arXiv:2604.20259cs.LG2026-04

用可解释的因果注意力模型,提前预测急性肾损伤。

Causal-Transformer with Adaptive Mutation-Locking for Early Prediction of Acute Kidney Injury

论文配图:Causal-Transformer with Adaptive Mutation-Locking for Early Prediction of Acute Kidney Injury
图 1 · 摘自论文原文
  • 引入连续时间状态演化,自然处理不规则采样数据
  • 在MIMIC-IV数据集上AUC达0.921,显著优于现有模型
  • 生成因果路径图,医生可追溯病情恶化源头

准确早期预测急性肾损伤(AKI)对及时临床干预至关重要。然而,现有深度学习模型难以处理不规则采样数据,且序列架构存在黑箱问题,严重限制临床信任。为此,我们提出CT-Former,融合连续时间建模与因果变压器。为应对数据不规则性而不依赖有偏的人工插补,框架采用连续时间状态演化机制,自然追踪患者时间轨迹。为解决黑箱问题,其因果注意力模块摒弃不可解释的隐状态聚合,转而生成有向结构因果矩阵,精准识别并追踪严重生理冲击的历史发生节点。通过建立历史异常与当前风险预测间的明确因果路径,CT-Former实现原生临床可解释性。训练采用解耦双阶段协议,独立优化因果融合过程。在包含18,419例患者的MIMIC-IV队列上的大量实验表明,CT-Former显著优于现有最先进基线,结果证实其显式透明架构为临床决策提供了准确可信的工具。

原文摘要 · Abstract (English)

Accurate early prediction of Acute Kidney Injury (AKI) is critical for timely clinical intervention. However, existing deep learning models struggle with irregularly sampled data and suffer from the opaque "black-box" nature of sequential architectures, strictly limiting clinical trust. To address these challenges, we propose CT-Former, integrating continuous-time modeling with a Causal-Transformer. To handle data irregularity without biased artificial imputation, our framework utilizes a continuous-time state evolution mechanism to naturally track patient temporal trajectories. To resolve the black-box problem, our Causal-Attention module abandons uninterpretable hidden state aggregation. Instead, it generates a directed structural causal matrix to identify and trace the exact historical onset of severe physiological shocks. By establishing clear causal pathways between historical anomalies and current risk predictions, CT-Former provides native clinical interpretability. Training follows a decoupled two-stage protocol to optimize the causal-fusion process independently. Extensive experiments on the MIMIC-IV cohort (N=18,419) demonstrate that CT-Former significantly outperforms state-of-the-art baselines. The results confirm that our explicitly transparent architecture offers an accurate and trustworthy tool for clinical decision-making.

医疗AI因果模型时序预测

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