{"about":{"site":"https://codewithpapers.app","non_affiliation":"Code with Papers and Syntology are not affiliated with, endorsed by, or sponsored by Papers with Code, Meta, or the pwc-archive mirror.","licence":"CC BY-SA 4.0","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","attribution":"https://codewithpapers.app/attribution","modified":"archive material modified by Syntology; see the attribution page"},"url":"/paper/foundation-model-of-electronic-medical","title":"Foundation Model of Electronic Medical Records for Adaptive Risk Estimation","arxiv_id":"2502.06124","date":"2025-02-10","proceeding":null,"authors":["Pawel Renc","Michal K. Grzeszczyk","Nassim Oufattole","Deirdre Goode","Yugang Jia","Szymon Bieganski","Matthew B. A. McDermott","Jaroslaw Was","Anthony E. Samir","Jonathan W. Cunningham","David W. Bates","Arkadiusz Sitek"],"abstract":"We developed the Enhanced Transformer for Health Outcome Simulation (ETHOS), an AI model that tokenizes patient health timelines (PHTs) from EHRs. ETHOS predicts future PHTs using transformer-based architectures. The Adaptive Risk Estimation System (ARES) employs ETHOS to compute dynamic and personalized risk probabilities for clinician-defined critical events. ARES incorporates a personalized explainability module that identifies key clinical factors influencing risk estimates for individual patients. ARES was evaluated on the MIMIC-IV v2.2 dataset in emergency department (ED) settings, benchmarking its performance against traditional early warning systems and machine learning models. We processed 299,721 unique patients from MIMIC-IV into 285,622 PHTs, with 60% including hospital admissions. The dataset contained over 357 million tokens. ETHOS outperformed benchmark models in predicting hospital admissions, ICU admissions, and prolonged hospital stays, achieving superior AUC scores. ETHOS-based risk estimates demonstrated robustness across demographic subgroups with strong model reliability, confirmed via calibration curves. The personalized explainability module provides insights into patient-specific factors contributing to risk. ARES, powered by ETHOS, advances predictive healthcare AI by providing dynamic, real-time, and personalized risk estimation with patient-specific explainability to enhance clinician trust. Its adaptability and superior accuracy position it as a transformative tool for clinical decision-making, potentially improving patient outcomes and resource allocation in emergency and inpatient settings. We release the full code at github.com/ipolharvard/ethos-ares to facilitate future research.","url_abs":"https://arxiv.org/abs/2502.06124v1","url_pdf":"https://arxiv.org/pdf/2502.06124v1.pdf","source":{"archive":"pwc-archive (Hugging Face), CC BY-SA 4.0","snapshot":"2025-07-28","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","row_kind":"abstracts"},"code_links":[{"paper_slug":"foundation-model-of-electronic-medical","repo_url":"https://github.com/ipolharvard/ethos-ares","is_official":1,"mentioned_in_paper":1,"mentioned_in_github":1,"framework":"pytorch","reach":null}],"tasks":[{"task_slug":"benchmarking","task_name":"Benchmarking"}],"methods":[{"method_slug":"absolute-position-encodings","method_name":"Absolute Position Encodings"},{"method_slug":"adam","method_name":"Adam"},{"method_slug":"attention","method_name":"Attention"},{"method_slug":"bpe","method_name":"BPE"},{"method_slug":"dense-connections","method_name":"Dense Connections"},{"method_slug":"dropout","method_name":"Dropout"},{"method_slug":"label-smoothing","method_name":"Label Smoothing"},{"method_slug":"layer-normalization","method_name":"Layer Normalization"},{"method_slug":"linear-layer","method_name":"Linear Layer"},{"method_slug":"multi-head-attention","method_name":"Multi-Head Attention"},{"method_slug":"position-wise-feed-forward-layer","method_name":"Position-Wise Feed-Forward Layer"},{"method_slug":"residual-connection","method_name":"Residual Connection"},{"method_slug":"softmax","method_name":"Softmax"},{"method_slug":"transformer","method_name":"Transformer"}],"datasets_introduced":[],"methods_introduced":[],"results":[],"syntology":{"syntology_url":null,"atlas_url":null,"mcp":null,"developers":"https://syntology.ai/developers"},"arxiv_metadata":null,"syntology_extracted_results":null}