基于病历相似性构建动态图,提升重症患者风险预测准确率
Similarity-Based Self-Construct Graph Model for Predicting Patient Criticalness Using Graph Neural Networks and EHR Data
- 从多模态病历数据动态构建患者相似图,融合特征与结构相似性
- 在MIMIC-III数据集上达到0.94的AUC-ROC,优于传统模型
- 集成GCN/GAT/GSAGE,注意力机制可解释预测结果,适合临床部署
准确预测重症监护病房(ICU)患者危重程度(如院内死亡风险)对早期干预至关重要。然而,传统模型通常孤立处理每位患者,难以挖掘电子健康记录(EHR)中的关系结构。本文提出相似性自构建图模型(SBSCGM),从多模态EHR数据中实时构建患者相似图,并采用混合图医学图神经网络(HybridGraphMedGNN)进行死亡率与连续危重评分预测。SBSCGM使用结合特征与结构相似性的混合度量方式,连接临床特征相近的患者。HybridGraphMedGNN融合图卷积网络(GCN)、GraphSAGE和图注意力网络(GAT)层,学习鲁棒的患者表征,兼顾局部与全局图模式。在包含6,000例ICU住院记录的MIMIC-III数据集上,该模型实现0.94的AUC-ROC,超越基线分类器与单一类型GNN模型。实验还显示更高的精确率/召回率,并验证注意力机制提供可解释的预测洞察。本框架为危重症风险预测提供了可扩展且可解释的解决方案,具备支持临床实际部署的潜力。
原文摘要 · Abstract (English)
Accurately predicting the criticalness of ICU patients (such as in-ICU mortality risk) is vital for early intervention in critical care. However, conventional models often treat each patient in isolation and struggle to exploit the relational structure in Electronic Health Records (EHR). We propose a Similarity-Based Self-Construct Graph Model (SBSCGM) that dynamically builds a patient similarity graph from multi-modal EHR data, and a HybridGraphMedGNN architecture that operates on this graph to predict patient mortality and a continuous criticalness score. SBSCGM uses a hybrid similarity measure (combining feature-based and structural similarities) to connect patients with analogous clinical profiles in real-time. The HybridGraphMedGNN integrates Graph Convolutional Network (GCN), GraphSAGE, and Graph Attention Network (GAT) layers to learn robust patient representations, leveraging both local and global graph patterns. In experiments on 6,000 ICU stays from the MIMIC-III dataset, our model achieves state-of-the-art performance (AUC-ROC $0.94$) outperforming baseline classifiers and single-type GNN models. We also demonstrate improved precision/recall and show that the attention mechanism provides interpretable insights into model predictions. Our framework offers a scalable and interpretable solution for critical care risk prediction, with potential to support clinicians in real-world ICU deployment.
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