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CN114822737B - Electronic medical record-based Litsea artificial liver preoperative diagnosis and treatment system and use method - Google Patents

Electronic medical record-based Litsea artificial liver preoperative diagnosis and treatment system and use method Download PDF

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CN114822737B
CN114822737B CN202210343260.3A CN202210343260A CN114822737B CN 114822737 B CN114822737 B CN 114822737B CN 202210343260 A CN202210343260 A CN 202210343260A CN 114822737 B CN114822737 B CN 114822737B
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金心宇
龚善超
张�杰
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Abstract

The invention discloses a Litsea artificial liver preoperative diagnosis and treatment system based on an electronic medical record, which comprises a medical record management subsystem and an intelligent analysis subsystem, wherein the medical record management subsystem comprises an electronic medical record uploading unit, a database storage unit and a search engine unit; the attention-based multi-feature fusion prediction unit comprises a text data feature extraction network, a numerical data extraction network and a feature fusion classification network, the invention also discloses a method for using the Litsea artificial liver preoperative diagnosis and treatment system based on the electronic medical record. According to the invention, the pure text data and the check value data in the electronic medical record information can be analyzed by adopting a deep learning network and a classification result is given.

Description

一种基于电子病历的李氏人工肝术前诊疗系统及使用方法A Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records and its use method

技术领域Technical Field

本发明涉及计算机辅助诊疗和图像识别领域,具体是一种基于电子病历的李氏人工肝术前诊疗系统及使用方法。The present invention relates to the field of computer-aided diagnosis and treatment and image recognition, and in particular to a Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records and a use method thereof.

背景技术Background Art

肝脏疾病一直以来都对人类生命健康构成了严重威胁。世界卫生组织的报道指出,肝癌已成为人类第二大死因,李氏人工肝支持系统是一种有效的重症肝病治疗手段,李氏人工肝主要通过肝细胞的再生能力,通过外部设备,包括机械、理化或生物装置,在清除肝衰竭产生的有害物质的同时补充人体的必需成分,稳定机体内环境,并暂时替代部分肝脏功能。Liver diseases have always posed a serious threat to human life and health. The World Health Organization reported that liver cancer has become the second leading cause of death in humans. The Lee's artificial liver support system is an effective treatment for severe liver diseases. The Lee's artificial liver mainly uses the regenerative ability of liver cells and external equipment, including mechanical, physical, chemical or biological devices, to replenish the body's essential components while removing harmful substances produced by liver failure, stabilize the body's internal environment, and temporarily replace some liver functions.

随着互联网技术的飞速发展和信息化的普及,医院的信息管理系统日趋完善。在此基础上,利用医院信息系统中现有数据资源进行人工肝的术前分析,不仅可以提高诊疗的效率,同时也可以提供辅助诊疗的意见,对人工肝诊疗成效具有重要意义。但肝衰竭患者入院后,需要接受大量的常规项目检查和综合的内科治疗,医院信息系统中肝衰竭患者现有数据量十分多,包括入院记录、病程记录、指标检验结果、CT影像等等一系列医疗数据,因此医生采用传统的人力方式进行术前分析需要耗费大量的时间和精力,且准确度受医生的经验和精力的限制,因此需要一种方法,能够通过深度学习算法实现对医院信息系统中现有数据资源分析,减轻医生的负担。With the rapid development of Internet technology and the popularization of informatization, the hospital's information management system is becoming more and more perfect. On this basis, using the existing data resources in the hospital information system to conduct preoperative analysis of artificial liver can not only improve the efficiency of diagnosis and treatment, but also provide auxiliary diagnosis and treatment opinions, which is of great significance to the effectiveness of artificial liver diagnosis and treatment. However, after admission to the hospital, patients with liver failure need to undergo a large number of routine examinations and comprehensive medical treatment. The amount of existing data on patients with liver failure in the hospital information system is very large, including admission records, medical records, index test results, CT images, and other medical data. Therefore, it takes a lot of time and energy for doctors to use traditional manpower methods for preoperative analysis, and the accuracy is limited by the doctor's experience and energy. Therefore, a method is needed to analyze the existing data resources in the hospital information system through deep learning algorithms to reduce the burden on doctors.

发明内容Summary of the invention

本发明要解决的技术问题是提供一种基于电子病历的李氏人工肝术前诊疗系统及使用方法,用以对电子病历信息中的纯本文类数据和检验数值数据采用深度学习网络进行分析并给出分类结果。The technical problem to be solved by the present invention is to provide a Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records and a method of use, which is used to analyze the pure text category data and test numerical data in the electronic medical record information using a deep learning network and give classification results.

为了解决上述技术问题,本发明提供一种基于电子病历的李氏人工肝术前诊疗系统及使用方法,包括:病历管理子系统和智能分析子系统,病历管理子系统包括电子病历记录上传单元、数据库存储单元和搜索引擎单元,智能分析子系统包括基于注意力的多特征融合预测单元;电子病历记录上传单元和数据库存储单元之间、数据库存储单元之间和搜索引擎单元之间、搜索引擎单元和智能分析子系统之间的相互信号连接;In order to solve the above technical problems, the present invention provides a preoperative diagnosis and treatment system of Lee's artificial liver based on electronic medical records and a method of use, including: a medical record management subsystem and an intelligent analysis subsystem, the medical record management subsystem includes an electronic medical record upload unit, a database storage unit and a search engine unit, the intelligent analysis subsystem includes an attention-based multi-feature fusion prediction unit; mutual signal connections between the electronic medical record upload unit and the database storage unit, between the database storage units and the search engine unit, and between the search engine unit and the intelligent analysis subsystem;

所述基于注意力的多特征融合预测单元包括文本数据特征提取网络、数值数据提取网络和特征融合分类网络,文本数据特征提取网络和数值数据提取网络的输出同时作为特征融合分类网络的输入。The attention-based multi-feature fusion prediction unit includes a text data feature extraction network, a numerical data extraction network and a feature fusion classification network, and the outputs of the text data feature extraction network and the numerical data extraction network are simultaneously used as inputs of the feature fusion classification network.

