Objective: realtime monitoring of invasive ventilation (iV) in intensive care units (ICUs) plays a crucial role in ensuring prompt interventions and better patient outcomes. However, conventional methods often overlook valuable insights embedded within clinical notes, relying solely on tabular data. In this study, we propose an innovative approach to enhance iV risk monitoring by incorporating clinical notes into the monitoring pipeline through using language models for text summarization. Results: We achieve superior performance in all metrics reported by the state-of-the-art in iV risk monitoring, namely: an AUROC of 0.86, an AUC-PR of 0.35, and an AUCt of up to 0.86. We also demonstrate that our methodology allows for more lead time in flagging iV for certain time buckets. Conclusion: Our study underscores the potential of integrating clinical notes and language models into realtime iV risk monitoring, paving the way for improved patient care and informed clinical decision-making in ICU settings.

Modern applications of survival analysis increasingly involve time-dependent covariates, which constitute a form of functional data. Learning from functional data generally involves repeated evaluations of time integrals which is numerically expensive. In this work we propose a lightweight data preprocessing step that transforms functional data into nonfunctional data. Boosting implementations for nonfunctional data can then be used, whereby the required numerical integration comes for free as part of the training phase. We use this to develop BoXHED 2.0, a quantum leap over the tree-boosted hazard package BoXHED 1.0. BoXHED 2.0 extends BoXHED 1.0 to Aalen's multiplicative intensity model, which covers censoring schemes far beyond right-censoring and also supports recurrent events data. It is also massively scalable because of preprocessing and also because it borrows from the core components of XGBoost. BoXHED 2.0 supports the use of GPUs and multicore CPUs, and is available from GitHub: www.github.com/BoXHED.