arXiv:2602.03562cs.LG2026-02

用伪文本建模病程,让聚类结果更符合临床实际。

NPCNet: Navigator-Driven Pseudo Text for Deep Clustering of Early Sepsis Phenotyping

  • 将连续临床数据转为伪文本,结合静态变量生成嵌入向量。
  • 通过导航器引入临床知识,使聚类结果更贴近真实表型。
  • 迭代优化聚类中心与患者表示,适合临床分型研究者使用。

电子健康记录(EHR)提供高维时间序列数据,对患者建模至关重要;然而传统算法常依赖数据聚合或插补,扭曲了疾病的时间演变轨迹。这一计算局限在脓毒症中尤为严重,该病异质性强,基于聚类的分型对识别可治疗的临床表型至关重要。现有聚类方法通常缺乏领域约束,导致表型临床意义不明确。本文提出NPCNet,包含文本嵌入生成器、聚类算子和目标导航器。首先将EHR离散化为伪文本,结合静态变量构建嵌入;目标导航器通过辅助任务注入临床知识,约束聚类结果以更好匹配临床表型;最后聚类算子采用迭代精炼机制,在领域约束下联合优化表型中心与患者表示。在公开数据集上的大量实验表明,NPCNet在内部聚类基准和临床有效性指标上均表现优异,为脓毒症精准治疗提供了可行路径。

原文摘要 · Abstract (English)

Electronic Health Records (EHRs) provide high-dimensional temporal data essential for patient modeling; however, conventional algorithmic approaches often rely on data aggregation or imputation, which distorts temporal disease trajectories. Such computational limitations are particularly critical in sepsis, a heterogeneous syndrome where clustering-based stratification plays a key role in identifying clinically distinct phenotypes for precise treatment strategies. Furthermore, existing clustering processes seldom incorporate domain-driven constraints, often resulting in phenotypes that lack clear clinical distinction. We propose a novel clustering network, NPCNet, that comprises a text embedding generator, a clustering operator, and a target navigator. We first transform EHRs into pseudo texts by discretizing continuous clinical measurements, then integrate them with static variables to construct the embeddings. The target navigator then infuses clinical knowledge into the embeddings through auxiliary tasks, constraining clustering results to better align sepsis phenotypes with clinical significance. Finally, the clustering operator employs an iterative refinement mechanism to jointly optimize phenotype centroids and patient representations under domain-driven constraints. Extensive experiments on public datasets validate that NPCNet achieves superior performance on both internal clustering benchmarks and clinical validity metrics, offering a viable pathway for precision treatment strategies in the management of sepsis.

聚类脓毒症临床表型EHR

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