Study identifies subphenotypes of pediatric sepsis to improve ML predictive performance.
problem Enhance machine learning predictive performance in pediatric sepsis.
method Latent profile analysis of clinical data to identify subphenotypes, followed by ML experiments.
result Improved predictive performance of ML models targeting specific subphenotypes of pediatric sepsis.
Study identifies sepsis subpopulations for better ICU prediction.
problem Lack of stratified sepsis subpopulations in ICU EHR predictions.
method Stratified sepsis subpopulations identified using machine learning.
result Machine learning models perform better with stratified subpopulations.
Sepsis is a dangerous condition that is a leading cause of patient mortality. Treating sepsis is highly challenging, because individual patients respond very differently to medical interventions and there is no universally agreed-upon treatment for sepsis. In this work, we explore the use of continuous state-space mode…
Characterizing a patient's progression through stages of sepsis is critical for enabling risk stratification and adaptive, personalized treatment. However, commonly used sepsis diagnostic criteria fail to account for significant underlying heterogeneity, both between patients as well as over time in a single patient. W…
New dataset from clinicians improves sepsis prediction models.
problem Circularity in previous sepsis prediction models.
method Developed an independent dataset from clinical judgments, avoiding circularity.
result Achieved state-of-the-art AUROC scores.
Sepsis is a life-threatening host response to infection associated with high mortality, morbidity, and health costs. Its management is highly time-sensitive since each hour of delayed treatment increases mortality due to irreversible organ damage. Meanwhile, despite decades of clinical research, robust biomarkers for s…
Our work focuses on the problem of predicting the transfer of pediatric patients from the general ward of a hospital to the pediatric intensive care unit. Using data collected over 5.5 years from the electronic health records of two medical facilities, we develop classifiers based on adaptive boosting and gradient tree…
DeepAISE predicts sepsis onset with high accuracy and low false alarms.
problem Early prediction of sepsis in ICU patients to improve clinical situational awareness.
method Recurrent neural survival model that combines clinical criteria and treatment policies.
result DeepAISE produces the most accurate predictions (AUC=0.90 and 0.87) and lowest false alarm rates (FAR=0.20 and 0.26) compared to baseline models.
We study multiple rule-based and machine learning (ML) models for sepsis detection. We report the first neural network detection and prediction results on three categories of sepsis. We have used the retrospective Medical Information Mart for Intensive Care (MIMIC)-III dataset, restricted to intensive care unit (ICU) p…
Develops a fast non-invasive tool for diagnosing pediatric sleep apnea.
problem Diagnosing pediatric obstructive sleep apnea using an overnight sleep study is often impractical.
method Combines persistent homology, geometric shape analysis, and convolutional neural networks to classify facial images.
result Facial features associated with obstructive sleep apnea can be recognized for diagnosis.
EHR-MPC optimizes sepsis treatment using digital twins and inference-time control.
problem Optimal sepsis treatment policies are contested and difficult to adapt during inference.
method EHR-MPC decouples learning patient dynamics from treatment optimization, enabling inference-time control over learned digital twins.
result EHR-MPC achieves comparable off-policy performance and improved simulation performance compared to RL baselines.
Simulates sepsis treatment decisions using a world model approach.
problem Predicting optimal sepsis treatment actions based on noisy EHR data.
method Uses a Variational Auto-Encoder and Mixture Density Network (MDN-RNN) to model sepsis patient trajectories.
result Simulator learns from MIMIC dataset to predict patient states.
Machine learning builds personalized pediatric abdominal phantoms.
problem Lack of individualized phantoms for radiation therapy studies.
method Combining imaging and machine learning to automatically build phantoms.
result Automatically constructed phantoms more accurately represent patient anatomy.
Survey of techniques for diagnosing pediatric sleep apnea from inexpensive data.
problem Diagnosing pediatric sleep apnea from limited and variable data.
method Exploratory data analysis using correlation networks, Mapper, SVD; supervised and unsupervised learning techniques.
result Analysis of various learning techniques applied to pediatric sleep apnea data.
