Comparing representations of long clinical texts for the task of patient note-identification

In this paper, we address the challenge of patient-note identification, which involves accurately matching an anonymized clinical note to its corresponding patient, represented by a set of related notes. This task has broad applications, including duplicate records detection and patient similarity analysis, which require robust patient-level representations. We explore various embedding methods, including Hierarchical Attention Networks (HAN), three-level Hierarchical Transformer Networks (HTN), LongFormer, and advanced BERT-based models, focusing on their ability to process mediumto-long clinical texts effectively. Additionally, we evaluate different pooling strategies (mean, max, and mean_max) for aggregating wordlevel embeddings into patient-level representations and we examine the impact of sliding windows on model performance. Our results indicate that BERT-based embeddings outperform traditional and hierarchical models, particularly in processing lengthy clinical notes and capturing nuanced patient representations. Among the pooling strategies, mean_max pooling consistently yields the best results, highlighting its ability to capture critical features from clinical notes. Furthermore, the reproduction of our results on both MIMIC dataset and Necker hospital data warehouse illustrates the generalizability of these approaches to real-world applications, emphasizing the importance of both embedding methods and aggregation strategies in optimizing patient-note identification and enhancing patient-level modeling.