  Objective: To compare different deep learning architectures for predicting
the risk of readmission within 30 days of discharge from the intensive care
unit (ICU). The interpretability of attention-based models is leveraged to
describe patients-at-risk. Methods: Several deep learning architectures making
use of attention mechanisms, recurrent layers, neural ordinary differential
equations (ODEs), and medical concept embeddings with time-aware attention were
trained using publicly available electronic medical record data (MIMIC-III)
associated with 45,298 ICU stays for 33,150 patients. Bayesian inference was
used to compute the posterior over weights of an attention-based model. Odds
ratios associated with an increased risk of readmission were computed for
static variables. Diagnoses, procedures, medications, and vital signs were
ranked according to the associated risk of readmission. Results: A recurrent
neural network, with time dynamics of code embeddings computed by neural ODEs,
achieved the highest average precision of 0.331 (AUROC: 0.739, F1-Score:
0.372). Predictive accuracy was comparable across neural network architectures.
Groups of patients at risk included those suffering from infectious
complications, with chronic or progressive conditions, and for whom standard
medical care was not suitable. Conclusions: Attention-based networks may be
preferable to recurrent networks if an interpretable model is required, at only
marginal cost in predictive accuracy.
