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GAMENet: Graph Augmented MEmory Networks for Recommending Medication Combination (1809.01852v3)

Published 6 Sep 2018 in cs.AI, cs.LG, and stat.ML

Abstract: Recent progress in deep learning is revolutionizing the healthcare domain including providing solutions to medication recommendations, especially recommending medication combination for patients with complex health conditions. Existing approaches either do not customize based on patient health history, or ignore existing knowledge on drug-drug interactions (DDI) that might lead to adverse outcomes. To fill this gap, we propose the Graph Augmented Memory Networks (GAMENet), which integrates the drug-drug interactions knowledge graph by a memory module implemented as a graph convolutional networks, and models longitudinal patient records as the query. It is trained end-to-end to provide safe and personalized recommendation of medication combination. We demonstrate the effectiveness and safety of GAMENet by comparing with several state-of-the-art methods on real EHR data. GAMENet outperformed all baselines in all effectiveness measures, and also achieved 3.60% DDI rate reduction from existing EHR data.

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Authors (5)
  1. Junyuan Shang (15 papers)
  2. Cao Xiao (84 papers)
  3. Tengfei Ma (73 papers)
  4. Hongyan Li (37 papers)
  5. Jimeng Sun (181 papers)
Citations (231)

Summary

  • The paper introduces a graph augmented memory network that improves medication safety by integrating patient history with drug-drug interaction data.
  • It employs a dual-RNN framework and graph convolutional networks to capture temporal dependencies and complex inter-medication relationships.
  • Evaluation on MIMIC-III data shows enhanced predictive accuracy, with reduced DDI risk by 3.60% compared to established methods.

Insights into Graph Augmented Memory Networks for Medication Recommendation

GAMENet proposes a novel approach for medication recommendation, particularly focusing on combinations of medications for patients with multifaceted health conditions, a significant challenge in personalized healthcare. The model addresses the limitations of existing methodologies, which often neglect patient history and crucial knowledge on drug-drug interactions (DDI). These oversights can lead to suboptimal and potentially harmful medication regimens. By leveraging longitudinal patient records and drug knowledge on DDI, GAMENet presents a robust framework to enhance both the safety and efficacy of medication recommendations.

Framework and Methodology

GAMENet's model architecture incorporates three main components: medical embedding, patient representation, and a graph augmented memory module. The medical embedding module transforms clinical codes into a continuous representation that captures underlying semantics. The patient representation module employs a dual-RNN framework that accommodates heterogeneous EHR data types, thus effectively capturing temporal dependencies crucial for personalized recommendations.

The graph augmented memory module is noteworthy for its integration of multi-modal data sources: the memory bank stores enriched medication embeddings from both EHR and DDI graphs via graph convolutional networks (GCN). This embedding scheme allows GAMENet to encode complex interactions present in medical data more effectively than isolated approaches.

The model is optimized using a combined loss function that balances accurate predictions with minimizing DDI risk. This assists in avoiding adverse interactions while achieving high predictive accuracy.

Numerical Results

In the evaluation using MIMIC-III EHR data, GAMENet demonstrates significant improvements over leading baselines such as RETAIN and DMNC in several performance metrics: Jaccard similarity and precision-recall area under curve (PR-AUC) improvements underscore its prowess in predictive accuracy. The model’s approach in reducing DDI rates by 3.60% relative to existing EHR data highlights its capability in recommending safer medication combinations.

Implications for AI in Healthcare

The implications of GAMENet's contributions extend to practical applications in clinical settings, where decision support systems must consider both efficacy and safety. Incorporating graph-augmented memory in neural networks can open new avenues for effectively managing and predicting outcomes in complex datasets beyond healthcare, potentially enhancing other recommendation systems.

Future Prospects

Future research directions could focus on expanding the scope of this work to other aspects of healthcare and personalized medicine, such as treatment optimizations that consider patient lifestyle factors or genomic data. There is also potential to explore advanced DDI mitigation strategies, such as proposing alternative medications with similar therapeutic effects but reduced adverse interaction risks. Enhancing the explainability of GAMENet's predictions will be crucial in fostering trust and interpretability among healthcare practitioners.

GAMENet stands as a promising advancement in the integration of machine learning, graph theory, and healthcare, demonstrating the practical benefits and broad potential of AI technologies in transforming medical decision-making.