arXiv:2608.06430cs.LGq-bio.QM2026-08

用图模型统一处理电子病历中的多类信息与时间关系,提升临床预测准确率。

MiGHT-EHR: A Multi-task Graph Transformer for Heterogeneous Temporal Electronic Health Records

论文配图:MiGHT-EHR: A Multi-task Graph Transformer for Heterogeneous Temporal Electronic Health Records
图 1 · 摘自论文原文
  • 构建异构图结构,融合患者、诊断、用药等多元临床实体及其关联
  • 在MIMIC-III/IV数据集上,对死亡率和再入院预测的性能超越现有方法
  • 学习到的表示具临床可解释性,能反映疾病轨迹与关键医学概念

电子病历(EHR)蕴含丰富的临床信息,但其异构性与时间顺序特性给学习带来挑战。现有方法仅能捕捉其中部分特征。本文提出多任务异构时序电子病历图变压器(MiGHT-EHR),在统一框架下同时建模:(i)多种临床实体(如患者、就诊、诊断、处方、操作)及其异构交互;(ii)跨多次就诊的纵向患者轨迹;(iii)相关预测任务间的统计依赖。通过归一化点互信息识别统计相关实体,构建异构图。在MIMIC-III与MIMIC-IV数据集上,针对药物推荐、住院时长、死亡率与再入院四个任务,MiGHT-EHR平均表现优于当前最优方法,尤其在死亡率与再入院预测中提升显著。后验分析显示,患者邻域按临床结局组织,重要医学概念可在线性方向恢复,任务概率校准良好。结果表明,该模型生成的表征既支持多任务预测,又保持临床可解释性。

原文摘要 · Abstract (English)

Learning from Electronic Health Records (EHRs) has gained significant attention due to its potential to improve clinical prediction. However, effective learning remains challenging because EHRs encode heterogeneous, temporally ordered clinical interactions. In particular, EHRs contain: (i) heterogeneous clinical entities, including patients, visits, diagnoses, prescriptions, and procedures, together with their heterogeneous interactions, (ii) longitudinal patient trajectories across hospital visits and (iii) shared statistical dependencies across related clinical prediction tasks. Existing EHR learning methods capture only a subset of these properties. To bridge this gap, we propose Multi-task Graph transformer for Heterogeneous Temporal EHRs (MiGHT-EHR), which jointly models all three within a unified representation learning method. MiGHT-EHR constructs a heterogeneous graph from EHRs in which nodes represent clinical entities and edges connect statistically associated entities identified via normalized point-wise mutual information. Across MIMIC-III and MIMIC-IV datasets, MiGHT-EHR outperforms state-of-the-art methods on average across four tasks: drug recommendation, prediction of length-of-stay, mortality, and readmission, with particularly strong improvements in mortality and readmission prediction. Furthermore, a post-hoc analysis of the learned representations reveals that patient neighborhoods are organized by clinical outcomes, salient medical concepts are recoverable as linear directions in the representation space, and task probabilities are well calibrated. Collectively, these findings demonstrate that MiGHT-EHR representations support diverse prediction tasks while preserving clinically interpretable structure.

电子病历图神经网络多任务学习临床预测

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