作为本发明的一种基于电子病历的李氏人工肝术前诊疗系统的改进:As an improvement of the Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records of the present invention:

所述病历管理子系统包括用以输电子病历信息的病历输入单元和上传电子病历信息的病历上传单元;所述数据库存储单元中包括存有电子病历信息的电子病历数据库。The medical record management subsystem includes a medical record input unit for inputting electronic medical record information and a medical record upload unit for uploading electronic medical record information; the database storage unit includes an electronic medical record database storing electronic medical record information.

作为本发明的一种基于电子病历的李氏人工肝术前诊疗系统的进一步改进:As a further improvement of the electronic medical record-based Lee's artificial liver preoperative diagnosis and treatment system of the present invention:

所述文本数据特征提取网络的结构为:第一层为词嵌入层,输出尺寸为32*256*200;第二层为BiLSTM层,输出尺寸为32*256*256;第三层为注意力层,输出尺寸为32*256*256,第四层为拼接层,输出尺寸为32*256*456;第5层为全连接层,输出尺寸为32*256*64;第6层为池化层,输出尺寸为32*64;第一层至第六层依次连接,且,第一层的词嵌入层的输出和第四层的拼接层输入相连接;The structure of the text data feature extraction network is as follows: the first layer is a word embedding layer with an output size of 32*256*200; the second layer is a BiLSTM layer with an output size of 32*256*256; the third layer is an attention layer with an output size of 32*256*256; the fourth layer is a splicing layer with an output size of 32*256*456; the fifth layer is a fully connected layer with an output size of 32*256*64; the sixth layer is a pooling layer with an output size of 32*64; the first to sixth layers are connected in sequence, and the output of the word embedding layer of the first layer is connected to the input of the splicing layer of the fourth layer;

所述数值特征提取网络的结构为:第一层输入层,输出尺寸32*200;第二层为全连接层,输出尺寸为32*128;第三层为全连接层,输出尺寸为32*64,且第一层至第三层依次连接;The structure of the numerical feature extraction network is as follows: the first layer is an input layer, and the output size is 32*200; the second layer is a fully connected layer, and the output size is 32*128; the third layer is a fully connected layer, and the output size is 32*64, and the first layer to the third layer are connected in sequence;

所述特征融合分类网络的结构为:第一层为拼接层,输出尺寸为32*128;第二层为全连接层,输出尺寸为32*64;第三层为全连接层,输出尺寸为32*2,评估的分类结果为二分类预测结果,且第一层至第三层依次连接。The structure of the feature fusion classification network is as follows: the first layer is a concatenation layer with an output size of 32*128; the second layer is a fully connected layer with an output size of 32*64; the third layer is a fully connected layer with an output size of 32*2. The evaluated classification result is a binary classification prediction result, and the first to third layers are connected in sequence.

作为本发明的一种基于电子病历的李氏人工肝术前诊疗系统的进一步改进:As a further improvement of the electronic medical record-based Lee's artificial liver preoperative diagnosis and treatment system of the present invention:

所述电子病历信息包括了病人基础信息、主治医生信息、纯本文类数据和检验数值数据;病人基础信息包括病人姓名、性别和病案号;主治医生信息包括主治医生姓名、科室和主治医生编号;纯本文类数据包括个人史、既往史和主诉;检验数值数据包括各种检验指标数据。The electronic medical record information includes patient basic information, attending physician information, pure text data and test numerical data; patient basic information includes patient name, gender and medical record number; attending physician information includes attending physician name, department and attending physician number; pure text data includes personal history, past history and chief complaint; test numerical data includes various test index data.

作为本发明的一种基于电子病历的李氏人工肝术前诊疗系统的进一步改进:As a further improvement of the electronic medical record-based Lee's artificial liver preoperative diagnosis and treatment system of the present invention:

所述基于注意力的多特征融合预测单元的训练和测试过程为:构建训练集、验证集和测试集,多特征融合预测单元的batch_size设为32,学习率为0.001,迭代次数为30,Dropout值设置为0.1,优化策略是Adam梯度下降法,激活函数为Relu:将训练集、验证集输入基于注意力的多特征融合预测单元进行训练,得到训练好的基于注意力的多特征融合预测单元;然后将测试集输入训练好的基于注意力的多特征融合预测单元中进行测试,并将输出的二分类预测结果与测试集中对应的标注进行对比达到在线使用的要求。The training and testing process of the attention-based multi-feature fusion prediction unit is as follows: construct a training set, a validation set and a test set, the batch_size of the multi-feature fusion prediction unit is set to 32, the learning rate is 0.001, the number of iterations is 30, the Dropout value is set to 0.1, the optimization strategy is the Adam gradient descent method, and the activation function is Relu: the training set and the validation set are input into the attention-based multi-feature fusion prediction unit for training to obtain a trained attention-based multi-feature fusion prediction unit; then the test set is input into the trained attention-based multi-feature fusion prediction unit for testing, and the output binary classification prediction results are compared with the corresponding annotations in the test set to meet the requirements for online use.

