Predictive models for medical outcomes hold great promise for enhancing clinical decision-making. These models are trained on rich patient data such as clinical notes, aggregating many patient signals into an outcome prediction. However, AI-based clinical models have typically been developed in isolation from the prominent paradigm of Evidence Based Medicine (EBM), in which medical decisions are based on explicit evidence from existing literature. In this work, we introduce techniques to help bridge this gap between EBM and AI-based clinical models, and show that these methods can improve predictive accuracy. We propose a novel system that automatically retrieves patient-specific literature based on intensive care (ICU) patient information, aggregates relevant papers and fuses them with internal admission notes to form outcome predictions. Our model is able to substantially boost predictive accuracy on three challenging tasks in comparison to strong recent baselines; for in-hospital mortality, we are able to boost top-10% precision by a large margin of over 25%.
翻译:医学结果的预测模型对于加强临床决策大有希望。这些模型是用临床记录等丰富的病人数据培训的,将许多病人的信号汇集到结果预测中。然而,基于AI的临床模型通常与基于证据的医学的突出范例(EBM)分离开发,而基于证据的医学决定是基于现有文献的明显证据。在这项工作中,我们引入技术帮助弥合基于EBM和基于AI的临床模型之间的这一差距,并表明这些方法可以提高预测准确性。我们建议建立一个新型系统,自动检索基于重症护理病人信息的针对病人的文献,汇总相关文件并将其与内部接收记录结合,形成结果预测。我们的模型能够大大提高三项具有挑战性的任务的预测准确性,与最近的强力基线相比;在医院内死亡率方面,我们能够以超过25%的大幅度提高10%的精准度。