Citation

Dong X, Wong R, Lyu W, Abell-Hart K, Deng J, Liu Y, Hajagos JG, Rosenthal RN, Chen C, Wang F. Artif. Intell. Med. 2023; 135: e102439.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.artmed.2022.102439

PMID

36628797

Abstract

Opioid overdose (OD) has become a leading cause of accidental death in the United States, and overdose deaths reached a record high during the COVID-19 pandemic. Combating the opioid crisis requires targeting high-need populations by identifying individuals at risk of OD. While deep learning emerges as a powerful method for building predictive models using large scale electronic health records (EHR), it is challenged by the complex intrinsic relationships among EHR data. Further, its utility is limited by the lack of clinically meaningful explainability, which is necessary for making informed clinical or policy decisions using such models. In this paper, we present LIGHTED, an integrated deep learning model combining long short term memory (LSTM) and graph neural networks (GNN) to predict patients' OD risk. The LIGHTED model can incorporate the temporal effects of disease progression and the knowledge learned from interactions among clinical features. We evaluated the model using Cerner's Health Facts database with over 5 million patients. Our experiments demonstrated that the model outperforms traditional machine learning methods and other deep learning models. We also proposed a novel interpretability method by exploiting embeddings provided by GNNs to cluster patients and EHR features respectively, and conducted qualitative feature cluster analysis for clinical interpretations. Our study shows that LIGHTED can take advantage of longitudinal EHR data and the intrinsic graph structure of EHRs among patients to provide effective and interpretable OD risk predictions that may potentially improve clinical decision support.

Language: en

Keywords

Humans; *COVID-19/epidemiology; Pandemics; Deep learning; Neural Networks, Computer; *Opiate Overdose; Clinical decision support; Electronic health records; Electronic Health Records; Graph neural network; Long short-term memory; Machine Learning; Opioid overdose; Opioid poisoning