针对新患者用药推荐冷启动问题,提出自适应元学习框架提升推荐准确性。
User-Adaptive Meta-Learning for Cold-Start Medication Recommendation with Uncertainty Filtering
- 分层元适应机制:自适应与同质患者协同优化新患者表征。
- 在MIMIC-III和AKI数据集上,冷启动患者推荐准确率显著优于现有方法。
- 引入不确定性过滤模块,剔除无关就诊记录,增强适应一致性。
大规模电子健康记录(EHR)数据库在支持临床决策方面日益重要,但现有药物推荐方法常面临患者冷启动问题,即新患者因缺乏足够的处方历史而难以生成可靠推荐。尽管已有研究利用医学知识图谱通过药理或化学关系连接药物概念,但主要缓解的是物品冷启动,难以实现个性化推荐。元学习虽在推荐系统中展现潜力,但在具有独特时序结构的EHR数据中应用仍不充分。为此,本文提出MetaDrug,一种多层级、不确定性感知的元学习框架,用于解决药物推荐中的患者冷启动问题。该框架包含两阶段元适应机制:自适应利用患者自身医疗事件作为支持集以捕捉时序依赖;同质适应则借助相似患者的就诊记录丰富新患者表征。同时,设计不确定性量化模块,对支持集就诊记录排序并过滤无关信息,提升适应一致性。在MIMIC-III和急性肾损伤(AKI)数据集上的实验表明,MetaDrug在冷启动患者上的推荐性能持续优于当前最优方法。
原文摘要 · Abstract (English)
Large-scale Electronic Health Record (EHR) databases have become indispensable in supporting clinical decision-making through data-driven treatment recommendations. However, existing medication recommender methods often struggle with a user (i.e., patient) cold-start problem, where recommendations for new patients are usually unreliable due to the lack of sufficient prescription history for patient profiling. While prior studies have utilized medical knowledge graphs to connect medication concepts through pharmacological or chemical relationships, these methods primarily focus on mitigating the item cold-start issue and fall short in providing personalized recommendations that adapt to individual patient characteristics. Meta-learning has shown promise in handling new users with sparse interactions in recommender systems. However, its application to EHRs remains underexplored due to the unique sequential structure of EHR data. To tackle these challenges, we propose MetaDrug, a multi-level, uncertainty-aware meta-learning framework designed to address the patient cold-start problem in medication recommendation. MetaDrug proposes a novel two-level meta-adaptation mechanism, including self-adaptation, which adapts the model to new patients using their own medical events as support sets to capture temporal dependencies; and peer-adaptation, which adapts the model using similar visits from peer patients to enrich new patient representations. Meanwhile, to further improve meta-adaptation outcomes, we introduce an uncertainty quantification module that ranks the support visits and filters out the unrelated information for adaptation consistency. We evaluate our approach on the MIMIC-III and Acute Kidney Injury (AKI) datasets. Experimental results on both datasets demonstrate that MetaDrug consistently outperforms state-of-the-art medication recommendation methods on cold-start patients.
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