Improving Clinical Decision Making with a Two-Stage Recommender System Based on Language Models: A Case Study on MIMIC-III Dataset

Abstract

Clinical decision making is a challenging and time-consuming task that involves integrating a vast amount of patient data, including medical history, test results, and notes from clinicians. To assist this process, clinical recommender systems have been developed to provide personalized recommendations to healthcare practitioners. However, creating effective clinical recommender systems is complex due to the diversity and intricacy of clinical data and the need for customized recommendations. In this paper, we propose a two-stage recommender framework for clinical decision making based on the publicly available MIMIC dataset of electronic health records. The first stage of the framework employs a deep neural network-based model to retrieve a set of candidate items, such as diagnosis, medication, and prescriptions, from the patient's electronic health records. The model is trained to extract relevant information from clinical notes using a pre-trained language model. The second stage of the framework utilizes a deep learning model to rank and recommend the most pertinent items to healthcare providers. The model considers the patient's medical history and the context of the current visit to offer personalized recommendations. To evaluate the proposed model, we compared it to various baseline models using multiple evaluation metrics, including precision and macro-average F1 score. The findings indicate that the proposed model achieved a precision of 89% and a macro-average F1 score of approximately 84%, indicating its potential to improve clinical decision making and reduce information overload for healthcare providers. The paper also discusses challenges, such as data availability, privacy, and bias, and suggests areas for future research in this field.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

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Data Availability

https://physionet.org/content/mimiciii/1.4/

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