Enhanced ICD-10 code assignment of clinical texts: A summarization-based approach

Background: Assigning International Classification of Diseases (ICD) codes to clinical texts is a common and crucial practice in patient classification, hospital management, and further statistics analysis. Current autocoding methods mainly transfer this task to a multi-label classification problem. Such solutions are suffering from high-dimensional mapping space and excessive redundant information in long clinical texts. To alleviate such a situation, we introduce text summarization methods to the ICD coding regime and apply text matching to select ICD codes. Method: We focus on the tenth revision of the ICD (ICD-10) coding and design a novel summarization-based approach (SuM) with an end-to-end strategy to efficiently assign ICD-10 code to clinical texts. In this approach, a knowledge-guided pointer network is purposed to distill and summarize key information in clinical texts precisely. Then a matching model with matching-aggregation architecture follows to align the summary result with code, tuning the one-vs-all scenario to one-vs-one matching so that the large-label-space obstacle laid in classification approaches would be avoided. Result: The 12,788 ICD-10 coded discharge summaries from a Chinese hospital were collected to evaluate the proposed approach. Compared with existing methods, the purposed model achieves the greatest coding results with Micro AUC of 0.9548, MRR@10 of 0.7977, Precision@10 of 0.0944, and Recall@10 of 0.9439 for the TOP50 Dataset. Results on the FULL-Dataset remain consistent. Also, the proposed knowledge encoder and applied end-to-end strategy are proven to facilitate the whole model to gain efficacy in selecting the most suitable code. Conclusion: The proposed automatic ICD-10 code assignment approach via text summarization can effectively capture critical messages in long clinical texts and improve the performance of ICD-10 coding of clinical texts.