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Automated Multi-Task Learning for Joint Disease Prediction on Electronic Health Records

Neural Information Processing Systems

In the realm of big data and digital healthcare, Electronic Health Records (EHR) have become a rich source of information with the potential to improve patient care and medical research. In recent years, machine learning models have proliferated for analyzing EHR data to predict patients' future health conditions. Among them, some studies advocate for multi-task learning (MTL) to jointly predict multiple target diseases for improving the prediction performance over single task learning. Nevertheless, current MTL frameworks for EHR data have significant limitations due to their heavy reliance on human experts to identify task groups for joint training and design model architectures. To reduce human intervention and improve the framework design, we propose an automated approach named AutoDP, which can search for the optimal configuration of task grouping and architectures simultaneously. To tackle the vast joint search space encompassing task combinations and architectures, we employ surrogate model-based optimization, enabling us to efficiently discover the optimal solution. Experimental results on real-world EHR data demonstrate the efficacy of the proposed AutoDP framework. It achieves significant performance improvements over both hand-crafted and automated state-of-the-art methods, also maintains a feasible search cost at the same time.


EHRSHOT: An EHR Benchmark for Few-Shot Evaluation of Foundation Models

Neural Information Processing Systems

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains de-identified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients.


Instruction Tuning Large Language Models to Understand Electronic Health Records

Neural Information Processing Systems

Large language models (LLMs) have shown impressive capabilities in solving a wide range of tasks based on human instructions. However, developing a conversational AI assistant for electronic health record (EHR) data remains challenging due to (1) the lack of large-scale instruction-following datasets and (2) the limitations of existing model architectures in handling complex and heterogeneous EHR data.In this paper, we introduce MIMIC-Instr, a dataset comprising over 400K open-ended instruction-following examples derived from the MIMIC-IV EHR database. This dataset covers various topics and is suitable for instruction-tuning general-purpose LLMs for diverse clinical use cases. Additionally, we propose Llemr, a general framework that enables LLMs to process and interpret EHRs with complex data structures. Llemr demonstrates competitive performance in answering a wide range of patient-related questions based on EHR data.Furthermore, our evaluations on clinical predictive modeling benchmarks reveal that the fine-tuned Llemr achieves performance comparable to state-of-the-art (SOTA) baselines using curated features.


MiME: Multilevel Medical Embedding of Electronic Health Records for Predictive Healthcare

Neural Information Processing Systems

Deep learning models exhibit state-of-the-art performance for many predictive healthcare tasks using electronic health records (EHR) data, but these models typically require training data volume that exceeds the capacity of most healthcare systems. External resources such as medical ontologies are used to bridge the data volume constraint, but this approach is often not directly applicable or useful because of inconsistencies with terminology. To solve the data insufficiency challenge, we leverage the inherent multilevel structure of EHR data and, in particular, the encoded relationships among medical codes. We propose Multilevel Medical Embedding (MiME) which learns the multilevel embedding of EHR data while jointly performing auxiliary prediction tasks that rely on this inherent EHR structure without the need for external labels. We conducted two prediction tasks, heart failure prediction and sequential disease prediction, where MiME outperformed baseline methods in diverse evaluation settings. In particular, MiME consistently outperformed all baselines when predicting heart failure on datasets of different volumes, especially demonstrating the greatest performance improvement (15% relative gain in PR-AUC over the best baseline) on the smallest dataset, demonstrating its ability to effectively model the multilevel structure of EHR data.


