AutoRADP: An Interpretable Deep Learning Framework to Predict Rapid Progression for Alzheimer’s Disease and Related Dementias Using Electronic Health Records

Alzheimer’s disease (AD) and AD-related dementias (ADRD) exhibit heterogeneous progression rates, with rapid progression (RP) posing significant challenges for timely intervention and treatment. The increasingly available patient-centered electronic health records (EHRs) have made it possible to develop advanced machine learning models for risk prediction of disease progression by leveraging comprehensive clinical, demographic, and laboratory data. In this study, we propose AutoRADP, an interpretable autoencoder-based framework that predicts rapid AD/ADRD progression using both structured and unstructured EHR data from UFHealth. AutoRADP incorporates a rule-based natural language processing method to extract critical cognitive assessments from clinical notes, combined with feature selection techniques to identify essential structured EHR features. To address the data imbalance issue, we implement a hybrid sampling strategy that combines similarity-based and clustering-based upsampling. Additionally, by utilizing SHapley Additive exPlanations (SHAP) values, we provide interpretable predictions, shedding light on the key factors driving the rapid progression of AD/ADRD. We demonstrate that AutoRADP outperforms existing methods, highlighting the potential of our framework to advance precision medicine by enabling accurate and interpretable predictions of rapid AD/ADRD progression, and thereby supporting improved clinical decision-making and personalized interventions.