作为本发明的一种基于电子病历的李氏人工肝术前诊疗系统的进一步改进:As a further improvement of the electronic medical record-based Lee's artificial liver preoperative diagnosis and treatment system of the present invention:

所述构建训练集、验证集和测试集的过程为:收集肝衰竭病人的电子病历信息,由专业医生对每份电子病历标注,并对每份电子病历信息中的纯本文类数据和检验数值数据分别进行预处理,然后将带有标注的预处理后的纯本文类数据和检验数值数据以7:2:1的比例划分为训练集、测试集和验证集The process of constructing the training set, validation set and test set is as follows: electronic medical record information of patients with liver failure is collected, each electronic medical record is annotated by a professional doctor, and the pure text category data and test value data in each electronic medical record information are preprocessed respectively, and then the preprocessed pure text category data and test value data with annotations are divided into the training set, the test set and the validation set in a ratio of 7:2:1.

检验数值数据的所述预处理为将检验数值数据按下式(1)进行归一化:The preprocessing of the test numerical data is to normalize the test numerical data according to the following formula (1):

其中xnorm、xmin、xmax分别为归一化后的检验数值、该项检验数值数据的最小值、该项检验数值数据的最大值;Where x norm , x min , and x max are the normalized test value, the minimum value of the test value data, and the maximum value of the test value data respectively;

纯本文类数据的所述预处理为先使用分词工具对纯本文类数据进行分词处理得到一组关键词,然后将关键词转换为200维向量。The preprocessing of the pure text category data is to first use a word segmentation tool to perform word segmentation processing on the pure text category data to obtain a group of keywords, and then convert the keywords into a 200-dimensional vector.

本发明还同时提供了一种基于电子病历的李氏人工肝术前诊疗系统的使用方法,包括的步骤为:The present invention also provides a method for using the Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records, comprising the following steps:

步骤S01、电子病历信息管理Step S01: Electronic medical record information management

步骤S101、电子病历信息上传Step S101: Upload electronic medical record information

通过电子病历记录上传单元录入并上传电子病历信息到数据库存储单元,包括纯本文类数据和检验数值数据;电子病历信息的数据统一存储到数据库存储单元中;Enter and upload electronic medical record information to the database storage unit through the electronic medical record upload unit, including pure text data and test numerical data; the data of the electronic medical record information is uniformly stored in the database storage unit;

步骤S102、电子病历搜索Step S102: Electronic medical record search

使用者通过搜索引擎单元输入关键词,包括“患者姓名”、“病案号”、“医生姓名”或“医生编号”;搜索引擎单元在数据库存储单元的电子病历信息中,按输入的关键词进行搜索匹配并在上位机上呈现搜索结果;The user inputs keywords, including "patient name", "medical record number", "doctor name" or "doctor number" through the search engine unit; the search engine unit searches and matches the electronic medical record information in the database storage unit according to the input keywords and presents the search results on the host computer;

步骤S103、电子病历信息更新Step S103: Update electronic medical record information

首先按步骤S102搜索获得待更新的电子病历信息,然后通过步骤S101录入并上传更新后的电子病历信息到数据库存储单元;First, the electronic medical record information to be updated is searched and obtained in step S102, and then the updated electronic medical record information is input and uploaded to the database storage unit in step S101;

步骤02、预测评估Step 02: Prediction Evaluation

步骤0201、通过步骤S102搜索获取电子病历信息并将电子病历信息传送至智能分析子系统;Step 0201, searching and acquiring electronic medical record information through step S102 and transmitting the electronic medical record information to the intelligent analysis subsystem;

步骤0202、智能分析子系统对电子病历信息中的纯文本类数据和检验数值数据分别进行预处理;Step 0202, the intelligent analysis subsystem pre-processes the plain text data and the test value data in the electronic medical record information respectively;

步骤0203、将纯文本类数据预处理获得的200维向量和检验数值数据预处理获得的归一化后的检验数值数据输入多特征融合预测单元,进行预测评估后获得二分类预测结果,并将预测结果在上位机上显示。Step 0203: Input the 200-dimensional vector obtained by preprocessing the pure text data and the normalized test numerical data obtained by preprocessing the test numerical data into the multi-feature fusion prediction unit, obtain the binary classification prediction result after prediction evaluation, and display the prediction result on the host computer.

本发明的有益效果主要体现在:The beneficial effects of the present invention are mainly reflected in:

1、本发明分别对电子病历记录中的纯本文类数据和检验数值数据提取特征,特征融合分类网络能够融合所提取的纯本文类数据和检验数值数据的特征并给出分类结果,从而提高了医生的工作效率,减少了时间成本和人力成本;1. The present invention extracts features from pure text category data and test value data in electronic medical records respectively. The feature fusion classification network can fuse the features of the extracted pure text category data and test value data and give classification results, thereby improving the doctor's work efficiency and reducing time and labor costs;

2、本发明的采用深度学习网络对电子病历记录进行分析和评估,能够提高评估结果的正确率,减少误判的次数。2. The present invention uses a deep learning network to analyze and evaluate electronic medical records, which can improve the accuracy of evaluation results and reduce the number of misjudgments.

附图说明BRIEF DESCRIPTION OF THE DRAWINGS

下面结合附图对本发明的具体实施方式作进一步详细说明。The specific implementation modes of the present invention are further described in detail below with reference to the accompanying drawings.

