Incorporating temporal EHR data in predictive models for risk stratification of renal function deterioration
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Guttag_Incorporating temporal.pdf
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Author(s)
Singh, Anima
Nadkarni, Girish
Gottesman, Omri
Ellis, Stephen B.
Bottinger, Erwin P.
Guttag, John V.
Date Issued
November 2014
Journal
Journal of Biomedical Informatics
Publisher
Elsevier
Citation
Singh, Anima, Girish Nadkarni, Omri Gottesman, Stephen B. Ellis, Erwin P. Bottinger, and John V. Guttag. “Incorporating Temporal EHR Data in Predictive Models for Risk Stratification of Renal Function Deterioration.” Journal of Biomedical Informatics 53 (February 2015): 220–228.
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Author's final manuscript
Abstract
Predictive models built using temporal data in electronic health records (EHRs) can potentially play a major role in improving management of chronic diseases. However, these data present a multitude of technical challenges, including irregular sampling of data and varying length of available patient history. In this paper, we describe and evaluate three different approaches that use machine learning to build predictive models using temporal EHR data of a patient.
The first approach is a commonly used non-temporal approach that aggregates values of the predictors in the patient’s medical history. The other two approaches exploit the temporal dynamics of the data. The two temporal approaches vary in how they model temporal information and handle missing data. Using data from the EHR of Mount Sinai Medical Center, we learned and evaluated the models in the context of predicting loss of estimated glomerular filtration rate (eGFR), the most common assessment of kidney function.
Our results show that incorporating temporal information in patient’s medical history can lead to better prediction of loss of kidney function. They also demonstrate that exactly how this information is incorporated is important. In particular, our results demonstrate that the relative importance of different predictors varies over time, and that using multi-task learning to account for this is an appropriate way to robustly capture the temporal dynamics in EHR data. Using a case study, we also demonstrate how the multi-task learning based model can yield predictive models with better performance for identifying patients at high risk of short-term loss of kidney function.
MIT Department
Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
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DOI of Published Version
https://doi.org/10.1016/j.jbi.2014.11.005
