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Foundation Model of Electronic Medical Records for Adaptive Risk Estimation

Created by
  • Haebom

Author

Pawel Renc, Michal K. Grzeszczyk, Nassim Oufattole, Deirdre Goode, Yugang Jia, Szymon Bieganski, Matthew BA McDermott, Jaroslaw Was, Anthony E. Samir, Jonathan W. Cunningham, David W. Bates, Arkadiusz Sitek.

Outline

To overcome the limitations of existing early warning systems (NEWS, MEWS) that use static and fixed thresholds, this paper presents the Adaptive Risk Estimation System (ARES), which utilizes ETHOS, an AI model that tokenizes patient health time-course (PHT) and utilizes a transformer-based architecture to calculate dynamic and personalized risk probabilities. ARES calculates dynamic and personalized risk probabilities for clinician-defined critical events and also includes a personalized explainability module that emphasizes patient-specific risk factors. Using the MIMIC-IV v2.2 dataset, ARES achieved superior AUC scores compared to existing early warning systems and state-of-the-art machine learning models in predicting hospitalization, intensive care unit admission, and long-term hospitalization. Risk estimates were robust across demographic subgroups, and calibration curves confirmed the model's reliability. The explainability module provided valuable insights into patient-specific risk factors.

Takeaways, Limitations

Takeaways:
We present a dynamic and personalized risk prediction system that is more accurate than existing early warning systems.
Supporting physician decision-making through modules that describe patient-specific risk factors.
Demonstrating the excellent performance and robustness of the ETHOS model.
Encouraging future research through open source code.
Limitations:
Validation of the usefulness of ARES in actual clinical settings is needed.
There is uncertainty about the clinical impact.
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