图1为本发明的一种基于电子病历的李氏人工肝术前诊疗系统的整体架构图;FIG1 is an overall architecture diagram of a Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records of the present invention;

图2为本发明的基于注意力的多特征融合预测单元的网络结构示意图。FIG2 is a schematic diagram of the network structure of the attention-based multi-feature fusion prediction unit of the present invention.

具体实施方式DETAILED DESCRIPTION

下面结合具体实施例对本发明进行进一步描述,但本发明的保护范围并不仅限于此:The present invention is further described below in conjunction with specific embodiments, but the protection scope of the present invention is not limited thereto:

实施例1、一种基于电子病历的李氏人工肝术前诊疗系统及使用方法,如图1-2所示,通过基于电子病历的李氏人工肝术前诊疗系统(包括病历管理子系统和智能分析子系统),让医生可以在上位机操作本系统,进行管理、更新、上传电子病历,同时能够间接调用深度学习的算法模型输出分类结果,为医生判断病人是否适用于李氏人工肝仪器提供参考。Embodiment 1, a preoperative diagnosis and treatment system of Lee's artificial liver based on electronic medical records and a method of use, as shown in Figure 1-2, through the Lee's artificial liver preoperative diagnosis and treatment system based on electronic medical records (including a medical record management subsystem and an intelligent analysis subsystem), doctors can operate the system on a host computer to manage, update, and upload electronic medical records. At the same time, it can indirectly call the deep learning algorithm model to output classification results, providing a reference for doctors to judge whether patients are suitable for Lee's artificial liver instruments.

病历管理子系统包括电子病历记录上传单元、数据库存储单元和搜索引擎单元;电子病历记录上传单元包括病历输入单元和病历上传单元,用于记录电子病历信息并上传存储至数据库存储单元,电子病历信息包括了病人基础信息(包括病人姓名、性别、病案号等)、主治医生信息(包括主治医生姓名、科室、主治医生编号等)、纯本文类数据(包括个人史、既往史、主诉等)、检验数值数据(包括血压、血糖等200种检验指标数据);数据库存储单元数据库存储单元中包括电子病历数据库,用于存放所有电子病历信息;搜索引擎单元可以通过“病人姓名”、“病案号”、“医生姓名”或“医生编号”等关键词,在数据库存储单元的各条电子病历信息中,对病人的相关信息进行搜索匹配;The medical record management subsystem includes an electronic medical record upload unit, a database storage unit and a search engine unit; the electronic medical record upload unit includes a medical record input unit and a medical record upload unit, which are used to record electronic medical record information and upload and store it in the database storage unit. The electronic medical record information includes basic patient information (including patient name, gender, medical record number, etc.), attending physician information (including attending physician name, department, attending physician number, etc.), pure text data (including personal history, past history, chief complaint, etc.), and test numerical data (including 200 test index data such as blood pressure and blood sugar); the database storage unit includes an electronic medical record database for storing all electronic medical record information; the search engine unit can search and match the patient's relevant information in each electronic medical record information of the database storage unit through keywords such as "patient name", "medical record number", "doctor name" or "doctor number";

智能分析子系统包括基于注意力的多特征融合预测单元。电子病历通过智能分析子系统的处理,可以得到基于注意力的多特征融合预测单元的分类结果,用于医生判断病人是否适用于李氏人工肝仪器提供参考。基于注意力的多特征融合预测单元创新性地融合了电子病历数据中的纯本文类数据和检验数值数据,使得评估效果更加准确。The intelligent analysis subsystem includes an attention-based multi-feature fusion prediction unit. After the electronic medical record is processed by the intelligent analysis subsystem, the classification results of the attention-based multi-feature fusion prediction unit can be obtained, which can be used by doctors to determine whether the patient is suitable for the Lee's artificial liver instrument. The attention-based multi-feature fusion prediction unit innovatively integrates the pure text category data and test numerical data in the electronic medical record data, making the evaluation effect more accurate.

基于注意力的多特征融合预测单元包括文本数据特征提取网络、数值数据提取网络和特征融合分类网络,如图2所示。文本数据特征提取网络是基于TextRCNN网络添加了注意力层和拼接层,具体结构为:第一层为词嵌入层,输出尺寸为32*256*200;第二层为BiLSTM层,输出尺寸为32*256*256;第三层为注意力层,输出尺寸为32*256*256,文本数据特征提取网络添加的注意力层主要用于优化病历文本中因非相关词汇较多而导致文本数据信息容量大、特征表征不突出的问题,用以增强对与病情预测关键词汇特征的影响,以提升模型预测准确率与泛化能力;第四层为拼接层,输出尺寸为32*256*456;第5层为全连接层,输出尺寸为32*256*64;第6层为池化层,输出尺寸为32*64;第一层至第六层依次连接,且,第一层的词嵌入层的输出和第四层的拼接层输入相连接,用于将第一层的词嵌入层输出和第三层的注意力层输出的结果进行拼接操作,可以同时保留注意力层的特征与词嵌入层的特征。文本数据特征提取网络用于提取电子病历信息中的纯本文类数据的特征。The attention-based multi-feature fusion prediction unit includes a text data feature extraction network, a numerical data extraction network, and a feature fusion classification network, as shown in Figure 2. The text data feature extraction network is based on the TextRCNN network with an added attention layer and a splicing layer. The specific structure is as follows: the first layer is a word embedding layer with an output size of 32*256*200; the second layer is a BiLSTM layer with an output size of 32*256*256; the third layer is an attention layer with an output size of 32*256*256. The attention layer added to the text data feature extraction network is mainly used to optimize the problem of large text data information capacity and unremarkable feature representation in the medical record text due to the large number of non-related words, so as to enhance the prediction of the disease. The influence of key vocabulary features is measured to improve the prediction accuracy and generalization ability of the model; the fourth layer is a concatenation layer with an output size of 32*256*456; the fifth layer is a fully connected layer with an output size of 32*256*64; the sixth layer is a pooling layer with an output size of 32*64; the first to sixth layers are connected in sequence, and the output of the word embedding layer of the first layer is connected to the input of the concatenation layer of the fourth layer, which is used to concatenate the output of the word embedding layer of the first layer and the output of the attention layer of the third layer, and the features of the attention layer and the word embedding layer can be retained at the same time. The text data feature extraction network is used to extract the features of pure text category data in electronic medical record information.

