Faculty Publications
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Item Diagnostic Code Group Prediction by Integrating Structured and Unstructured Clinical Data(Springer Science and Business Media Deutschland GmbH, 2021) Prabhakar, A.; Shidharth, S.; S. Krishnan, G.S.; Kamath S․, S.Diagnostic coding is a process by which written, verbal and other patient-case related documentation are used for enabling disease prediction, accurate documentation, and insurance settlements. It is a prevalently manual process even in countries that have successfully adopted Electronic Health Record (EHR) systems. The problem is exacerbated in developing countries where widespread adoption of EHR systems is still not at par with Western counterparts. EHRs contain a wealth of patient information embedded in numerical, text, and image formats. A disease prediction model that exploits all this information, enabling accurate and faster diagnosis would be quite beneficial. We address this challenging task by proposing mixed ensemble models consisting of boosting and deep learning architectures for the task of diagnostic code group prediction. The models are trained on a dataset created by integrating features from structured (lab test reports) as well as unstructured (clinical text) data. We analyze the proposed model’s performance on MIMIC-III, an open dataset of clinical data using standard multi-label metrics. Empirical evaluations underscored the significant performance of our approach for this task, compared to state-of-the-art works which rely on a single data source. Our novelty lies in effectively integrating relevant information from both data sources thereby ensuring larger ICD-9 code coverage, handling the inherent class imbalance, and adopting a novel approach to form the ensemble models. © 2021, Springer Nature Switzerland AG.Item Ontology-driven Text Feature Modeling for Disease Prediction using Unstructured Radiological Notes(Instituto Politecnico Nacional revista@cic.ipn.mx, 2019) S. Krishnan, G.S.; Kamath S?, S.Clinical Decision Support Systems (CDSSs) support medical personnel by offering aid in decision-making and timely interventions in patient care. Typically such systems are built on structured Electronic Health Records (EHRs), which, unfortunately have a very low adoption rate in developing countries at present. In such situations, clinical notes recorded by medical personnel, though unstructured, can be a significant source for rich patient related information. However, conversion of unstructured clinical notes to a structured EHR form is a manual and time consuming task, underscoring a critical need for more efficient, automated methods. In this paper, a generic disease prediction CDSS built on unstructured radiology text reports is proposed. We incorporate word embeddings and clinical ontologies to model the textual features of the patient data for training a feed-forward neural network for ICD9 disease group prediction. The proposed model built on unstructured text outperformed the state-of-the-art model built on structured data by 9% in terms of AUROC and 23% in terms of AUPRC, thus eliminating the dependency on the availability of structured clinical data. © 2019 Instituto Politecnico Nacional. All rights reserved.Item Multi-channel, convolutional attention based neural model for automated diagnostic coding of unstructured patient discharge summaries(Elsevier B.V., 2021) Mayya, V.; Kamath S?, S.S.; S. Krishnan, G.S.; Gangavarapu, T.Effective coding of patient records in hospitals is an essential requirement for epidemiology, billing, and managing insurance claims. The prevalent practice of manual coding, carried out by trained medical coders, is error-prone and time-consuming. Mitigating this labor-intensive process by developing diagnostic coding systems built on patients’ Electronic Medical Records (EMRs) is vital. However, developing nations with low digitization rates have limited availability of structured EMRs, thereby necessitating a need for systems that leverage unstructured data sources. Despite the rich clinical information available in such unstructured data, modeling them is complex, owing to the variety and sparseness of diagnostic codes, complex structural and temporal nature of summaries, and prolific use of medical jargon. This work proposes a context-attentive network to facilitate automatic diagnostic code assignment as a multi-label classification problem. The proposed model facilitates information aggregation across a patient's discharge summary via multi-channel, variable-sized convolutional filters to extract multi-granular snippets. The attention mechanism enables selecting vital segments in those snippets that map to the clinical codes. The model's superior performance underscores its effectiveness compared to the state-of-the-art on the MIMIC-III database. Additionally, experimental validation using the CodiEsp dataset exhibited the model's interpretability and explainability. © 2021 Elsevier B.V.