Dynamically modeling Patient's health state from electronic medical records: A time series approach

Abstract

In this paper, we present a method to dynamically estimate the probability of mortality inside the Intensive Care Unit (ICU) by combining heterogeneous data. We propose a method based on Generalized Linear Dynamic Models that models the probability of mortality as a latent state that evolves over time. This framework allows us to combine different types of features (lab results, vital signs readings, doctor and nurse notes, etc) into a single state, which is updated each time new patient data is observed. In addition, we include the use of text features, based on medical noun phrase extraction and Statistical Topic Models. These features provide context about the patient that cannot be captured when only numerical features are used. We fill out the missing values using a Regularized Expectation Maximization based method assuming temporal data. We test our proposed approach using 15,000 Electronic Medical Records (EMRs) obtained from the MIMIC II public dataset. Experimental results show that the proposed model allows us to detect an increase in the probability of mortality before it occurs. We report an AUC 0.8657. Our proposed model clearly outperforms other methods of the literature in terms of sensitivity with 0.7885 compared to 0.6559 of Naive Bayes and F-score with 0.5929 compared to 0.4662 of Apache III score after 24 hours.