Heart failure (HF) is one of the leading causes of rehospitalization among older adults in the United States. Although clinical notes contain rich, detailed patient information and make up a large portion of electronic health records (EHRs), they remain underutilized for HF readmission risk analysis. Traditional computational models for HF readmission often rely on expert-crafted rules, medical thesauri, and ontologies to interpret clinical notes, which are typically written under time pressure and may contain misspellings, abbreviations, and domain-specific jargon. We present ClinNoteAgents, an LLM-based multi-agent framework that transforms free-text clinical notes into (1) structured representations of clinical and social risk factors for association analysis and (2) clinician-style abstractions for HF 30-day readmission prediction. We evaluate ClinNoteAgents on 3,544 notes from 2,065 patients (readmission rate=35.16%), demonstrating strong performance in extracting risk factors from free-text, identifying key contributing factors, and predicting readmission risk. By reducing reliance on structured fields and minimizing manual annotation and model training, ClinNoteAgents provides a scalable and interpretable approach to note-based HF readmission risk modeling in data-limited healthcare systems.

Electronic Health Records (EHRs) enable deep learning for clinical predictions, but the optimal method for representing patient data remains unclear due to inconsistent evaluation practices. We present the first systematic benchmark to compare EHR representation methods, including multivariate time-series, event streams, and textual event streams for LLMs. This benchmark standardises data curation and evaluation across two distinct clinical settings: the MIMIC-IV dataset for ICU tasks (mortality, phenotyping) and the EHRSHOT dataset for longitudinal care (30-day readmission, 1-year pancreatic cancer). For each paradigm, we evaluate appropriate modelling families--including Transformers, MLP, LSTMs and Retain for time-series, CLMBR and count-based models for event streams, 8-20B LLMs for textual streams--and analyse the impact of feature pruning based on data missingness. Our experiments reveal that event stream models consistently deliver the strongest performance. Pre-trained models like CLMBR are highly sample-efficient in few-shot settings, though simpler count-based models can be competitive given sufficient data. Furthermore, we find that feature selection strategies must be adapted to the clinical setting: pruning sparse features improves ICU predictions, while retaining them is critical for longitudinal tasks. Our results, enabled by a unified and reproducible pipeline, provide practical guidance for selecting EHR representations based on the clinical context and data regime.

Diabetes is a disease-causing high level of blood sugar. In type 1 Diabetes, body doesn't produce insulin, but if injected from external sources, will use it and in type 2, the body doesn't produce as well as use insulin. It is estimated that 30.3 million people of all ages in the US are suffering from Diabetes as of 2015, out of which 7.2 million are unaware[1]. As of 2016, it is ranked seventh in the list of global causes of mortality. Diabetes can be an underlying cause for many cardiovascular diseases, retinopathy, and nephropathy leading to frequent readmission in the hospital. The Centers for Medicare and Medicaid Services(CMS) labeled a 30-day readmission rate as a measure of healthcare quality offered by the hospital in order to provide the best inpatient care and improve the healthcare quality. Hospitals with high readmission rates will be penalized as per the Patient Protection and Affordable Care Act(ACA) of 2010[2]. During the recent studies[19], it was observed that a 30-day readmission rate for patients with Diabetes ranges between 14.4%-22.7%,

Heart failures in the United States cost an estimated 30.7 billion dollars annually and predictive analysis can decrease costs due to readmission of heart failure patients. Deep learning can predict readmissions but does not give reasons for its predictions. Ours is the first study on a deep-learning approach to explaining decisions behind readmission predictions. Additionally, it provides an automatic patient stratification to explain cohorts of readmitted patients. The new deep-learning model called a point-wise linear model is a meta-learning machine of linear models. It generates a logistic regression model to predict early readmission for each patient. The custom-made prediction models allow us to analyze feature importance. We evaluated the approach using a dataset that had 30-days readmission patients with heart failures. This study has been submitted in PLOS ONE. In advance, we would like to share the theoretical aspect of the point-wise linear model as a part of our study.

Heart failure hospitalization is a severe burden on healthcare. How to predict and therefore prevent readmission has been a significant challenge in outcomes research. To address this, we propose a deep learning approach to predict readmission from clinical notes. Unlike conventional methods that use structured data for prediction, we leverage the unstructured clinical notes to train deep learning models based on convolutional neural networks (CNN). We then use the trained models to classify and predict potentially high-risk admissions/patients. For evaluation, we trained CNNs using the discharge summary notes in the MIMIC III database. We also trained regular machine learning models based on random forest using the same datasets. The result shows that deep learning models outperform the regular models in prediction tasks. CNN method achieves a F1 score of 0.756 in general readmission prediction and 0.733 in 30-day readmission prediction, while random forest only achieves a F1 score of 0.674 and 0.656 respectively. We also propose a chi-square test based method to interpret key features associated with deep learning predicted readmissions. It reveals clinical insights about readmission embedded in the clinical notes. Collectively, our method can make the human evaluation process more efficient and potentially facilitate the reduction of readmission rates.

We augment linear Support Vector Machine (SVM) classifiers by adding three important features: (i) we introduce a regularization constraint to induce a sparse classifier; (ii) we devise a method that partitions the positive class into clusters and selects a sparse SVM classifier for each cluster; and (iii) we develop a method to optimize the values of controllable variables in order to reduce the number of data points which are predicted to have an undesirable outcome, which, in our setting, coincides with being in the positive class. The latter feature leads to personalized prescriptions/recommendations. We apply our methods to the problem of predicting and preventing hospital readmissions within 30-days from discharge for patients that underwent a general surgical procedure. To that end, we leverage a large dataset containing over 2.28 million patients who had surgeries in the period 2011--2014 in the U.S. The dataset has been collected as part of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP).