# NeuraHealth: An Automated Screening Pipeline to Detect Undiagnosed Cognitive Impairment in Electronic Health Records with Deep Learning and Natural Language Processing

arXiv: https://arxiv.org/abs/2202.00478 · HTML: https://mlsanity.com/paper/2202.00478/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 57 references that are in the map.
- First posted on arXiv 12 Jan 2022.

## Builds on (most cited first, 14 of 14)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Efficient Estimation of Word Representations in Vector Space](https://mlsanity.com/paper/1301.3781/) (2013)
- [UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction](https://mlsanity.com/paper/1802.03426/) (2018)
- [Optuna: A Next-generation Hyperparameter Optimization Framework](https://mlsanity.com/paper/1907.10902/) (2019)
- [HuggingFace's Transformers: State-of-the-art Natural Language Processing](https://mlsanity.com/paper/1910.03771/) (2019)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Scalable and accurate deep learning for electronic health records](https://mlsanity.com/paper/1801.07860/) (2018)
- [Alzheimer's Dementia Recognition through Spontaneous Speech: The ADReSS Challenge](https://mlsanity.com/paper/2004.06833/) (2020)
- [Detecting Linguistic Characteristics of Alzheimer's Dementia by Interpreting Neural Models](https://mlsanity.com/paper/1804.06440/) (2018)
- [Comparing Natural Language Processing Techniques for Alzheimer's Dementia Prediction in Spontaneous Speech](https://mlsanity.com/paper/2006.07358/) (2020)
- [Natural Language Processing to Detect Cognitive Concerns in Electronic Health Records Using Deep Learning](https://mlsanity.com/paper/2011.06489/) (2020)
- [Using Deep Learning to Identify Patients with Cognitive Impairment in Electronic Health Records](https://mlsanity.com/paper/2111.09115/) (2021)

## Abstract (arXiv)

Dementia related cognitive impairment (CI) is a neurodegenerative disorder, affecting over 55 million people worldwide and growing rapidly at the rate of one new case every 3 seconds. 75% cases go undiagnosed globally with up to 90% in low-and-middle-income countries, leading to an estimated annual worldwide cost of USD 1.3 trillion, forecasted to reach 2.8 trillion by 2030. With no cure, a recurring failure of clinical trials, and a lack of early diagnosis, the mortality rate is 100%. Information in electronic health records (EHR) can provide vital clues for early detection of CI, but a manual review by experts is tedious and error prone. Several computational methods have been proposed, however, they lack an enhanced understanding of the linguistic context in complex language structures of EHR. Therefore, I propose a novel and more accurate framework, NeuraHealth, to identify patients who had no earlier diagnosis. In NeuraHealth, using patient EHR from Mass General Brigham BioBank, I fine-tuned a bi-directional attention-based deep learning natural language processing model to classify sequences. The sequence predictions were used to generate structured features as input for a patient level regularized logistic regression model. This two-step framework creates high dimensionality, outperforming all existing state-of-the-art computational methods as well as clinical methods. Further, I integrate the models into a real-world product, a web app, to create an automated EHR screening pipeline for scalable and high-speed discovery of undetected CI in EHR, making early diagnosis viable in medical facilities and in regions with scarce health services.