Deep learning (DL)-based predictive models from electronic health records (EHRs) deliver impressive performance in many clinical tasks. Large training cohorts, however, are often required by these models to achieve high accuracy, hindering the adoption of DL-based models in scenarios with limited training data. Recently, bidirectional encoder representations from transformers (BERT) and related models have achieved tremendous successes in the natural language processing domain. The pretraining of BERT on a very large training corpus generates contextualized embeddings that can boost the performance of models trained on smaller datasets. Inspired by BERT, we propose Med-BERT, which adapts the BERT framework originally developed for the text domain to the structured EHR domain. Med-BERT is a contextualized embedding model pretrained on a structured EHR dataset of 28,490,650 patients. Fine-tuning experiments showed that Med-BERT substantially improves the prediction accuracy, boosting the area under the receiver operating characteristics curve (AUC) by 1.21–6.14% in two disease prediction tasks from two clinical databases. In particular, pretrained Med-BERT obtains promising performances on tasks with small fine-tuning training sets and can boost the AUC by more than 20% or obtain an AUC as high as a model trained on a training set ten times larger, compared with deep learning models without Med-BERT. We believe that Med-BERT will benefit disease prediction studies with small local training datasets, reduce data collection expenses, and accelerate the pace of artificial intelligence aided healthcare.

Recently, the study of multi-modal brain connectome has recorded a tremendous increase and facilitated the diagnosis of brain disorders. In this paradigm, functional and structural networks, e.g., functional and structural connectivity derived from fMRI and DTI, are in some manner interacted but are not necessarily linearly related. Accordingly, there remains a great challenge to leverage complementary information for brain connectome analysis. Recently, Graph Convolutional Networks (GNN) have been widely applied to the fusion of multi-modal brain connectome. However, most existing GNN methods fail to couple inter-modal relationships. In this regard, we propose a Cross-modal Graph Neural Network (Cross-GNN) that captures inter-modal dependencies through dynamic graph learning and mutual learning. Specifically, the inter-modal representations are attentively coupled into a compositional space for reasoning inter-modal dependencies. Additionally, we investigate mutual learning in explicit and implicit ways: (1) Cross-modal representations are obtained by cross-embedding explicitly based on the inter-modal correspondence matrix. (2) We propose a cross-modal distillation method to implicitly regularize latent representations with cross-modal semantic contexts. We carry out statistical analysis on the attentively learned correspondence matrices to evaluate inter-modal relationships for associating disease biomarkers. Our extensive experiments on three datasets demonstrate the superiority of our proposed method for disease diagnosis with promising prediction performance and multi-modal connectome biomarker location.