融合文本与表格数据,用贝叶斯网络提升病历信息提取的准确性与可解释性。
Patient-level Information Extraction by Consistent Integration of Textual and Tabular Evidence with Bayesian Networks
- 构建专家指导的贝叶斯网络,融合结构化表格与非结构化文本信息。
- 引入一致性节点,使预测校准更优,有效处理数据缺失与矛盾。
- 适用于高风险医疗决策支持系统,提升模型透明度与可靠性。
电子健康记录(EHR)是训练临床决策支持系统的重要资源。为在高风险场景中发挥其潜力,需要大规模、结构化的表格数据来构建透明的特征模型。尽管部分EHR已包含结构化信息(如诊断编码、用药记录、检验结果),大量信息仍存在于非结构化文本中(如出院小结和护理记录)。本文提出一种多模态患者级信息提取方法,利用患者EHR中的结构化特征(基于专家指导的贝叶斯网络)以及描述症状的临床笔记(通过神经文本分类器)。采用虚拟证据结合一致性节点,实现模型预测的可解释性概率融合。该一致性节点显著改善了最终预测的校准效果,使贝叶斯网络能更好调整神经分类器输出,以应对信息缺失并解决表格与文本间的矛盾。我们在SimSUM数据集上验证了该方法的有效性,该数据集是通过专家知识将结构化EHR与临床笔记关联的模拟基准。
原文摘要 · Abstract (English)
Electronic health records (EHRs) form an invaluable resource for training clinical decision support systems. To leverage the potential of such systems in high-risk applications, we need large, structured tabular datasets on which we can build transparent feature-based models. While part of the EHR already contains structured information (e.g. diagnosis codes, medications, and lab results), much of the information is contained within unstructured text (e.g. discharge summaries and nursing notes). In this work, we propose a method for multi-modal patient-level information extraction that leverages both the tabular features available in the patient's EHR (using an expert-informed Bayesian network) as well as clinical notes describing the patient's symptoms (using neural text classifiers). We propose the use of virtual evidence augmented with a consistency node to provide an interpretable, probabilistic fusion of the models' predictions. The consistency node improves the calibration of the final predictions compared to virtual evidence alone, allowing the Bayesian network to better adjust the neural classifier's output to handle missing information and resolve contradictions between the tabular and text data. We show the potential of our method on the SimSUM dataset, a simulated benchmark linking tabular EHRs with clinical notes through expert knowledge.
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