Event-Based Contrastive Learning for Medical Time Series

In clinical practice, one often needs to identify whether a patient is at high risk of adverse outcomes after some key medical event; e.g., the short-term risk of death after an admission for heart failure. This task, however, remains challenging due to the complexity, variability, and heterogeneity of longitudinal medical data, especially for individuals suffering from chronic diseases like heart failure. In this paper, we introduce Event-Based Contrastive Learning (EBCL) - a method for learning embeddings of heterogeneous patient data that preserves temporal information before and after key index events. We demonstrate that EBCL produces models that yield better fine-tuning performance on critical downstream tasks including 30-day readmission, 1-year mortality, and 1-week length of stay relative to other representation learning methods that do not exploit temporal information surrounding key medical events.

A Knowledge Distillation Approach for Sepsis Outcome Prediction from Multivariate Clinical Time Series

Sepsis is a life-threatening condition triggered by an extreme infection response. Our objective is to forecast sepsis patient outcomes using their medical history and treatments, while learning interpretable state representations to assess patients' risks in developing various adverse outcomes. While neural networks excel in outcome prediction, their limited interpretability remains a key issue. In this work, we use knowledge distillation via constrained variational inference to distill the knowledge of a powerful "teacher" neural network model with high predictive power to train a "student" latent variable model to learn interpretable hidden state representations to achieve high predictive performance for sepsis outcome prediction. Using real-world data from the MIMIC-IV database, we trained an LSTM as the "teacher" model to predict mortality for sepsis patients, given information about their recent history of vital signs, lab values and treatments. For our student model, we use an autoregressive hidden Markov model (AR-HMM) to learn interpretable hidden states from patients' clinical time series, and use the posterior distribution of the learned state representations to predict various downstream outcomes, including hospital mortality, pulmonary edema, need for diuretics, dialysis, and mechanical ventilation. Our results show that our approach successfully incorporates the constraint to achieve high predictive power similar to the teacher model, while maintaining the generative performance.

What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams

Open domain question answering (OpenQA) tasks have been recently attracting more and more attention from the natural language processing (NLP) community. In this work, we present the first free-form multiple-choice OpenQA dataset for solving medical problems, MedQA, collected from the professional medical board exams. It covers three languages: English, simplified Chinese, and traditional Chinese, and contains 12,723, 34,251, and 14,123 questions for the three languages, respectively. We implement both rule-based and popular neural methods by sequentially combining a document retriever and a machine comprehension model. Through experiments, we find that even the current best method can only achieve 36.7\%, 42.0\%, and 70.1\% of test accuracy on the English, traditional Chinese, and simplified Chinese questions, respectively. We expect MedQA to present great challenges to existing OpenQA systems and hope that it can serve as a platform to promote much stronger OpenQA models from the NLP community in the future.