Clinical Outcome Prediction from Admission Notes using Self-Supervised Knowledge Integration

Outcome prediction from clinical text can prevent doctors from overlooking\npossible risks and help hospitals to plan capacities. We simulate patients at\nadmission time, when decision support can be especially valuable, and\ncontribute a novel admission to discharge task with four common outcome\nprediction targets: Diagnoses at discharge, procedures performed, in-hospital\nmortality and length-of-stay prediction. The ideal system should infer outcomes\nbased on symptoms, pre-conditions and risk factors of a patient. We evaluate\nthe effectiveness of language models to handle this scenario and propose\nclinical outcome pre-training to integrate knowledge about patient outcomes\nfrom multiple public sources. We further present a simple method to incorporate\nICD code hierarchy into the models. We show that our approach improves\nperformance on the outcome tasks against several baselines. A detailed analysis\nreveals further strengths of the model, including transferability, but also\nweaknesses such as handling of vital values and inconsistencies in the\nunderlying data.\n

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