无法提供个性化管理建议。本文提出一种可解释的深度学习框架,结合向量嵌入与注意力机制,以提升NMIBC复发预测性能。通过为吸烟状态、膀胱内治疗等分类变量引入向量嵌入,模型能够捕捉患者特征与复发风险间的复杂关联,增强特征交互,提升预测表现。该方法不仅实现70%的准确率,超越传统统计方法,还通过特征注意力生成患者级解释,帮助临床医生理解个体化风险来源。不同于以往研究,本模型识别出手术持续时间、住院时长等新重要影响因素,此前未被纳入现有预测模型。
原文摘要 · Abstract (English)
Non-muscle-invasive bladder cancer (NMIBC) is a relentless challenge in oncology, with recurrence rates soaring as high as 70-80%. Each recurrence triggers a cascade of invasive procedures, lifelong surveillance, and escalating healthcare costs - affecting 460,000 individuals worldwide. However, existing clinical prediction tools remain fundamentally flawed, often overestimating recurrence risk and failing to provide personalized insights for patient management. In this work, we propose an interpretable deep learning framework that integrates vector embeddings and attention mechanisms to improve NMIBC recurrence prediction performance. We incorporate vector embeddings for categorical variables such as smoking status and intravesical treatments, allowing the model to capture complex relationships between patient attributes and recurrence risk. These embeddings provide a richer representation of the data, enabling improved feature interactions and enhancing prediction performance. Our approach not only enhances performance but also provides clinicians with patient-specific insights by highlighting the most influential features contributing to recurrence risk for each patient. Our model achieves accuracy of 70% with tabular data, outperforming conventional statistical methods while providing clinician-friendly patient-level explanations through feature attention. Unlike previous studies, our approach identifies new important factors influencing recurrence, such as surgical duration and hospital stay, which had not been considered in existing NMIBC prediction models.
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