Improving patient clustering by incorporating structured label relationships in similarity measures
Bibliographic record
Abstract
Abstract Context Patient stratification is the cornerstone of numerous health studies, serving to enhance medicine efficacy estimation and facilitate patient matching. To stratify patients, similarity measured between patients can be computed from medical health records databases, such as medico-administrative databases. Importantly, the variables included in medico-administrative databases can be associated with labels, which can be organized in ontologies or other classification systems. However, to the best of our knowledge, the relevance of considering such label classification in the computation of patient similarity measures has been poorly studied. Objective We propose and evaluate several weighted versions of the Cosine similarity that consider structured label relationships to compute patient similarities from a medico-administrative database. Material and Methods As a use case, we analyze medicine reimbursements contained in the Échantillon Généraliste des Bénéficiaires , a French medico-administrative database. We compute the standard Cosine similarity between patients based on their medicine reimbursement. In addition, we computed a weighted Cosine similarity measure that includes variable frequencies and two weighted Cosine similarity measures that consider label relationships. We construct patient networks from each similarity measure and identify clusters of patients. We evaluate the performance of the different similarity measures with enrichment tests using information on chronic diseases. Results The similarity measures that include label relationships perform better to identify similar patients. Indeed, using these weighted measures, we identify distinct patient clusters with a higher number of chronic disease enrichments as compared to the other measures. Importantly, the enrichment tests provide clinically interpretable insights into these patient clusters. Conclusion Considering label relationships when computing patient similarities improves stratification of patients regarding their health status.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.000 | 0.004 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".