Abstract
Background
Clinical notes are documents that contain detailed information about the health status of patients. Medical codes generally accompany them. However, the manual diagnosis is costly and error-prone. Moreover, large datasets in clinical diagnosis are susceptible to noise labels because of erroneous manual annotation. Therefore, machine learning has been utilized to perform automatic diagnoses. Previous state-of-the-art (SOTA) models used convolutional neural networks to build document representations for predicting medical codes. However, the clinical notes are usually long-tailed. Moreover, most models fail to deal with the noise during code allocation. Therefore, denoising mechanism and long-tailed classification are the keys to automated coding at scale.
Results
In this paper, a new joint learning model is proposed to extend our attention model for predicting medical codes from clinical notes. On the MIMIC-III-50 dataset, our model outperforms all the baselines and SOTA models in all quantitative metrics. On the MIMIC-III-full dataset, our model outperforms in the macro-F1, micro-F1, macro-AUC, and precision at eight compared to the most advanced models. In addition, after introducing the denoising mechanism, the convergence speed of the model becomes faster, and the loss of the model is reduced overall.
Conclusions
The innovations of our model are threefold: firstly, the code-specific representation can be identified by adopted the self-attention mechanism and the label attention mechanism. Secondly, the performance of the long-tailed distributions can be boosted by introducing the joint learning mechanism. Thirdly, the denoising mechanism is suitable for reducing the noise effects in medical code prediction. Finally, we evaluate the effectiveness of our model on the widely-used MIMIC-III datasets and achieve new SOTA results.
Explainable automated coding of clinical notes using hierarchical label-wise attention networks and label embedding initialisation