数值特征提取网络用于提取电子病历信息中检验数值数据的特征;数值特征提取网络的具体结构为:第一层为输入层,输出尺寸32*200;第二层为全连接层,输出尺寸为32*128;第三层为全连接层,输出尺寸为32*64,且第一层至第三层依次连接。电子病历信息中的检验数值数据有血压、血糖等200种检验数据。由于检验数值数据特征之间量纲不一,不具可比性,若直接送入网络会导致数值较高的数据特征会更显著,而数值低的数据特征会更弱,因此需要先对检验数值数据进行归一化:The numerical feature extraction network is used to extract the features of the test numerical data in the electronic medical record information; the specific structure of the numerical feature extraction network is: the first layer is the input layer, and the output size is 32*200; the second layer is the fully connected layer, and the output size is 32*128; the third layer is the fully connected layer, and the output size is 32*64, and the first to third layers are connected in sequence. The test numerical data in the electronic medical record information includes 200 types of test data such as blood pressure and blood sugar. Because the features of the test numerical data are of different dimensions and are not comparable, if they are directly sent to the network, the features of the data with higher values will be more significant, while the features of the data with lower values will be weaker. Therefore, the test numerical data needs to be normalized first:

其中,xnorm,xmin,xmax分别为归一化后的检验数值、该项检验数值数据的最小值、该项检验数值数据的最大值。Among them, x norm , x min , and x max are the normalized test value, the minimum value of the test value data, and the maximum value of the test value data, respectively.

特征融合分类网络主要用于纯本文类数据的特征与检验数值数据的特征融合并进行分类预测;特征融合分类网络的具体结构为第一层为拼接层,输出尺寸为32*128;第二层为全连接层,输出尺寸为32*64;第三层为全连接层,输出尺寸为32*2,且第一层至第三层依次连接。评估的分类结果为二分类预测结果。The feature fusion classification network is mainly used to fuse the features of pure text data with the features of test numerical data and perform classification prediction; the specific structure of the feature fusion classification network is that the first layer is a concatenation layer with an output size of 32*128; the second layer is a fully connected layer with an output size of 32*64; the third layer is a fully connected layer with an output size of 32*2, and the first to third layers are connected in sequence. The classification results evaluated are binary classification prediction results.

对基于注意力的多特征融合预测单元需进行训练,训练使用的上位机配置为Centos6.7操作系统,选用E5-2667 v4@3.20GHz、8核心数的CPU,2块型号为Tesla P4的GPU;训练所用的数据集为在三甲医院提供的肝衰竭的电子病历信息集,共有1024份电子病历信息,每份电子病历信息均由专业医生根据病人的真实病情进行分类标注,其中分类标注为1的有498份表示适用于李氏人工肝仪器,分类标注为2的有526份表示不适用于李氏人工肝仪器。The attention-based multi-feature fusion prediction unit needs to be trained. The host computer used for training is configured with the Centos6.7 operating system, and uses an E5-2667 v4@3.20GHz, 8-core CPU, and 2 Tesla P4 GPUs. The data set used for training is the electronic medical record information set of liver failure provided by a tertiary hospital. There are a total of 1,024 electronic medical records, and each electronic medical record is classified and labeled by a professional doctor according to the patient's actual condition. Among them, 498 records are classified as 1, indicating that they are suitable for the Lee's artificial liver instrument, and 526 records are classified as 2, indicating that they are not suitable for the Lee's artificial liver instrument.

然后对1024份电子病历信息中的纯本文类数据和检验数值数据分别进行预处理,纯文本类数据的预处理包括:Then, the pure text data and test value data in the 1024 electronic medical records were preprocessed respectively. The preprocessing of the pure text data included:

1)、使用Jieba分词工具对纯本文类数据进行分词处理,得到一组关键词;1) Use Jieba word segmentation tool to segment the pure text data to obtain a set of keywords;

2)、使用Glove工具将得到的关键词转换为200维向量。2) Use the Glove tool to convert the obtained keywords into a 200-dimensional vector.

检验数值数据的预处理是按式(1)对检验数值数据分别进行归一化操作。The preprocessing of the test numerical data is to perform normalization operation on the test numerical data according to formula (1).

将预处理获得的200维向量、归一化的检验数值数据及对应的分类标注以7:2:1的比例划分为训练集、测试集和验证集。网络的batch_size设为32,学习率为0.001,迭代次数为30,Dropout值设置为0.1,优化策略是Adam梯度下降法,激活函数为Relu,公式如下,优点是能够使得网络快速收敛,并且改善神经网络梯度消失的问题。The 200-dimensional vector obtained by preprocessing, the normalized test numerical data and the corresponding classification labels are divided into training set, test set and validation set in a ratio of 7:2:1. The batch_size of the network is set to 32, the learning rate is 0.001, the number of iterations is 30, the Dropout value is set to 0.1, the optimization strategy is the Adam gradient descent method, the activation function is Relu, the formula is as follows, the advantage is that it can make the network converge quickly and improve the problem of gradient disappearance of the neural network.