EXR: An Interactive Immersive EHR Visualization in Extended Reality

Marteau, Benoit, Tan, Shaun Q. Y., Li, Jieru, Hornback, Andrew, Zhong, Yishan, Wang, Shaunna, Lowson, Christian, Woloff, Jason, Pahys, Joshua M., Hwang, Steven W., Hilton, Coleman, Wang, May D.

arXiv.org Artificial Intelligence

This paper presents the design and implementation of an Extended Reality (XR) platform for immersive, interactive visualization of Electronic Health Records (EHRs). The system extends beyond conventional 2D interfaces by visualizing both structured and unstructured patient data into a shared 3D environment, enabling intuitive exploration and real-time collaboration. The modular infrastructure integrates FHIR-based EHR data with volumetric medical imaging and AI-generated segmentation, ensuring interoperability with modern healthcare systems. The platform's capabilities are demonstrated using synthetic EHR datasets and computed tomography (CT)-derived spine models processed through an AI-powered segmentation pipeline. This work suggests that such integrated XR solutions could form the foundation for next-generation clinical decision-support tools, where advanced data infrastructures are directly accessible in an interactive and spatially rich environment.


medDreamer: Model-Based Reinforcement Learning with Latent Imagination on Complex EHRs for Clinical Decision Support

Xu, Qianyi, Habib, Gousia, Wu, Feng, Perera, Dilruk, Feng, Mengling

arXiv.org Artificial Intelligence

Timely and personalized treatment decisions are essential across a wide range of healthcare settings where patient responses can vary significantly and evolve over time. Clinical data used to support these treatment decisions are often irregularly sampled, where missing data frequencies may implicitly convey information about the patient's condition. Existing Reinforcement Learning (RL) based clinical decision support systems often ignore the missing patterns and distort them with coarse discretization and simple imputation. They are also predominantly model-free and largely depend on retrospective data, which could lead to insufficient exploration and bias by historical behaviors. To address these limitations, we propose medDreamer, a novel model-based reinforcement learning framework for personalized treatment recommendation. medDreamer contains a world model with an Adaptive Feature Integration module that simulates latent patient states from irregular data and a two-phase policy trained on a hybrid of real and imagined trajectories. This enables learning optimal policies that go beyond the sub-optimality of historical clinical decisions, while remaining close to real clinical data. We evaluate medDreamer on both sepsis and mechanical ventilation treatment tasks using two large-scale Electronic Health Records (EHRs) datasets. Comprehensive evaluations show that medDreamer significantly outperforms model-free and model-based baselines in both clinical outcomes and off-policy metrics.



A survey of using EHR as real-world evidence for discovering and validating new drug indications

Talukdar, Nabasmita, Zhang, Xiaodan, Paithankar, Shreya, Wang, Hui, Chen, Bin

arXiv.org Artificial Intelligence

Electronic Health Records (EHRs) have been increasingly used as real-world evidence (RWE) to support the discovery and validation of new drug indications. This paper surveys current approaches to EHR-based drug repurposing, covering data sources, processing methodologies, and representation techniques. It discusses study designs and statistical frameworks for evaluating drug efficacy. Key challenges in validation are discussed, with emphasis on the role of large language models (LLMs) and target trial emulation. By synthesizing recent developments and methodological advances, this work provides a foundational resource for researchers aiming to translate real-world data into actionable drug-repurposing evidence.


MiME: Multilevel Medical Embedding of Electronic Health Records for Predictive Healthcare

Neural Information Processing Systems

Deep learning models exhibit state-of-the-art performance for many predictive healthcare tasks using electronic health records (EHR) data, but these models typically require training data volume that exceeds the capacity of most healthcare systems. External resources such as medical ontologies are used to bridge the data volume constraint, but this approach is often not directly applicable or useful because of inconsistencies with terminology. To solve the data insufficiency challenge, we leverage the inherent multilevel structure of EHR data and, in particular, the encoded relationships among medical codes. We propose Multilevel Medical Embedding (MiME) which learns the multilevel embedding of EHR data while jointly performing auxiliary prediction tasks that rely on this inherent EHR structure without the need for external labels. We conducted two prediction tasks, heart failure prediction and sequential disease prediction, where MiME outperformed baseline methods in diverse evaluation settings. In particular, MiME consistently outperformed all baselines when predicting heart failure on datasets of different volumes, especially demonstrating the greatest performance improvement (15% relative gain in PR-AUC over the best baseline) on the smallest dataset, demonstrating its ability to effectively model the multilevel structure of EHR data.