arXiv:2506.06192cs.LG2025-06

首个基于时序病历的患者分层基准,助力个性化医疗研究。

ICU-TSB: A Benchmark for Temporal Patient Representation Learning for Unsupervised Stratification into Patient Cohorts

  • 构建首个基于三大数据集的时序患者表征学习基准,支持无监督分组。
  • 模型可发现临床有意义的患者亚群,顶层聚类准确率最高达0.46。
  • 提供可解释标签分配策略,适合临床研究与机器学习交叉方向者参考。

患者分层识别具有临床意义的亚群,是推动个性化医疗、提升诊断与治疗策略的关键。重症监护室(ICU)电子健康记录(EHR)包含丰富的时序临床数据,可用于此目的。本文提出 ICU-TSB(时序分层基准),首个基于三个公开可用的ICU EHR数据集评估时序患者表征学习在无监督分组中表现的综合性基准。其核心贡献是一个新颖的层级评估框架,利用疾病分类体系衡量发现聚类与临床验证疾病分组的一致性。我们在 ICU-TSB 上对比了统计方法和多种循环神经网络(包括 LSTM 与 GRU),评估其生成有效患者表征以聚类患者轨迹的能力。结果表明,时序表征学习能重新发现具有临床意义的患者群体,但任务仍具挑战性:在分类体系顶层,v-measure 最高达 0.46,在底层最高为 0.40。为增强实用性,我们还评估了多种为聚类分配可解释标签的策略。实验与基准代码完全可复现,详见 https://github.com/ds4dh/CBMS2025stratification。

原文摘要 · Abstract (English)

Patient stratification identifying clinically meaningful subgroups is essential for advancing personalized medicine through improved diagnostics and treatment strategies. Electronic health records (EHRs), particularly those from intensive care units (ICUs), contain rich temporal clinical data that can be leveraged for this purpose. In this work, we introduce ICU-TSB (Temporal Stratification Benchmark), the first comprehensive benchmark for evaluating patient stratification based on temporal patient representation learning using three publicly available ICU EHR datasets. A key contribution of our benchmark is a novel hierarchical evaluation framework utilizing disease taxonomies to measure the alignment of discovered clusters with clinically validated disease groupings. In our experiments with ICU-TSB, we compared statistical methods and several recurrent neural networks, including LSTM and GRU, for their ability to generate effective patient representations for subsequent clustering of patient trajectories. Our results demonstrate that temporal representation learning can rediscover clinically meaningful patient cohorts; nevertheless, it remains a challenging task, with v-measuring varying from up to 0.46 at the top level of the taxonomy to up to 0.40 at the lowest level. To further enhance the practical utility of our findings, we also evaluate multiple strategies for assigning interpretable labels to the identified clusters. The experiments and benchmark are fully reproducible and available at https://github.com/ds4dh/CBMS2025stratification.

患者分层时序建模ICU数据无监督学习

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