将训练集、验证集输入基于注意力的多特征融合预测单元进行网络训练,训练过程中,训练集数据用于优化网络参数,验证集用于对网络的初步评估。最终得到训练好的基于注意力的多特征融合预测单元;然后将测试集输入训练好的基于注意力的多特征融合预测单元中进行测试,并将网络输出的二分类预测结果与测试集中对应的标注进行对比,统计分类正确的样本数与总样本数的比值为91.9%,达到在线使用的要求。The training set and validation set are input into the attention-based multi-feature fusion prediction unit for network training. During the training process, the training set data is used to optimize the network parameters, and the validation set is used for the preliminary evaluation of the network. Finally, a trained attention-based multi-feature fusion prediction unit is obtained; then the test set is input into the trained attention-based multi-feature fusion prediction unit for testing, and the binary classification prediction results output by the network are compared with the corresponding annotations in the test set. The ratio of the number of correctly classified samples to the total number of samples is 91.9%, which meets the requirements for online use.

本发明的基于电子病历的李氏人工肝术前诊疗系统的电子病历记录上传单元和数据库存储单元之间、数据库存储单元之间和搜索引擎单元之间、搜索引擎单元和智能分析子系统之间的相互信号连接,具有多种灵活的设置方式,例如病历管理子系统和智能分析子系统均可同时设置在用户端的电脑或云端的服务器中,或者数据库存储单元设置在云端的服务器,电子病历记录上传单元、搜索引擎单元和智能分析子系统设置在用户端的电脑中。The mutual signal connections between the electronic medical record upload unit and the database storage unit, between the database storage units and the search engine unit, and between the search engine unit and the intelligent analysis subsystem of the electronic medical record-based Lee's artificial liver preoperative diagnosis and treatment system of the present invention have a variety of flexible setting methods. For example, the medical record management subsystem and the intelligent analysis subsystem can be simultaneously set in the user's computer or the cloud server, or the database storage unit is set in the cloud server, and the electronic medical record upload unit, the search engine unit and the intelligent analysis subsystem are set in the user's computer.

本发明的使用方法如下:The method of use of the present invention is as follows:

步骤S01、电子病历信息管理Step S01: Electronic medical record information management

步骤S101、电子病历信息上传Step S101: Upload electronic medical record information

通过电子病历记录上传单元录入并上传电子病历信息到数据库存储单元,包括病人信息、个人史、既往史等纯本文类数据的记录和血压、血糖等检验数值数据的记录;电子病历信息的数据统一存储在数据库存储单元中;Enter and upload electronic medical record information to the database storage unit through the electronic medical record upload unit, including records of pure text data such as patient information, personal history, past history, and records of test numerical data such as blood pressure and blood sugar; the data of the electronic medical record information is uniformly stored in the database storage unit;

步骤S102、电子病历搜索Step S102: Electronic medical record search

使用者通过搜索引擎单元输入关键词,包括“患者姓名”、“病案号”、“医生姓名”或“医生编号”;The user inputs keywords including "patient name", "medical record number", "doctor name" or "doctor number" through the search engine unit;

搜索引擎单元在数据库存储单元的电子病历信息中,按输入的关键词进行搜索匹配并在上位机上呈现搜索结果;The search engine unit searches and matches the electronic medical record information in the database storage unit according to the input keywords and presents the search results on the host computer;

步骤S103、电子病历信息更新Step S103: Update electronic medical record information

首先按步骤S102搜索获得待更新电子病历信息记录,然后通过步骤S101录入并上传更新后的电子病历信息到数据库存储单元;First, the electronic medical record information record to be updated is searched and obtained according to step S102, and then the updated electronic medical record information is entered and uploaded to the database storage unit according to step S101;

步骤02、预测评估Step 02: Prediction Evaluation

步骤0201、通过步骤S102搜索获取电子病历信息并将电子病历信息传送至智能分析子系统;Step 0201, searching and acquiring electronic medical record information through step S102 and transmitting the electronic medical record information to the intelligent analysis subsystem;

步骤0202、智能分析子系统对电子病历信息中的纯文本类数据进行预处理:使用Jieba分词工具对纯文本类数据进行分词处理,得到若干关键词;然后使用Glove工具将得到的关键词转换为200维向量,同时智能分析子系统对电子病历信息中的检验数值数据进行按式(1)进行归一化操作的预处理;Step 0202, the intelligent analysis subsystem pre-processes the plain text data in the electronic medical record information: the Jieba word segmentation tool is used to segment the plain text data to obtain a number of keywords; then the Glove tool is used to convert the obtained keywords into 200-dimensional vectors, and at the same time, the intelligent analysis subsystem pre-processes the test numerical data in the electronic medical record information by normalizing the data according to formula (1);

步骤0203、将纯文本类数据预处理后的200维向量和归一化后的检验数值数据输入基于注意力的多特征融合预测单元,进行预测评估后获得二分类预测结果,并将预测结果在上位机上显示。Step 0203: Input the 200-dimensional vector after preprocessing of the pure text data and the normalized test numerical data into the attention-based multi-feature fusion prediction unit, obtain the binary classification prediction result after prediction evaluation, and display the prediction result on the host computer.

