Representation Learning to Advance Multi-institutional Studies with Electronic Health Record Data

• URL: http://arxiv.org/abs/2502.08547v1
• Date: Wed, 12 Feb 2025 16:29:39 GMT
• Title: Representation Learning to Advance Multi-institutional Studies with Electronic Health Record Data
• Authors: Doudou Zhou, Han Tong, Linshanshan Wang, Suqi Liu, Xin Xiong, Ziming Gan, Romain Griffier, Boris Hejblum, Yun-Chung Liu, Chuan Hong, Clara-Lea Bonzel, Tianrun Cai, Kevin Pan, Yuk-Lam Ho, Lauren Costa, Vidul A. Panickan, J. Michael Gaziano, Kenneth Mandl, Vianney Jouhet, Rodolphe Thiebaut, Zongqi Xia, Kelly Cho, Katherine Liao, Tianxi Cai,
• Abstract summary: GAME algorithm is tested and validated across 7 institutions and 2 languages. Jointly trained embeddings are created using transfer and federated learning to preserve data privacy. We highlight the application of GAME in a study of Alzheimer's disease outcomes and suicide risk among patients with mental health disorders.
• Score: 4.571383121011556
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• Abstract: The adoption of EHRs has expanded opportunities to leverage data-driven algorithms in clinical care and research. A major bottleneck in effectively conducting multi-institutional EHR studies is the data heterogeneity across systems with numerous codes that either do not exist or represent different clinical concepts across institutions. The need for data privacy further limits the feasibility of including multi-institutional patient-level data required to study similarities and differences across patient subgroups. To address these challenges, we developed the GAME algorithm. Tested and validated across 7 institutions and 2 languages, GAME integrates data in several levels: (1) at the institutional level with knowledge graphs to establish relationships between codes and existing knowledge sources, providing the medical context for standard codes and their relationship to each other; (2) between institutions, leveraging language models to determine the relationships between institution-specific codes with established standard codes; and (3) quantifying the strength of the relationships between codes using a graph attention network. Jointly trained embeddings are created using transfer and federated learning to preserve data privacy. In this study, we demonstrate the applicability of GAME in selecting relevant features as inputs for AI-driven algorithms in a range of conditions, e.g., heart failure, rheumatoid arthritis. We then highlight the application of GAME harmonized multi-institutional EHR data in a study of Alzheimer's disease outcomes and suicide risk among patients with mental health disorders, without sharing patient-level data outside individual institutions.

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