用Transformer模型同时预警术中6类并发症,准确率提升超7%。
Early Warning of Intraoperative Adverse Events via Transformer-Driven Multi-Label Learning
- 设计新型多标签框架IAENet,融合静态与动态临床数据。
- 在5~15分钟预警任务中平均F1提升最高达7.57%。
- 适合关注手术安全与智能辅助决策的临床研究者。
术中不良事件的早期预警对降低手术风险、提升患者安全至关重要。尽管深度学习在单事件预测上展现潜力,但仍面临忽视事件关联性、未充分利用异构临床数据以及医疗数据固有的类别不平衡等挑战。为此,我们构建了首个针对术中不良事件的多标签数据集MuAE,涵盖六类关键事件。提出基于Transformer的多标签学习框架IAENet,结合改进的时间感知特征逐元素线性调制(TAFiLM)模块,实现静态协变量与动态变量的稳健融合及复杂时序依赖建模。此外,引入带共现正则化的标签约束重加权损失(LCRLoss),有效缓解事件内不平衡问题,并强化频繁共现事件间的结构一致性。大量实验表明,IAENet在5、10和15分钟早期预警任务中持续优于强基线,平均F1分数分别提升+5.05%、+2.82%和+7.57%。结果凸显了IAENet在临床智能术中决策支持中的潜力。
原文摘要 · Abstract (English)
Early warning of intraoperative adverse events plays a vital role in reducing surgical risk and improving patient safety. While deep learning has shown promise in predicting the single adverse event, several key challenges remain: overlooking adverse event dependencies, underutilizing heterogeneous clinical data, and suffering from the class imbalance inherent in medical datasets. To address these issues, we construct the first Multi-label Adverse Events dataset (MuAE) for intraoperative adverse events prediction, covering six critical events. Next, we propose a novel Transformerbased multi-label learning framework (IAENet) that combines an improved Time-Aware Feature-wise Linear Modulation (TAFiLM) module for static covariates and dynamic variables robust fusion and complex temporal dependencies modeling. Furthermore, we introduce a Label-Constrained Reweighting Loss (LCRLoss) with co-occurrence regularization to effectively mitigate intra-event imbalance and enforce structured consistency among frequently co-occurring events. Extensive experiments demonstrate that IAENet consistently outperforms strong baselines on 5, 10, and 15-minute early warning tasks, achieving improvements of +5.05%, +2.82%, and +7.57% on average F1 score. These results highlight the potential of IAENet for supporting intelligent intraoperative decision-making in clinical practice.
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