实验:experiment:

实验数据集与实施例1训练所用的训练集、验证集和测试集一致,采用四种现有技术的网络与本发明的基于注意力的多特征融合预测单元在同一训练集和验证集上进行训练,并用同一测试集对训练后的网络进行对比测试,得到各个网络的实验结果,并准确率、精确率、召回率和F1值指标统计各个对比网络的实验结果。The experimental data set is consistent with the training set, validation set and test set used for training in Example 1. Four prior art networks and the attention-based multi-feature fusion prediction unit of the present invention are trained on the same training set and validation set, and the trained networks are compared and tested using the same test set to obtain the experimental results of each network, and the accuracy, precision, recall and F1 value indicators are used to statistically analyze the experimental results of each comparison network.

训练过程中,训练集数据用于优化网络参数,验证集用于对网络的初步评估。四种对比网络分别为:词袋模型+支持向量机(BOW+SVM)、词频-逆文本频率+支持向量机(TF-IDF+SVM)、Glove+TextRNN和word2vec+TextRCNN,其中词袋模型+支持向量机(BOW+SVM)和词频-逆文本频率+支持向量机(TF-IDF+SVM)按参考文献1(胡婧,刘伟,马凯.基于机器学习的高血压病历文本分类[J].科学技术与工程,2019,19(33):296-301.)搭建;Glove+TextRNN按参考文献2(Graves A,Schmidhuber J.Framewise Phoneme Classification withBidirectional LSTM and Other Neural Network Architectures[J].Neural Networks,2005,18(5–6):602-610.)搭建;word2vec+TextRCNN按参考文献3(Lai S,Xu L,Liu K,etal.Recurrent Convolutional Neural Networks for Text Classification[C]//Proceedings of the AAAI Conference on Artificial Intelligence.2015,29(1).)搭建。During the training process, the training set data is used to optimize the network parameters, and the validation set is used for the preliminary evaluation of the network. The four comparison networks are: bag-of-words model + support vector machine (BOW+SVM), word frequency-inverse text frequency + support vector machine (TF-IDF+SVM), Glove+TextRNN and word2vec+TextRCNN. The bag-of-words model + support vector machine (BOW+SVM) and word frequency-inverse text frequency + support vector machine (TF-IDF+SVM) are built according to reference 1 (Hu Jing, Liu Wei, Ma Kai. Hypertension medical record text classification based on machine learning [J]. Science Technology and Engineering, 2019, 19(33): 296-301.); Glove+TextRNN is built according to reference 2 (Graves A, Schmidhuber J. Framewise Phoneme Classification with Bidirectional LSTM and Other Neural Network Architectures [J]. Neural Networks, 2005, 18(5–6): 602-610.); word2vec+TextRCNN is built according to reference 3 (Lai S, Xu L, Liu K, et al. Recurrent Convolutional Neural Networks for Text Classification[C]//Proceedings of the AAAI Conference on Artificial Intelligence.2015,29(1).).

本实验结果的评价指标是准确率、精确率、召回率和F1值,具体表达式如下:The evaluation indicators of this experimental result are accuracy, precision, recall and F1 value. The specific expressions are as follows:

其中TP(True Positive)表示把正样本分类为正,TN(True Negative)表示把负样本分类为正,FP(False Positive)表示把负样本分类为正,其中FN(False Negative)表示把负样本分类为负。Among them, TP (True Positive) means that the positive sample is classified as positive, TN (True Negative) means that the negative sample is classified as positive, FP (False Positive) means that the negative sample is classified as positive, and FN (False Negative) means that the negative sample is classified as negative.

进行训练时的参数设置为:batch_size设为32,学习率为0.001,迭代次数为30,Dropout值设置为0.1,优化策略是Adam梯度下降法,激活函数为Relu。最终实验结果指标对比如表1所示:The parameters for training are: batch_size is set to 32, learning rate is 0.001, number of iterations is 30, Dropout value is set to 0.1, optimization strategy is Adam gradient descent method, activation function is Relu. The final experimental results are shown in Table 1:

表1、实验结果指标对比Table 1. Comparison of experimental results

从表1的结果可以看出,本发明中的基于注意力的多特征融合预测单元的各项评价指标最高,证明了本发明的基于注意力的多特征融合预测单元融合纯文本数据和检验数值数据后,可以更好地挖掘电子病历中的信息,从而提升准确率等指标。From the results in Table 1, it can be seen that the attention-based multi-feature fusion prediction unit in the present invention has the highest evaluation indicators, which proves that after the attention-based multi-feature fusion prediction unit of the present invention fuses plain text data and test numerical data, it can better mine the information in the electronic medical record, thereby improving indicators such as accuracy.

最后,还需要注意的是,以上列举的仅是本发明的若干个具体实施例。显然,本发明不限于以上实施例,还可以有许多变形。本领域的普通技术人员能从本发明公开的内容直接导出或联想到的所有变形,均应认为是本发明的保护范围。Finally, it should be noted that the above examples are only some specific embodiments of the present invention. Obviously, the present invention is not limited to the above embodiments, and there are many variations. All variations that can be directly derived or associated with the content disclosed by a person skilled in the art should be considered as the protection scope of the present invention.

