An empirical study of using radiology reports and images to improve intensive care unit mortality prediction

Objectives: The predictive intensive care unit (ICU) scoring system is crucial for predicting patient outcomes, particularly mortality. Traditional scoring systems rely mainly on structured clinical data from electronic health records, which can overlook important clinical information in narratives and images. Materials and Methods: In this work, we build a deep learning-based survival prediction model that utilizes multimodality data for ICU mortality prediction. Four sets of features are investigated: (1) physiological measurements of Simplified Acute Physiology Score (SAPS) II, (2) common thorax diseases predefined by radiologists, (3) bidirectional encoder representations from transformers-based text representations, and (4) chest X-ray image features. The model was evaluated using the Medical Information Mart for Intensive Care IV dataset. Results: Our model achieves an average C-index of 0.7829 (95% CI, 0.7620-0.8038), surpassing the baseline using only SAPS-II features, which had a C-index of 0.7470 (95% CI: 0.7263-0.7676). Ablation studies further demonstrate the contributions of incorporating predefined labels (2.00% improvement), text features (2.44% improvement), and image features (2.82% improvement). Discussion and Conclusion: The deep learning model demonstrated superior performance to traditional machine learning methods under the same feature fusion setting for ICU mortality prediction. This study highlights the potential of integrating multimodal data into deep learning models to enhance the accuracy of ICU mortality prediction.