A Deep Learning Framework for Automated ICD-10 Coding.

The International Statistical Classification of Diseases and Related Health Problems (ICD) is one of the widely used classification system for diagnoses and procedures to assign diagnosis codes to Electronic Health Record (EHR) associated with a patient's stay. The aim of this paper is to propose an automated coding system to assist physicians in the assignment of ICD codes to EHR. For this purpose, we created a pipeline of Natural Language Processing (NLP) and Deep Learning (DL) models able to extract the useful information from French medical texts and to perform classification. After the evaluation phase, our approach was able to predict 346 diagnosis codes from heterogeneous medical units with an accuracy average of 83%. Our results were finally validated by physicians of the Medical Information Department (MID) in charge of coding hospital stays.

The detection of hospitalized patients at risk of testing positive to multi-drug resistant bacteria using MOCA-I, a rule-based "white-box" classification algorithm for medical data.

BACKGROUND: Multi-drug resistant (MDR) bacteria are a major health concern. In this retrospective study, a rule-based classification algorithm, MOCA-I (Multi-Objective Classification Algorithm for Imbalanced data) is used to identify hospitalized patients at risk of testing positive for multidrug-resistant (MDR) bacteria, including Methicillin-resistant Staphylococcus aureus (MRSA), before or during their stay. METHODS: Applied to a data set of 48,945 hospital stays (including known cases of carriage) with up to 16,325 attributes per stay, MOCA-I generated alert rules for risk of carriage or infection. A risk score was then computed from each stay according to the triggered rules.Recall and precision curves were plotted. RESULTS: The classification can be focused on specifically detecting high risk of having a positive test, or identifying large numbers of at-risk patients by modulating the risk score cut-off level. For a risk score above 0.85,recall (sensitivity) is 62 % with 69 % precision (confidence) for MDR bacteria, recall is 58 % with 88 % precision for MRSA. In addition, MOCA-I identifies 38 and 21 cases of previously unknown MDR and MRSA respectively. CONCLUSIONS: MOCA-I generates medically pertinent alert rules. This classification algorithm can be used to detect patients with high risk of testing positive to MDR bacteria (including MRSA). Classification can be modulated by appropriately setting the risk score cut-off level to favor specific detection of small numbers of patients at very high risk or identification of large numbers of patients at risk. MOCA-I can thus contribute to more adapted treatments and preventive measures from admission, depending on the clinical setting or management strategy.

Comparing Drools and ontology reasoning approaches for telecardiology decision support.

Implantable cardioverter defibrillators can generate numerous alerts. Automatically classifying these alerts according to their severity hinges on the CHA2DS2VASc score. It requires some reasoning capabilities for interpreting the patient's data. We compared two approaches for implementing the reasoning module. One is based on the Drools engine, and the other is based on semantic web formalisms. Both were valid approaches with correct performances. For a broader domain, their limitations are the number and complexity of Drools rules and the performances of ontology-based reasoning, which suggests using the ontology for automatically generating a part of the Drools rules.