Explainable Prediction of Medical Codes With Knowledge Graphs

Abstract

International Classification of Diseases (ICD) is an authoritative health care classification system of different diseases. It is widely used for disease and health records, assisted medical reimbursement decisions, and collecting morbidity and mortality statistics. The most existing ICD coding models only translate the simple diagnosis descriptions into ICD codes. And it obscures the reasons and details behind specific diagnoses. Besides, the label (code) distribution is uneven. And there is a dependency between labels. Based on the above considerations, the knowledge graph and attention mechanism were expanded into medical code prediction to improve interpretability. In this study, a new method called G_Coder was presented, which mainly consists of Multi-CNN, graph presentation, attentional matching, and adversarial learning. The medical knowledge graph was constructed by extracting entities related to ICD-9 from freebase. Ontology contains 5 entity classes, which are disease, symptom, medicine, surgery, and examination. The result of G_Coder on the MIMIC-III dataset showed that the micro-F1 score is 69.2% surpassing the state of art. The following conclusions can be obtained through the experiment: G_Coder integrates information across medical records using Multi-CNN and embeds knowledge into ICD codes. Adversarial learning is used to generate the adversarial samples to reconcile the writing styles of doctor. With the knowledge graph and attention mechanism, most relevant segments of medical codes can be explained. This suggests that the knowledge graph significantly improves the precision of code prediction and reduces the working pressure of the human coders.

Keywords: automated ICD coding; explainable; knowledge graphs; medical records; natural language processing.