Deep generative learning for automated EHR diagnosis of traditional Chinese medicine

Background: Computer-aided medical decision-making (CAMDM) is the method to utilize massive EMR data as both empirical and evidence support for the decision procedure of healthcare activities. Well-developed information infrastructure, such as hospital information systems and disease surveillance systems, provides abundant data for CAMDM. However, the complexity of EMR data with abstract medical knowledge makes the conventional model incompetent for the analysis. Thus a deep belief networks (DBN) based model is proposed to simulate the information analysis and decision-making procedure in medical practice. The purpose of this paper is to evaluate a deep learning architecture as an effective solution for CAMDM. Methods: A two-step model is applied in our study. At the first step, an optimized seven-layer deep belief network (DBN) is applied as an unsupervised learning algorithm to perform model training to acquire feature representation. Then a support vector machine model is adopted to DBN at the second step of the supervised learning. There are two data sets used in the experiments. One is a plain text data set indexed by medical experts. The other is a structured dataset on primary hypertension. The data are randomly divided to generate the training set for the unsupervised learning and the testing set for the supervised learning. The model performance is evaluated by the statistics of mean and variance, the average precision and coverage on the data sets. Two conventional shallow models (support vector machine / SVM and decision tree / DT) are applied as the comparisons to show the superiority of our proposed approach. Results: The deep learning (DEN SVM) model outperforms simple SVM and DT on two data sets in terms of all the evaluation measures, which confirms our motivation that the deep model is good at capturing the key features with less dependence when the index is built up by manpower. Conclusions: Our study shows the two-step deep learning model achieves high performance for medical information retrieval over the conventional shallow models. It is able to capture the features of both plain text and the highly-structured database of EMR data. The performance of the deep model is superior to the conventional shallow learning models such as SVM and DT. It is an appropriate knowledge-learning model for information retrieval of EMR system. Therefore, deep learning provides a good solution to improve the performance of CAMDM systems. (C) 2018 Elsevier B.V. All rights reserved.