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Human intention recognition for trauma resuscitation: An interpretable deep learning approach for medical process data
Journal article   Open access   Peer reviewed

Human intention recognition for trauma resuscitation: An interpretable deep learning approach for medical process data

Keyi Li, Mary S Kim, Wenjin Zhang, Sen Yang, Genevieve J Sippel, Aleksandra Sarcevic, Randall S Burd and Ivan Marsic
Journal of biomedical informatics, v 161, 104767
31 Dec 2024
PMID: 39746431
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC12208189/pdf/nihms-2092470.pdfView
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Abstract

Deep learning Process mining Predictive models Explainable AI Decision support system Trauma resuscitation
Trauma resuscitation is the initial evaluation and management of injured patients in the emergency department. This time-critical process requires the simultaneous pursuit of multiple resuscitation goals. Recognizing whether the required goal is being pursued can reduce errors in goal-related task performance and improve patient outcomes. The intention to pursue a goal can often be inferred from ongoing and completed treatment activities, but monitoring goal pursuit is cognitively demanding and prone to errors. We introduced an interpretable deep learning-based approach to aid decision making by automatically recognizing goal pursuit during trauma resuscitation. We developed a predictive model to recognize the pursuit of two resuscitation goals: airway stabilization and circulatory support. We used event logs of 381 pediatric trauma resuscitations from August 2014 to November 2022 to train a neural network model with a dual-GRU structure that learns from both time-level and activity-type-level features. Our model makes predictions based on a sequence of activities and corresponding timestamps. To enhance the model and facilitate interpretation of predictions, we used the attention weights assigned by our model to represent the importance of features. These weights identified the critical time points and contributing activities during a goal pursuit. Our model achieved an average area under the receiver operating characteristic curve (AUC) score of 0.84 for recognizing airway stabilization and 0.83 for recognizing circulatory support. The most contributing activities and timestamps were aligned with domain knowledge. Our interpretable predictive model can recognize provider intention based on a limited number of treatment activities. The model outperformed existing predictive models for medical events in accuracy and in interpretability. Integrating our model into a decision-support system would automate the tracking of provider actions, optimizing workflow to ensure timely delivery of care.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Computer Science, Interdisciplinary Applications
Medical Informatics
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