Knowledge-Enriched Structured EHR Features for 30-Day Hospital Readmission Prediction on MIMIC-IV

2026-09-14

AI Summary

该研究通过结合四种医学知识源增强结构化电子健康记录特征，不依赖临床笔记预测30天内再入院情况，减少计算成本并提高解释性。

Abstract

Recent approaches to 30-day hospital readmission prediction rely on pre-trained language models applied to discharge summaries. Although these methods achieve strong performance, they depend on the availability of clinical notes, incur substantial computational costs, and yield representations that lack interpretability. We propose a knowledge-enriched feature representation that augments structured Electronic Health Record (EHR) data with four medical knowledge sources: disease ontology mapping, procedure classification, drug ingredient vocabulary, and organ system laboratory aggregation, without using clinical notes. Each feature dimension corresponds to a named clinical concept, yielding a sparse and interpretable patient representation. The approach is evaluated with six classifiers on a MIMIC-IV v2.2 cohort. Under 20-fold cross-validation, the best configuration achieves an AUROC of 0.743. This performance is comparable to that of previously reported methods on this dataset, including both those using only structured data and those incorporating clinical notes, while requiring considerably less computational cost. Interpretability analysis shows that demographics, organ system labs, drug ingredient features, and first-level ontology disease categories drive prediction, while deeper hierarchy levels contribute negligibly. These findings indicate that knowledge-enriched structured features offer a competitive and efficient alternative to embeddings from clinical notes for 30-day readmission prediction.

Problem

• 30-day hospital readmission
• pre-trained language models
• clinical notes
• computational costs
• interpretability

Innovation

• knowledge-enriched
• structured EHR
• feature representation
• interpretability
• computational cost