Self-supervised representation learning for clinical decision making using EHR categorical data: a scoping review

Abstract

The widespread adoption of Electronic Health Records (EHRs) and deep learning, particularly through Self-Supervised Representation Learning (SSRL) for categorical data, has transformed clinical decision-making. This scoping review, following PRISMA-ScR guidelines, examines 46 studies published from January 2019 to April 2024 across databases including PubMed, MEDLINE, Embase, ACM, and Web of Science, focusing on SSRL for unlabeled categorical EHR data. The review systematically assesses research trends in building efficient representations for medical tasks, identifying major trends in model families: Transformer-based (43%), Autoencoder-based (28%), and Graph Neural Network-based (17%) models. The analysis highlights scenarios where healthcare institutions can leverage or develop SSRL technologies. It also addresses current limitations in assessing the impact of these technologies and identifies research opportunities to enhance their influence on clinical practice.