Multitask Deep Learning for Accurate Risk Stratification and Prediction of Next Steps for Coronary CT Angiography Patients

Abstract

Diagnostic investigation has an important role in risk stratification and clinical decision making of patients with suspected and documented Coronary Artery Disease (CAD). However, the majority of existing tools are primarily focused on the selection of gatekeeper tests, whereas only a handful of systems contain information regarding the downstream testing or treatment. We propose a multi-task deep learning model to support risk stratification and down-stream test selection for patients undergoing Coronary Computed Tomography Angiography (CCTA). The analysis included 14,021 patients who underwent CCTA between 2006 and 2017. Our novel multitask deep learning framework extends the state-of-the art Perceiver model to deal with real-world CCTA report data. Our model achieved an Area Under the receiver operating characteristic Curve (AUC) of 0.76 in CAD risk stratification, and 0.72 AUC in predicting downstream tests. Our proposed deep learning model can accurately estimate the likelihood of CAD and provide recommended downstream tests based on prior CCTA data. In clinical practice, the utilization of such an approach could bring a paradigm shift in risk stratification and downstream management. Despite significant progress using deep learning models for tabular data, they do not outperform gradient boosting decision trees, and further research is required in this area. However, neural networks appear to benefit more readily from multi-task learning than tree-based models. This could offset the shortcomings of using single task learning approach when working with tabular data.