A Disease-Prediction Protocol Integrating Triage Priority and BERT-Based Transfer Learning for Intelligent Triage

Bioengineering (Basel). 2023 Mar 27;10(4):420. doi: 10.3390/bioengineering10040420.

Abstract

Large hospitals can be complex, with numerous discipline and subspecialty settings. Patients may have limited medical knowledge, making it difficult for them to determine which department to visit. As a result, visits to the wrong departments and unnecessary appointments are common. To address this issue, modern hospitals require a remote system capable of performing intelligent triage, enabling patients to perform self-service triage. To address the challenges outlined above, this study presents an intelligent triage system based on transfer learning, capable of processing multilabel neurological medical texts. The system predicts a diagnosis and corresponding department based on the patient's input. It utilizes the triage priority (TP) method to label diagnostic combinations found in medical records, converting a multilabel problem into a single-label one. The system considers disease severity and reduces the "class overlapping" of the dataset. The BERT model classifies the chief complaint text, predicting a primary diagnosis corresponding to the complaint. To address data imbalance, a composite loss function based on cost-sensitive learning is added to the BERT architecture. The study results indicate that the TP method achieves a classification accuracy of 87.47% on medical record text, outperforming other problem transformation methods. By incorporating the composite loss function, the system's accuracy rate improves to 88.38% surpassing other loss functions. Compared to traditional methods, this system does not introduce significant complexity, yet substantially improves triage accuracy, reduces patient input confusion, and enhances hospital triage capabilities, ultimately improving the patient's medical experience. The findings could provide a reference for intelligent triage development.

Keywords: BERT; cost-sensitive; data imbalance; intelligent triage; multilabel; neurological; transfer learning.