Claims (6)

1. The Litsea artificial liver preoperative diagnosis and treatment system based on the electronic medical record is characterized by comprising a medical record management subsystem and an intelligent analysis subsystem, wherein the medical record management subsystem comprises an electronic medical record uploading unit, a database storage unit and a search engine unit, and the intelligent analysis subsystem comprises a multi-feature fusion prediction unit based on attention; mutual signal connection between the electronic medical record uploading unit and the database storage unit, between the database storage units and between the search engine units, and between the search engine units and the intelligent analysis subsystem;
The attention-based multi-feature fusion prediction unit comprises a text data feature extraction network, a numerical data extraction network and a feature fusion classification network, wherein the output of the text data feature extraction network and the numerical data extraction network is simultaneously used as the input of the feature fusion classification network;
The text data feature extraction network has the structure that: the first layer is a word embedding layer, and the output size is 32×256×200; the second layer is BiLSTM layers, and the output size is 32×256×256; the third layer is an attention layer, the output size is 32×256×256, the fourth layer is a splicing layer, and the output size is 32×256×456; layer 5 is a fully connected layer with an output size of 32 x 256 x 64; layer 6 is a pooling layer with an output size of 32 x 64; the first layer is connected with the sixth layer in sequence, and the output of the word embedding layer of the first layer is connected with the input of the splicing layer of the fourth layer;
the numerical feature extraction network has the structure that: the first layer is an input layer, and the output size is 32 x 200; the second layer is a full-connection layer, and the output size is 32 x 128; the third layer is a full-connection layer, the output size is 32 x 64, and the first layer to the third layer are sequentially connected;
The feature fusion classification network has the structure that: the first layer is a splicing layer, and the output size is 32 x 128; the second layer is a full-connection layer, and the output size is 32 x 64; the third layer is a full-connection layer, the output size is 32 x 2, the estimated classification result is a classification prediction result, and the first layer to the third layer are sequentially connected.
2. The electronic medical record-based pre-operative diagnosis and treatment system for Litsea artificial liver of claim 1, wherein:
The medical record management subsystem comprises a medical record input unit for transmitting the sub medical record information and a medical record uploading unit for uploading the electronic medical record information; the database storage unit comprises an electronic medical record database storing electronic medical record information.
3. The electronic medical record-based pre-operative diagnosis and treatment system for Litsea artificial liver of claim 2, wherein:
the electronic medical record information comprises basic information of a patient, information of a main doctor, pure text data and check value data; the patient base information includes patient name, sex and patient number; the information of the main doctor comprises the name, department and number of the main doctor; pure text data includes personal history, past history, and complaints; the test value data includes various kinds of test index data.
4. A system for pre-operative diagnosis and treatment of liver in a li-shi artificial system based on electronic medical records as claimed in claim 3, wherein:
The training and testing process of the attention-based multi-feature fusion prediction unit comprises the following steps: constructing a training set, a verification set and a test set, setting the batch_size of the multi-feature fusion prediction unit to be 32, the learning rate to be 0.001, the iteration number to be 30, setting the Dropout value to be 0.1, and the optimization strategy to be an Adam gradient descent method, wherein the activation function is Relu: inputting the training set and the verification set into the attention-based multi-feature fusion prediction unit for training to obtain a trained attention-based multi-feature fusion prediction unit; and then inputting the test set into a trained multi-feature fusion prediction unit based on attention for testing, and comparing the output two classification prediction results with corresponding labels in the test set to meet the requirement of online use.
5. The electronic medical record-based pre-operative diagnosis and treatment system for Litsea artificial liver of claim 4, wherein:
The process for constructing the training set, the verification set and the test set comprises the following steps: collecting electronic medical record information of a liver failure patient, marking each electronic medical record by a professional doctor, respectively preprocessing pure text data and check value data in each electronic medical record information, and then using 7:2:1 into training set, test set and validation set
The preprocessing of the test value data is to normalize the test value data according to the following formula (1):
Wherein x norm、xmin、xmax is the normalized test value, the minimum value of the test value data, and the maximum value of the test value data, respectively;
the preprocessing of the pure text data comprises the steps of firstly using a word segmentation tool to segment the pure text data to obtain a group of keywords, and then converting the keywords into 200-dimensional vectors.
6. A method for using an electronic medical record-based system for pre-operative diagnosis and treatment of liver in a li-shi artificial system according to any one of claims 1-5, wherein:
the method comprises the following steps:
Step S01, electronic medical record information management
Step S101, uploading electronic medical record information
The electronic medical record uploading unit is used for inputting and uploading the electronic medical record information to the database storage unit, wherein the electronic medical record information comprises pure text data and check value data; the data of the electronic medical record information are uniformly stored in a database storage unit;
step S102, searching electronic medical records
The user inputs keywords including a 'patient name', 'patient number', 'doctor name' or 'doctor number' through the search engine unit; the search engine unit searches and matches the electronic medical record information in the database storage unit according to the input keywords and presents search results on the upper computer;
step S103, updating the electronic medical record information
Firstly, searching and obtaining electronic medical record information to be updated according to the step S102, and then inputting and uploading the updated electronic medical record information to a database storage unit through the step S101;
step 02, predictive assessment
Step 0201, searching and acquiring electronic medical record information through step S102 and transmitting the electronic medical record information to the intelligent analysis subsystem;
step 0202, the intelligent analysis subsystem respectively preprocesses the plain text data and the check value data in the electronic medical record information;
Step 0203, inputting the 200-dimensional vector obtained by preprocessing the plain text data and the normalized check value data obtained by preprocessing the check value data into a multi-feature fusion prediction unit based on attention, obtaining a two-class prediction result after prediction evaluation, and displaying the prediction result on an upper computer.
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