用可解释的动态图模型,提前发现重症患者心率异常
Early Detection of Patient Deterioration from Real-Time Wearable Monitoring System
- 构建心率片段动态关系图,捕捉病情演化模式
- 在真实ICU数据上实现高可靠早期预警,提前识别恶化趋势
- 适合临床辅助决策,尤其关注重症监护中的智能预警
早期发现患者病情恶化对降低死亡率至关重要。心率数据在评估患者健康状况方面展现出潜力,而可穿戴设备为实时监测提供了低成本解决方案。然而,从多样化的心率数据中提取有效信息,并处理可穿戴设备数据中的缺失值仍是关键挑战。为此,我们提出TARL,一种创新方法,通过建模心率时间序列中代表性子序列(即形状片段)的结构关系,构建形状片段-转移知识图谱,以刻画心率序列中的动态变化,反映疾病进展及未来潜在变化。我们进一步引入一种考虑转移关系的知识嵌入方法,强化片段间关联,并量化缺失值的影响,从而形成全面的心率表征。这些表征既包含可解释的结构信息,又能预测未来心率趋势,助力早期疾病检测。我们与医生和护士合作,收集了来自可穿戴设备的重症监护室(ICU)患者心率数据及诊断指标用于评估病情严重程度。在真实世界ICU数据上的实验表明,TARL在高可靠性基础上实现了早期检测。案例研究进一步展示了TARL的可解释检测过程,凸显其作为人工智能辅助工具在帮助临床人员识别患者早期恶化迹象方面的潜力。
原文摘要 · Abstract (English)
Early detection of patient deterioration is crucial for reducing mortality rates. Heart rate data has shown promise in assessing patient health, and wearable devices offer a cost-effective solution for real-time monitoring. However, extracting meaningful insights from diverse heart rate data and handling missing values in wearable device data remain key challenges. To address these challenges, we propose TARL, an innovative approach that models the structural relationships of representative subsequences, known as shapelets, in heart rate time series. TARL creates a shapelet-transition knowledge graph to model shapelet dynamics in heart rate time series, indicating illness progression and potential future changes. We further introduce a transition-aware knowledge embedding to reinforce relationships among shapelets and quantify the impact of missing values, enabling the formulation of comprehensive heart rate representations. These representations capture explanatory structures and predict future heart rate trends, aiding early illness detection. We collaborate with physicians and nurses to gather ICU patient heart rate data from wearables and diagnostic metrics assessing illness severity for evaluating deterioration. Experiments on real-world ICU data demonstrate that TARL achieves both high reliability and early detection. A case study further showcases TARL's explainable detection process, highlighting its potential as an AI-driven tool to assist clinicians in recognizing early signs of patient deterioration.
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