BackgroundIn‐hospital cardiac arrest is a major burden to public health, which affects patient safety. Although traditional track‐and‐trigger systems are used to predict cardiac arrest early, they have limitations, with low sensitivity and high false‐alarm rates. We propose a deep learning–based early warning system that shows higher performance than the existing track‐and‐trigger systems.Methods and ResultsThis retrospective cohort study reviewed patients who were admitted to 2 hospitals from June 2010 to July 2017. A total of 52 131 patients were included. Specifically, a recurrent neural network was trained using data from June 2010 to January 2017. The result was tested using the data from February to July 2017. The primary outcome was cardiac arrest, and the secondary outcome was death without attempted resuscitation. As comparative measures, we used the area under the receiver operating characteristic curve (AUROC), the area under the precision–recall curve (AUPRC), and the net reclassification index. Furthermore, we evaluated sensitivity while varying the number of alarms. The deep learning–based early warning system (AUROC: 0.850; AUPRC: 0.044) significantly outperformed a modified early warning score (AUROC: 0.603; AUPRC: 0.003), a random forest algorithm (AUROC: 0.780; AUPRC: 0.014), and logistic regression (AUROC: 0.613; AUPRC: 0.007). Furthermore, the deep learning–based early warning system reduced the number of alarms by 82.2%, 13.5%, and 42.1% compared with the modified early warning system, random forest, and logistic regression, respectively, at the same sensitivity.ConclusionsAn algorithm based on deep learning had high sensitivity and a low false‐alarm rate for detection of patients with cardiac arrest in the multicenter study.
Knowledge tracing, the act of modeling a student's knowledge through learning activities, is an extensively studied problem in the field of computer-aided education. Armed with attention mechanisms focusing on relevant information for target prediction, recurrent neural networks and Transformer-based knowledge tracing models have outperformed traditional approaches such as Bayesian knowledge tracing and collaborative filtering. However, the attention mechanisms of current state-of-the-art knowledge tracing models share two limitations. Firstly, the models fail to leverage deep self-attentive computations for knowledge tracing. As a result, they fail to capture complex relations among exercises and responses over time. Secondly, appropriate features for constructing queries, keys and values for the self-attention layer for knowledge tracing have not been extensively explored. The usual practice of using exercises and interactions (exercise-response pairs), as queries and keys/values, respectively, lacks empirical support.In this paper, we propose a novel Transformer-based model for knowledge tracing, SAINT: Separated Self-AttentIve Neural Knowledge Tracing. SAINT has an encoder-decoder structure where the exercise and response embedding sequences separately enter, respectively, the encoder and the decoder. The encoder applies self-attention layers to the sequence of exercise embeddings, and the decoder alternately applies selfattention layers and encoder-decoder attention layers to the sequence of response embeddings. This separation of input allows us to stack attention layers multiple times, resulting in an improvement in area under receiver operating characteristic curve (AUC). To the best of our knowledge, this is the first work to suggest an encoder-decoder model for knowledge tracing that applies deep self-attentive layers to exercises and responses separately.We empirically evaluate SAINT on a large-scale knowledge tracing dataset, EdNet, collected by an active mobile education
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