An Explainable CNN Approach for Medical Codes Prediction from Clinical Text

Method: We develop CNN-based methods for automatic ICD coding based on clinical text from intensive care unit (ICU) stays. We come up with the Shallow and Wide Attention convolutional Mechanism (SWAM), which allows our model to learn local and low-level features for each label. The key idea behind our model design is to look for the presence of informative snippets in the clinical text that correlated with each code, and we infer that there exists a correspondence between "informative snippet" and convolution filter. Results: We evaluate our approach on MIMIC-III, an open-access dataset of ICU medical records. Our approach substantially outperforms previous results on top-50 medical code prediction on MIMIC-III dataset. We attribute this improvement to SWAM, by which the wide architecture gives the model ability to more extensively learn the unique features of different codes, and we prove it by ablation experiment. Besides, we perform manual analysis of the performance imbalance between different codes, and preliminary conclude the characteristics that determine the difficulty of learning specific codes. Conclusions: We present SWAM, an explainable CNN approach for multi-label document classification, which employs a wide convolution layer to learn local and low-level features for each label, yields strong improvements over previous metrics on the ICD-9 code prediction task, while providing satisfactory explanations for its internal mechanics.