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Oss Boll H, Amirahmadi A, Ghazani MM, Morais WOD, Freitas EPD, Soliman A, Etminani F, Byttner S, Recamonde-Mendoza M. Graph neural networks for clinical risk prediction based on electronic health records: A survey. J Biomed Inform 2024; 151:104616. [PMID: 38423267 DOI: 10.1016/j.jbi.2024.104616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE This study aims to comprehensively review the use of graph neural networks (GNNs) for clinical risk prediction based on electronic health records (EHRs). The primary goal is to provide an overview of the state-of-the-art of this subject, highlighting ongoing research efforts and identifying existing challenges in developing effective GNNs for improved prediction of clinical risks. METHODS A search was conducted in the Scopus, PubMed, ACM Digital Library, and Embase databases to identify relevant English-language papers that used GNNs for clinical risk prediction based on EHR data. The study includes original research papers published between January 2009 and May 2023. RESULTS Following the initial screening process, 50 articles were included in the data collection. A significant increase in publications from 2020 was observed, with most selected papers focusing on diagnosis prediction (n = 36). The study revealed that the graph attention network (GAT) (n = 19) was the most prevalent architecture, and MIMIC-III (n = 23) was the most common data resource. CONCLUSION GNNs are relevant tools for predicting clinical risk by accounting for the relational aspects among medical events and entities and managing large volumes of EHR data. Future studies in this area may address challenges such as EHR data heterogeneity, multimodality, and model interpretability, aiming to develop more holistic GNN models that can produce more accurate predictions, be effectively implemented in clinical settings, and ultimately improve patient care.
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Affiliation(s)
- Heloísa Oss Boll
- Institute of Informatics, Universidade Federal do Rio Grande do Sul, Avenida Bento Gonçalves, 9500, Porto Alegre, 91501-970, RS, Brazil; School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden.
| | - Ali Amirahmadi
- School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden
| | - Mirfarid Musavian Ghazani
- School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden
| | - Wagner Ourique de Morais
- School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden
| | - Edison Pignaton de Freitas
- Institute of Informatics, Universidade Federal do Rio Grande do Sul, Avenida Bento Gonçalves, 9500, Porto Alegre, 91501-970, RS, Brazil
| | - Amira Soliman
- School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden
| | - Farzaneh Etminani
- School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden
| | - Stefan Byttner
- School of Information Technology, Halmstad University, Kristian IV:s väg 3, Halmstad, 301 18, Sweden
| | - Mariana Recamonde-Mendoza
- Institute of Informatics, Universidade Federal do Rio Grande do Sul, Avenida Bento Gonçalves, 9500, Porto Alegre, 91501-970, RS, Brazil; Bioinformatics Core, Hospital de Clínicas de Porto Alegre (HCPA), Av. Protásio Alves, 211, Bloco C, Porto Alegre, 90035-903, RS, Brazil
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Li Y, Feng L. Patient multi-relational graph structure learning for diabetes clinical assistant diagnosis. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:8428-8445. [PMID: 37161205 DOI: 10.3934/mbe.2023369] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The rapid accumulation of electronic health records (EHRs) and the advancements in data analysis technology have laid the foundation for research and clinical decision-making in the healthcare community. Graph neural networks (GNNs), a deep learning model family for graph embedding representations, have been widely used in the field of smart healthcare. However, traditional GNNs rely on the basic assumption that the graph structure extracted from the complex interactions among the EHRs must be a real topology. Noisy connections or false topology in the graph structure leads to inefficient disease prediction. We devise a new model named PM-GSL to improve diabetes clinical assistant diagnosis based on patient multi-relational graph structure learning. Specifically, we first build a patient multi-relational graph based on patient demographics, diagnostic information, laboratory tests, and complex interactions between medicines in EHRs. Second, to fully consider the heterogeneity of the patient multi-relational graph, we consider the node characteristics and the higher-order semantics of nodes. Thus, three candidate graphs are generated in the PM-GSL model: original subgraph, overall feature graph, and higher-order semantic graph. Finally, we fuse the three candidate graphs into a new heterogeneous graph and jointly optimize the graph structure with GNNs in the disease prediction task. The experimental results indicate that PM-GSL outperforms other state-of-the-art models in diabetes clinical assistant diagnosis tasks.
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Affiliation(s)
- Yong Li
- College of Computer Science and Engineering, Northwest Normal University, 967 Anning East Road, Lanzhou 730070, China
| | - Li Feng
- College of Computer Science and Engineering, Northwest Normal University, 967 Anning East Road, Lanzhou 730070, China
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Lu X, Wang L, Jiang Z, Liu S, Lin J. MRE: A translational knowledge graph completion model based on multiple relation embedding. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:5481-5900. [PMID: 36896554 DOI: 10.3934/mbe.2023253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Knowledge graph completion (KGC) has attracted significant research interest in applying knowledge graphs (KGs). Previously, many works have been proposed to solve the KGC problem, such as a series of translational and semantic matching models. However, most previous methods suffer from two limitations. First, current models only consider the single form of relations, thus failing to simultaneously capture the semantics of multiple relations (direct, multi-hop and rule-based). Second, the data-sparse problem of knowledge graphs would make part of relations challenging to embed. This paper proposes a novel translational knowledge graph completion model named multiple relation embedding (MRE) to address the above limitations. We attempt to embed multiple relations to provide more semantic information for representing KGs. To be more specific, we first leverage PTransE and AMIE+ to extract multi-hop and rule-based relations. Then, we propose two specific encoders to encode extracted relations and capture semantic information of multiple relations. We note that our proposed encoders can achieve interactions between relations and connected entities in relation encoding, which is rarely considered in existing methods. Next, we define three energy functions to model KGs based on the translational assumption. At last, a joint training method is adopted to perform KGC. Experimental results illustrate that MRE outperforms other baselines on KGC, demonstrating the effectiveness of embedding multiple relations for advancing knowledge graph completion.
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Affiliation(s)
- Xinyu Lu
- School of Computer Science and Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Lifang Wang
- School of Computer Science and Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Zejun Jiang
- School of Computer Science and Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Shizhong Liu
- School of Computer Science and Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Jiashi Lin
- School of Computer Science and Engineering, Northwestern Polytechnical University, Xi'an 710072, China
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