用患者-特征-值三元组建图,提升脓毒症早期预测准确率。
Sepsis Prediction Using Graph Convolutional Networks over Patient-Feature-Value Triplets
- 将病历数据转为三元组构建双部图,通过GCN学习患者表示。
- 在648例多中心数据上,敏感性与特异性平衡优于多种传统模型。
- 适合临床部署的端到端脓毒症风险预警系统,尤其关注数据稀疏场景。
在重症监护环境中,脓毒症仍是导致患者病情恶化和死亡的主要原因;然而,其及时检测受到电子健康记录(EHR)数据复杂、稀疏且异构性的阻碍。本文提出Triplet-GCN,一种单分支图卷积模型,将每次就诊表示为患者-特征-值三元组,构建双部EHR图,并通过图卷积网络(GCN)结合轻量级多层感知机(MLP)学习患者嵌入。该流程采用类型特定预处理:数值变量使用中位数插补与标准化,二元特征使用效应编码,稀有类别属性使用众数插补与低维嵌入。患者节点初始化为汇总统计量,边保留测量值以体现“谁测了什么及数值”。在来自三家三甲医院的回顾性多中心中国队列(N=648,70/30训练测试分割)中,Triplet-GCN在区分度和平衡误差指标上持续优于强基准模型(KNN、SVM、XGBoost、随机森林),实现更优的敏感性-特异性权衡,显著提升早期预警的整体效用。结果表明,将EHR编码为三元组并在患者-特征图上传播信息,可生成比特征独立模型更具信息量的患者表征,为可部署的脓毒症风险分层提供简洁的端到端范式。
原文摘要 · Abstract (English)
In the intensive care setting, sepsis continues to be a major contributor to patient illness and death; however, its timely detection is hindered by the complex, sparse, and heterogeneous nature of electronic health record (EHR) data. We propose Triplet-GCN, a single-branch graph convolutional model that represents each encounter as patient-feature-value triplets, constructs a bipartite EHR graph, and learns patient embeddings via a Graph Convolutional Network (GCN) followed by a lightweight multilayer perceptron (MLP). The pipeline applies type-specific preprocessing -- median imputation and standardization for numeric variables, effect coding for binary features, and mode imputation with low-dimensional embeddings for rare categorical attributes -- and initializes patient nodes with summary statistics, while retaining measurement values on edges to preserve "who measured what and by how much". In a retrospective, multi-center Chinese cohort (N = 648; 70/30 train-test split) drawn from three tertiary hospitals, Triplet-GCN consistently outperforms strong tabular baselines (KNN, SVM, XGBoost, Random Forest) across discrimination and balanced error metrics, yielding a more favorable sensitivity-specificity trade-off and improved overall utility for early warning. These findings indicate that encoding EHR as triplets and propagating information over a patient-feature graph produce more informative patient representations than feature-independent models, offering a simple, end-to-end blueprint for deployable sepsis risk stratification.
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。