Use of deep learning to develop continuous-risk models for adverse event prediction from electronic health records.

Journal: Nature protocols
Published Date:

Abstract

Early prediction of patient outcomes is important for targeting preventive care. This protocol describes a practical workflow for developing deep-learning risk models that can predict various clinical and operational outcomes from structured electronic health record (EHR) data. The protocol comprises five main stages: formal problem definition, data pre-processing, architecture selection, calibration and uncertainty, and generalizability evaluation. We have applied the workflow to four endpoints (acute kidney injury, mortality, length of stay and 30-day hospital readmission). The workflow can enable continuous (e.g., triggered every 6 h) and static (e.g., triggered at 24 h after admission) predictions. We also provide an open-source codebase that illustrates some key principles in EHR modeling. This protocol can be used by interdisciplinary teams with programming and clinical expertise to build deep-learning prediction models with alternate data sources and prediction tasks.

Authors

  • Nenad Tomasev
    DeepMind, London, EC4A 3TW, UK.
  • Natalie Harris
    Google Health, London, UK.
  • Sebastien Baur
    Synthetic Biology Group, Microbiology Department, Institut Pasteur, Paris, France.
  • Anne Mottram
    DeepMind, London, UK.
  • Xavier Glorot
    DeepMind, London, UK.
  • Jack W Rae
    DeepMind, London, UK.
  • Michal Zielinski
    DeepMind, London, UK.
  • Harry Askham
    DeepMind, London, UK.
  • Andre Saraiva
    DeepMind, London, UK.
  • Valerio Magliulo
    Google Health, London, UK.
  • Clemens Meyer
    DeepMind, London, UK.
  • Suman Ravuri
    DeepMind, London, UK.
  • Ivan Protsyuk
    Google Health, London, UK.
  • Alistair Connell
    Google Health, London, UK.
  • Cian O Hughes
    DeepMind, London, EC4A 3TW, UK.
  • Alan Karthikesalingam
    Department of Outcomes Research, St George's Vascular Institute, London, SW17 0QT, United Kingdom.
  • Julien Cornebise
    DeepMind, London, EC4A 3TW, UK.
  • Hugh Montgomery
    Institute of Sport, Exercise and Health, London, W1T 7HA, UK.
  • Geraint Rees
    Institute of Neurology, University College London, London, WC1N 3BG, UK.
  • Chris Laing
    University College London Hospitals, London, UK.
  • Clifton R Baker
    Department of Veterans Affairs, Washington, DC, USA.
  • Thomas F Osborne
    VA Palo Alto Healthcare System, Palo Alto, CA, USA.
  • Ruth Reeves
    Department of Veterans Affairs, Washington, DC, USA.
  • Demis Hassabis
    Google DeepMind, 5 New Street Square, London EC4A 3TW, UK.
  • Dominic King
    DeepMind, London, UK.
  • Mustafa Suleyman
    DeepMind, London, UK.
  • Trevor Back
    DeepMind, London, EC4A 3TW, UK.
  • Christopher Nielson
    Department of Veterans Affairs, Washington, DC, USA.
  • Martin G Seneviratne
    Department of Biomedical Informatics, Stanford School of Medicine, CA.
  • Joseph R Ledsam
    DeepMind, London, UK.
  • Shakir Mohamed
    DeepMind, London, UK.