JMIR Publications

ABSTRACT

Background:

Clinical diagnosis and treatment decision making support is at the core of medical artificial intelligent research, in which Traditional Chinese Medicine (TCM) decision making is an important part. Traditional Chinese Medicine is a traditional medical system originated from China, of which the main clinical model is to conduct individualized diagnosis and treatment by relying on the four-diagnosis information. One of the key tasks of the TCM artificial intelligence research is to develop techniques and methods of clinical prescription decision making which takes all the relevant information of a patient as input, and produces a diagnosis and treatment scheme as output. Given the complexity of TCM clinical diagnosis and treatment schemes, decision making support of clinical diagnosis and treatment schemes remains as a research challenge for lacking of an effective solution. Fortunately, as the volume of the massive clinical data in the form of electronic medical records increases rapidly, it becomes possible for the computer to produce personalized diagnosis and treatment scheme recommendation through machine learning on the basis of the clinical big data.

Objective:

The objective of this research is to develop a real-time diagnosis and treatment scheme recommendation model for TCM inpatients. This is accomplished by using historical clinical medical records as training data to train a Transformer network. Furthermore, to alleviate the issue of overfitting, a Generative Adversarial Network is used to generate noise-added samples from the original training data. These noise-added samples along with the original samples form the complete train data set.

Methods:

valid information, such as the patient’s current sickness situation, medicines taken, nursing care given, vital signs, examinations and test results, is extracted from the patient’s electronic medical records, then the obtained information is sorted chronically, to produce a sequence of data of each patient. These time-sequence data is then used as input to the Transformer network. The output of the network would be the prescription information a physician would give. Overfitting is a common problem in machine learning, and becomes especially server when the network is complex with insufficient training data. In this research, a Generative Adversarial Network, is used to double the number of training samples by producing noise-added samples from the original samples. This, to a great extent, lessens the overfitting problem.

Results:

A total of 21,295 copies of inpatient electronic medical records from Guang’anmen traditional Chinese medicine hospital was used in this research. These records were created between January 2017 and December 2018, covering a total of 6352 kinds of medicines. These medicines were sorted into 829 types of first category medicines based on the class relationships among medicines. As shown by the test results, the performance of a fully trained Transformer model can have an average precision rate of 80.58%，and an average recall rate of 68.49%.

Conclusions:

As shown by the preliminary test results, the Transformer-based TCM prescription recommendation model outperforms the existing conventional methods. The extra training samples generated by the GAN network helps to overcome the overfitting issue, leading a further improved recall rate and precision rate.