Integrating multi-modal clinical data, such as electronic health records (EHR) and chest X-ray images (CXR), is particularly beneficial for clinical prediction tasks. However, in a temporal setting, multi-modal data are often inherently asynchronous.

This study addresses the challenge of predicting post-stroke rigidity by emphasizing feature interactions through graph-based explainable AI. Post-stroke rigidity, characterized by increased muscle tone and stiffness, significantly affects survivors' mobility and quality of life. Despite its prevalence, early prediction remains limited, delaying intervention. We analyze 519K stroke hospitalization records from the Healthcare Cost and Utilization Project dataset, where 43% of patients exhibited rigidity. We compare traditional approaches such as Logistic Regression, XGBoost, and Transformer with graph-based models like Graphormer and Graph Attention Network. These graph models inherently capture feature interactions and incorporate intrinsic or post-hoc explainability. Our results show that graph-based methods outperform others (AUROC 0.75), identifying key predictors such as NIH Stroke Scale and APR-DRG mortality risk scores. They also uncover interactions missed by conventional models. This research provides a novel application of graph-based XAI in stroke prognosis, with potential to guide early identification and personalized rehabilitation strategies.

Creation and curation of knowledge graphs can accelerate disease discovery and analysis in real-world data. While disease ontologies aid in biological data annotation, codified categories (SNOMED-CT, ICD10, CPT) may not capture patient condition nuances or rare diseases. Multiple disease definitions across data sources complicate ontology mapping and disease clustering. We propose creating patient knowledge graphs using large language model extraction techniques, allowing data extraction via natural language rather than rigid ontological hierarchies. Our method maps to existing ontologies (MeSH, SNOMED-CT, RxNORM, HPO) to ground extracted entities. Using a large ambulatory care EHR database with 33.6M patients, we demonstrate our method through the patient search for Dravet syndrome, which received ICD10 recognition in October 2020. We describe our construction of patient-specific knowledge graphs and symptom-based patient searches. Using confirmed Dravet syndrome ICD10 codes as ground truth, we employ LLM-based entity extraction to characterize patients in grounded ontologies. We then apply this method to identify Beta-propeller protein-associated neurodegeneration (BPAN) patients, demonstrating real-world discovery where no ground truth exists.

Integrating multi-modal clinical data, such as electronic health records (EHR) and chest X-ray images (CXR), is particularly beneficial for clinical prediction tasks. However, in a temporal setting, multi-modal data are often inherently asynchronous. EHR can be continuously collected but CXR is generally taken with a much longer interval due to its high cost and radiation dose. When clinical prediction is needed, the last available CXR image might have been outdated, leading to suboptimal predictions. To address this challenge, we propose DDL-CXR, a method that dynamically generates an up-to-date latent representation of the individualized CXR images. Our approach leverages latent diffusion models for patient-specific generation strategically conditioned on a previous CXR image and EHR time series, providing information regarding anatomical structures and disease progressions, respectively. In this way, the interaction across modalities could be better captured by the latent CXR generation process, ultimately improving the prediction performance. Experiments using MIMIC datasets show that the proposed model could effectively address asynchronicity in multimodal fusion and consistently outperform existing methods.

Introduction: Ensuring timely and accurate diagnosis of medical conditions is paramount for effective patient care. Electrocardiogram (ECG) signals are fundamental for evaluating a patient's cardiac health and are readily available. Despite this, little attention has been given to the remarkable potential of ECG data in detecting non-cardiac conditions. Methods: In our study, we used publicly available datasets (MIMIC-IV-ECG-ICD and ECG-VIEW II) to investigate the feasibility of inferring general diagnostic conditions from ECG features. To this end, we trained a tree-based model (XGBoost) based on ECG features and basic demographic features to estimate a wide range of diagnoses, encompassing both cardiac and non-cardiac conditions. Results: Our results demonstrate the reliability of estimating 23 cardiac as well as 21 non-cardiac conditions above 0.7 AUROC in a statistically significant manner across a wide range of physiological categories. Our findings underscore the predictive potential of ECG data in identifying well-known cardiac conditions. However, even more striking, this research represents a pioneering effort in systematically expanding the scope of ECG-based diagnosis to conditions not traditionally associated with the cardiac system.

SHAP is a popular approach to explain black-box models by revealing the importance of individual features. As it ignores feature interactions, SHAP explanations can be confusing up to misleading. NSHAP, on the other hand, reports the additive importance for all subsets of features. While this does include all interacting sets of features, it also leads to an exponentially sized, difficult to interpret explanation. In this paper, we propose to combine the best of these two worlds, by partitioning the features into parts that significantly interact, and use these parts to compose a succinct, interpretable, additive explanation. We derive a criterion by which to measure the representativeness of such a partition for a models behavior, traded off against the complexity of the resulting explanation. To efficiently find the best partition out of super-exponentially many, we show how to prune sub-optimal solutions using a statistical test, which not only improves runtime but also helps to detect spurious interactions. Experiments on synthetic and real world data show that our explanations are both more accurate resp. more easily interpretable than those of SHAP and NSHAP.

Machine learning-aided clinical decision support has the potential to significantly improve patient care. However, existing efforts in this domain for principled quantification of uncertainty have largely been limited to applications of ad-hoc solutions that do not consistently improve reliability. In this work, we consider stochastic neural networks and design a tailor-made multimodal data-driven (M2D2) prior distribution over network parameters. We use simple and scalable Gaussian mean-field variational inference to train a Bayesian neural network using the M2D2 prior. We train and evaluate the proposed approach using clinical time-series data in MIMIC-IV and corresponding chest X-ray images in MIMIC-CXR for the classification of acute care conditions. Our empirical results show that the proposed method produces a more reliable predictive model compared to deterministic and Bayesian neural network baselines.

Biomedical research is growing in such an exponential pace that scientists, researchers and practitioners are no more able to cope with the amount of published literature in the domain. The knowledge presented in the literature needs to be systematized in such a ways that claims and hypothesis can be easily found, accessed and validated. Knowledge graphs can provide such framework for semantic knowledge representation from literature. However, in order to build knowledge graph, it is necessary to extract knowledge in form of relationships between biomedical entities and normalize both entities and relationship types. In this paper, we present and compare few rule-based and machine learning-based (Naive Bayes, Random Forests as examples of traditional machine learning methods and T5-based model as an example of modern deep learning) methods for scalable relationship extraction from biomedical literature for the integration into the knowledge graphs. We examine how resilient are these various methods to unbalanced and fairly small datasets, showing that T5 model handles well both small datasets, due to its pre-training on large C4 dataset as well as unbalanced data. The best performing model was T5 model fine-tuned on balanced data, with reported F1-score of 0.88.

Knowledge Graph has been proven effective in modeling structured information and conceptual knowledge, especially in the medical domain. However, the lack of high-quality annotated corpora remains a crucial problem for advancing the research and applications on this task. In order to accelerate the research for domain-specific knowledge graphs in the medical domain, we introduce DiaKG, a high-quality Chinese dataset for Diabetes knowledge graph, which contains 22,050 entities and 6,890 relations in total. We implement recent typical methods for Named Entity Recognition and Relation Extraction as a benchmark to evaluate the proposed dataset thoroughly. Empirical results show that the DiaKG is challenging for most existing methods and further analysis is conducted to discuss future research direction for improvements. We hope the release of this dataset can assist the construction of diabetes knowledge graphs and facilitate AI-based applications.