Collaborative Coarse-to-Fine Disease Learning With Discharge Summary Awareness for EHR Event Prediction

Deep learning-based models have been widely used to predict electronic health record (EHR) events by exploiting diagnostic characteristics. Despite significant progress, three limitations remain: 1) effectively modeling dynamic relationships among diseases, 2) fully leveraging diagnosis code ontologies from multiple perspectives, and 3) incorporating unstructured discharge summaries. To address these challenges, we propose a coarse-to-fine disease learning framework with patient notes for EHR event prediction, tailored to capture both dynamic and static disease characteristics. First, we construct a fine-grained dynamic disease graph by removing disease weakly correlated disease pairs based on co-occurrence distributions. Second, disease embeddings are refined by integrating coarse and fine-grained information within the hierarchical structure of ICD-9-CM codes. In addition, discharge summaries are combined with auxiliary patient notes for collaborative disease learning. Finally, gated recurrent units, location-based attention, and soft attention mechanisms are utilized to further enhance embedding representations. Experiments on two real-world EHR datasets, MIMIC-III and MIMIC-IV, demonstrate that our model consistently outperforms nine baseline methods in EHR prediction. The source code can be found at https://github.com/YNU-L/CCDLD.