Predictive modeling with electronic health record (EHR) data is anticipated to drive personalized medicine and improve healthcare quality. Constructing predictive statistical models typically requires extraction of curated predictor variables from normalized EHR data, a labor-intensive process that discards the vast majority of information in each patient’s record. We propose a representation of patients’ entire raw EHR records based on the Fast Healthcare Interoperability Resources (FHIR) format. We demonstrate that deep learning methods using this representation are capable of accurately predicting multiple medical events from multiple centers without site-specific data harmonization. We validated our approach using de-identified EHR data from two US academic medical centers with 216,221 adult patients hospitalized for at least 24 h. In the sequential format we propose, this volume of EHR data unrolled into a total of 46,864,534,945 data points, including clinical notes. Deep learning models achieved high accuracy for tasks such as predicting: in-hospital mortality (area under the receiver operator curve [AUROC] across sites 0.93–0.94), 30-day unplanned readmission (AUROC 0.75–0.76), prolonged length of stay (AUROC 0.85–0.86), and all of a patient’s final discharge diagnoses (frequency-weighted AUROC 0.90). These models outperformed traditional, clinically-used predictive models in all cases. We believe that this approach can be used to create accurate and scalable predictions for a variety of clinical scenarios. In a case study of a particular prediction, we demonstrate that neural networks can be used to identify relevant information from the patient’s chart.

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We present a method to accelerate global illumination computation in pre-rendered animations by taking advantage of limitations of the human visual system. A spatiotemporal error tolerance map, constructed from psychophysical data based on velocity dependent contrast sensitivity, is used to accelerate rendering. The error map is augmented by a model of visual attention in order to account for the tracking behavior of the eye. Perceptual acceleration combined with good sampling protocols provide a global illumination solution feasible for use in animation. Results indicate an order of magnitude improvement in computational speed.

Making recommendations by learning to rank is becoming an increasingly studied area. Approaches that use stochastic gradient descent scale well to large collaborative filtering datasets, and it has been shown how to approximately optimize the mean rank, or more recently the top of the ranked list. In this work we present a family of loss functions, the korder statistic loss, that includes these previous approaches as special cases, and also derives new ones that we show to be useful. In particular, we present (i) a new variant that more accurately optimizes precision at k, and (ii) a novel procedure of optimizing the mean maximum rank, which we hypothesize is useful to more accurately cover all of the user's tastes. The general approach works by sampling N positive items, ordering them by the score assigned by the model, and then weighting the example as a function of this ordered set. Our approach is studied in two real-world systems, Google Music and YouTube video recommendations, where we obtain improvements for computable metrics, and in the YouTube case, increased user click through and watch duration when deployed live on www.youtube.com.

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