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Large-scale pre-trained models (PTMs) such as BERT and GPT have recently achieved great success in Natural Language Processing and Computer … (see more)Vision domains. However, the development of PTMs on healthcare time-series data is lagging behind.This underscores the limitations of the existing transformer-based architectures, particularly their scalability to handle large-scale time series and ability to capture long-term temporal dependencies. In this study, we present Timely Generative Pre-trained Transformer (TimelyGPT). TimelyGPT employs an extrapolatable position (xPos) embedding to encode trend and periodic patterns into time-series representations. It also integrates recurrent attention and temporal convolution modules to effectively capture global-local temporal dependencies. We evaluated TimelyGPT on two large-scale healthcare time series datasets corresponding to continuous biosignals and irregularly-sampled time series, respectively. Our experiments show that during pre-training, TimelyGPT excels in learning time-series representations from continuously monitored biosignals and irregularly-sampled time series data commonly observed in longitudinal electronic health records (EHRs). In forecasting continuous biosignals, TimelyGPT achieves accurate extrapolation up to 6,000 timesteps of body temperature during the sleep stage transition, given a short look-up window (i.e., prompt) containing only 2,000 timesteps. For irregularly-sampled time series, TimelyGPT with a proposed time-specific inference demonstrates high top recall scores in predicting future diagnoses using early diagnostic records, effectively handling irregular intervals between clinical records. Together, we envision TimelyGPT to be useful in a broad spectrum of health domains, including long-term patient health state forecasting and patient risk trajectory prediction.
2025-10-13
Health Information Science and Systems (published)
Identifying the genetic and molecular drivers of phenotypic heterogeneity among individuals is vital for understanding human health and for … (see more)diagnosing, monitoring, and treating diseases. To this end, international consortia such as the Human Cell Atlas and the Tabula Sapiens are creating comprehensive cellular references. Due to the massive volume of data generated, machine learning methods, especially transformer architectures, have been widely employed in related studies. However, applying machine learning to cellular data presents several challenges. One such challenge is making the methods interpretable with respect to both the input cellular information and its context. Another less explored challenge is the accurate representation of cells outside existing references, referred to as out-of-distribution (OOD) cells. The out-of-distribution could be attributed to various physiological conditions, such as comparing diseased cells, particularly tumor cells, with healthy reference data, or significant technical variations, such as using transfer learning from single-cell reference to spatial query data. Inspired by the global workspace theory in cognitive neuroscience, we introduce CellMemory, a bottlenecked Transformer with improved generalization capabilities designed for the hierarchical interpretation of OOD cells unseen during reference building. Even without pre-training, it exceeds the performance of large language models pre-trained with tens of millions of cells. In particular, when deciphering spatially resolved single-cell transcriptomics data, CellMemory demonstrates the ability to interpret data at the granule level accurately. Finally, we harness CellMemory's robust representational capabilities to elucidate malignant cells and their founder cells in different patients, providing reliable characterizations of the cellular changes caused by the disease.
Federated learning (FL) enables collaborative analysis of decentralized medical data while preserving patient privacy. However, the covariat… (see more)e shift from demographic and clinical differences can reduce model generalizability. We propose FedWeight, a novel FL framework that mitigates covariate shift by reweighting patient data from the source sites using density estimators, allowing the trained model to better align with the distribution of the target site. To support unsupervised applications, we introduce FedWeight ETM, a federated embedded topic model. We evaluated FedWeight in cross-site FL on the eICU dataset and cross-dataset FL between eICU and MIMIC III. FedWeight consistently outperforms standard FL baselines in predicting ICU mortality, ventilator use, sepsis diagnosis, and length of stay. SHAP-based interpretation and ETM-based topic modeling reveal improved identification of clinically relevant characteristics and disease topics associated with ICU readmission.
In the healthcare domain, time-series data are often irregularly sampled with varying intervals through outpatient visits, posing challenges… (see more) for existing models designed for equally spaced sequential data. To address this, we propose Trajectory Generative Pre-trained Transformer (TrajGPT) for representation learning on irregularly-sampled healthcare time series. TrajGPT introduces a novel Selective Recurrent Attention (SRA) module that leverages a data-dependent decay to adaptively filter irrelevant past information. As a discretized ordinary differential equation (ODE) framework, TrajGPT captures underlying continuous dynamics and enables a time-specific inference for forecasting arbitrary target timesteps without auto-regressive prediction. Experimental results based on the longitudinal EHR data PopHR from Montreal health system and eICU from PhysioNet showcase TrajGPT's superior zero-shot performance in disease forecasting, drug usage prediction, and sepsis detection. The inferred trajectories of diabetic and cardiac patients reveal meaningful comorbidity conditions, underscoring TrajGPT as a useful tool for forecasting patient health evolution.
2024-12-31
IEEE Journal of Biomedical and Health Informatics (unknown)