An Interpretable Deep-Learning Framework for Predicting Hospital Readmissions From Electronic Health Records

With the increasing availability of patients' data, modern medicine is shifting towards prospective healthcare. Electronic health records contain a variety of information useful for clinical patient description and can be exploited for the construction of predictive models, given that similar medical histories will likely lead to similar progressions. One example is unplanned hospital readmission prediction, an essential task for reducing hospital costs and improving patient health. Despite predictive models showing very good performances especially with deep-learning models, they are often criticized for the poor interpretability of their results, a fundamental characteristic in the medical field, where incorrect predictions might have serious consequences for the patient health. In this paper we propose a novel, interpretable deep-learning framework for predicting unplanned hospital readmissions, supported by NLP findings on word embeddings and by neural-network models (ConvLSTM) for better handling temporal data. We validate our system on the two predictive tasks of hospital readmission within 30 and 180 days, using real-world data. In addition, we introduce and test a model-dependent technique to make the representation of results easily interpretable by the medical staff. Our solution achieves better performances compared to traditional models based on machine learning, while providing at the same time more interpretable results.

Towards Assessing Data Bias in Clinical Trials

Algorithms and technologies are essential tools that pervade all aspects of our daily lives. In the last decades, health care research benefited from new computer-based recruiting methods, the use of federated architectures for data storage, the introduction of innovative analyses of datasets, and so on. Nevertheless, health care datasets can still be affected by data bias. Due to data bias, they provide a distorted view of reality, leading to wrong analysis results and, consequently, decisions. For example, in a clinical trial that studied the risk of cardiovascular diseases, predictions were wrong due to the lack of data on ethnic minorities. It is, therefore, of paramount importance for researchers to acknowledge data bias that may be present in the datasets they use, eventually adopt techniques to mitigate them and control if and how analyses results are impacted. This paper proposes a method to address bias in datasets that: (i) defines the types of data bias that may be present in the dataset, (ii) characterizes and quantifies data bias with adequate metrics, (iii) provides guidelines to identify, measure, and mitigate data bias for different data sources. The method we propose is applicable both for prospective and retrospective clinical trials. We evaluate our proposal both through theoretical considerations and through interviews with researchers in the health care environment.