用多模态电子病历预测患者住院全程路径,支持主动诊疗决策。
EHR2Path: Comprehensive Pathway-Level Modeling of Longitudinal Patient Trajectories from Multimodal Electronic Health Records
- 将多种临床数据统一建模为时序表示,扩展信息覆盖范围。
- 在MIMIC-IV上实现完整住院轨迹预测,优于现有基线模型。
- 适合临床决策支持、智能病程管理等医疗人工智能场景。
预测患者病情演变(包括恶化、恢复、治疗需求和护理转诊)可支持更主动的个性化医疗,但需对异构且长期的电子健康记录(EHR)数据进行建模。现有方法通常聚焦单一预测任务、特征空间狭窄或上下文窗口短,难以建模完整的患者路径。为此,我们提出EHR2Path,一个从常规EHR中预测与模拟完整住院路径的多模态框架。EHR2Path将多样化临床输入转化为统一时序表示,可建模包括影像报告、医生笔记、生命体征、用药与检验模式及密集床边记录在内的广泛信息。为支持长期病史与宽广特征空间,引入掩码摘要瓶颈(Masked Summarization Bottleneck),将长期历史压缩为紧凑的任务优化摘要标记,同时保留近期上下文,提升性能与令牌效率。在MIMIC-IV的回顾性实验中,EHR2Path实现了下一步路径预测与完整住院轨迹的迭代模拟,在直接可比任务上超越强基线。结果证明了从常规EHR中进行路径级建模的可行性,并表明其在支持前瞻性临床决策方面的潜力。代码已开源:https://github.com/ChantalMP/EHR2Path。
原文摘要 · Abstract (English)
Forecasting how a patient's condition is likely to evolve, including possible deterioration, recovery, treatment needs, and care transitions, could support more proactive and personalized care, but requires modeling heterogeneous and longitudinal electronic health record (EHR) data. Yet, existing approaches typically focus on isolated prediction tasks, narrow feature spaces, or short context windows, limiting their ability to model full patient pathways. To address this gap, we introduce EHR2Path, a multimodal framework for forecasting and simulating full in-hospital patient pathways from routine EHRs. EHR2Path converts diverse clinical inputs into a unified temporal representation, enabling modeling of a substantially broader set of patient information, including radiology reports, physician notes, vital signs, medication and laboratory patterns, and dense bedside charting. To support long clinical histories and broad feature spaces, we introduce a Masked Summarization Bottleneck that compresses long-term history into compact, task-optimized summary tokens while preserving recent context, improving both performance and token efficiency. In retrospective experiments on MIMIC-IV, EHR2Path enables next-step pathway forecasting and iterative simulation of complete in-hospital trajectories, while outperforming strong baselines on directly comparable tasks. These results demonstrate the feasibility of pathway-level modeling from routine EHRs, and indicate potential for supporting anticipatory clinical decision-making. Our code is available at https://github.com/ChantalMP/EHR2Path.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。