Cardiovascular diseases are associated with high mortality rates as well as long-lasting morbidities, accounting for 167,000 deaths in the UK each year. They represent a significant burden to the NHS and continued efforts to improve risk prediction are of great importance as they allow preventive interventions.
Existing clinical tools such as the QRISK2 score are often used in primary care settings to assess the 10-year cardiovascular risk of a patient. These tools are derived from population studies and consider well-established risk factors such as age, BMI, smoking, cholesterol levels, hypertension and diabetes. However, short-term predictions can be made following hospital encounter using secondary care electronic health records (EHR).
The new algorithm predicts the likelihood of a patient developing an ischaemic stroke or heart attack based on the EHR data recorded during their previous in-hospital observations. Sensyne Health developed a deep learning-based approach which makes use of a recurrent neural network, with an attention mechanism, for multi-task prediction (prediction over several time horizons, from 1 month to 12 months after the last observation). The new algorithm leverages the full breadth of EHR data for prediction, including information on diagnoses, procedures, medications, encounters, demographics, laboratory values and vital signs.
The algorithm demonstrates advantages compared to traditional methods, when assessing risks over various prediction horizons. Through deep learning, the algorithm can analyze and integrate large amounts of data to predict one of two acute cardiovascular events and the attention mechanism provides clinicians with a better understanding of which specific data points at which time in the patient’s history contributed the most to the risk of a cardiovascular event.
This approach could be used as a risk stratification tool and has the potential to facilitate the targeting of preventive strategies to those most at-risk. The Sensyne Health team will be presenting the findings at the Healthcare Systems, Population Health, and the Role of Health-Tech workshop at the International Conference on Machine Learning (HSYS-ICML 2020).