The recent success of machine learning methods applied to time series collected from Intensive Care Units (ICU) exposes the lack of standardized machine learning benchmarks for developing and comparing such methods. While raw datasets, such as MIMIC-IV or eICU, can be freely accessed on Physionet, the choice of tasks and pre-processing is often chosen ad-hoc for each publication, limiting comparability across publications. In this work, we aim to improve this situation by providing a benchmark covering a large spectrum of ICU-related tasks. Using the HiRID dataset, we define multiple clinically relevant tasks in collaboration with clinicians. In addition, we provide a reproducible end-to-end pipeline to construct both data and labels. Finally, we provide an in-depth analysis of current state-of-the-art sequence modeling methods, highlighting some limitations of deep learning approaches for this type of data. With this benchmark, we hope to give the research community the possibility of a fair comparison of their work.
Leading up to August 2020, COVID-19 has spread to almost every country in the world, causing millions of infected and hundreds of thousands of deaths. In this paper, we first verify the assumption that clinical variables could have time-varying effects on COVID-19 outcomes. Then, we develop a temporal stratification approach to make daily predictions on patients' outcome at the end of hospital stay. Training data is segmented by the remaining length of stay, which is a proxy for the patient's overall condition. Based on this, a sequence of predictive models are built, one for each time segment. Thanks to the publicly shared data, we were able to build and evaluate prototype models. Preliminary experiments show 0.98 AUROC, 0.91 F1 score and 0.97 AUPR on continuous deterioration prediction, encouraging further development of the model as well as validations on different datasets. We also verify the key assumption which motivates our method. Clinical variables could have time-varying effects on COVID-19 outcomes. That is to say, the feature importance of a variable in the predictive model varies at different disease stages.
The pressure of ever-increasing patient demand and budget restrictions make hospital bed management a daily challenge for clinical staff. Most critical is the efficient allocation of resource-heavy Intensive Care Unit (ICU) beds to the patients who need life support. Central to solving this problem is knowing for how long the current set of ICU patients are likely to stay in the unit. In this work, we propose a new deep learning model based on the combination of temporal convolution and pointwise (1x1) convolution, to solve the length of stay prediction task on the eICU and MIMIC-IV critical care datasets. The model - which we refer to as Temporal Pointwise Convolution (TPC) - is specifically designed to mitigate common challenges with Electronic Health Records, such as skewness, irregular sampling and missing data. In doing so, we have achieved significant performance benefits of 18-68% (metric and dataset dependent) over the commonly used Long-Short Term Memory (LSTM) network, and the multi-head self-attention network known as the Transformer. By adding mortality prediction as a side-task, we can improve performance further still, resulting in a mean absolute deviation of 1.55 days (eICU) and 2.28 days (MIMIC-IV) on predicting remaining length of stay.