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Automated Medical Coding on MIMIC-III and MIMIC-IV: A Critical Review and Replicability Study

2023-04-21Code Available1· sign in to hype

Joakim Edin, Alexander Junge, Jakob D. Havtorn, Lasse Borgholt, Maria Maistro, Tuukka Ruotsalo, Lars Maaløe

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Abstract

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

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Benchmark Results

DatasetModelMetricClaimedVerifiedStatus
MIMIC-IV ICD-10CNNPrecision@860.3Unverified
MIMIC-IV ICD-10PLM-ICDPrecision@869.9Unverified
MIMIC-IV ICD-10LAATPrecision@868.9Unverified
MIMIC-IV ICD-10MultiResCNNPrecision@867.8Unverified
MIMIC-IV ICD-10CAMLPrecision@866.8Unverified
MIMIC-IV ICD-10Bi-GRUPrecision@862.6Unverified
MIMIC-IV ICD-9PLM-ICDAUC Macro97.2Unverified
MIMIC-IV ICD-9LAATAUC Macro96Unverified
MIMIC-IV ICD-9MultiResCNNAUC Macro95.1Unverified
MIMIC-IV ICD-9Bi-GRUAUC Macro93.8Unverified
MIMIC-IV ICD-9CAMLAUC Macro90.7Unverified
MIMIC-IV ICD-9CNNAUC Macro89.4Unverified

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