Paper uses ensemblers to predict sepsis early from patient records.
problem Early detection of sepsis in patients.
method Imputation and weak ensembler technique applied to 40k patient records.
result Model achieved 93.45% accuracy and 0.271 utility score.
Model predicts sepsis early with high accuracy.
problem Early detection of sepsis to reduce mortality.
method MGP-AttTCN: Gaussian Process and attention-based deep learning.
result Model outperforms state-of-the-art with AUROC 0.660 and AUPR 0.483.
Enhances early risk assessments for pediatric outcomes using contrastive learning.
problem Improving risk assessments in early stages of pediatric development.
method Contrastive multi-modal framework that treats each time window as a distinct modality, training on all available data.
result Consistent improvements in early-stage risk assessments validated on real-world tasks.
Although timely sepsis diagnosis and prompt interventions in Intensive Care Unit (ICU) patients are associated with reduced mortality, early clinical recognition is frequently impeded by non-specific signs of infection and failure to detect signs of sepsis-induced organ dysfunction in a constellation of dynamically cha…
New CNN architecture improves pediatric image segmentation by homogenizing pose and size.
problem Challenges in segmenting pediatric images due to pose and size heterogeneity.
method Spatial Transformer Network (STN) for pose and scale invariance, combined with UNet for segmentation.
result Improved pediatric segmentation, especially renal tumor delineation, with accelerated processing.
The timeliness of detection of a sepsis event in progress is a crucial factor in the outcome for the patient. Machine learning models built from data in electronic health records can be used as an effective tool for improving this timeliness, but so far the potential for clinical implementations has been largely limite…
New method identifies sepsis-related patient features in EMR data.
problem Identify sepsis-related patient features in EMR data.
method Linear multivariate Hawkes process model with ReLU link function, coupled with gradient-based method.
result Identifies several interpretable GC chains that precede sepsis.
Sepsis is a poorly understood and potentially life-threatening complication that can occur as a result of infection. Early detection and treatment improves patient outcomes, and as such it poses an important challenge in medicine. In this work, we develop a flexible classifier that leverages streaming lab results, vita…
Sepsis is the leading cause of mortality in the ICU. It is challenging to manage because individual patients respond differently to treatment. Thus, tailoring treatment to the individual patient is essential for the best outcomes. In this paper, we take steps toward this goal by applying a mixture-of-experts framework …
Predict sepsis early from EHR data with aggregated clinical events.
problem Predict sepsis from clinical data in EHR with temporal interactions.
method Aggregates heterogeneous clinical events, captures temporal interactions with LSTM.
result Achieved high utility score (0.321) in PhysioNet/Computing in Cardiology Challenge 2019.
Study evaluates how framing affects machine learning models for sepsis prediction.
problem Understanding and reporting framing is crucial for AI technology success.
method Four different approaches applied to AI models of sepsis prediction.
result On-clinical-demand framing showed the lowest missing values and best temporal dependencies.
Viewing the trajectory of a patient as a dynamical system, a recurrent neural network was developed to learn the course of patient encounters in the Pediatric Intensive Care Unit (PICU) of a major tertiary care center. Data extracted from Electronic Medical Records (EMR) of about 12000 patients who were admitted to the…
Deep learning predicts asthma ED visits better than traditional methods.
problem Predicting asthma-related ED visits to improve patient management.
method Deep learning (Artificial Neural Networks) compared to Lasso logistic regression.
result Deep learning model (ANN) outperforms traditional Lasso logistic regression (AUC = 0.845 vs. AUC = 0.842).
We present a scalable end-to-end classifier that uses streaming physiological and medication data to accurately predict the onset of sepsis, a life-threatening complication from infections that has high mortality and morbidity. Our proposed framework models the multivariate trajectories of continuous-valued physiologic…
Bayesian model estimates ACT impact on pediatric AML survival.
problem Estimating ACT impact on survival in AML patients with treatment timing issues.
method Generative Bayesian semi-parametric model with Gamma Process priors.
result Posterior inference for ACT efficacy under dynamic rules.
New methods for evaluating and optimizing policies in offline RL with unobserved confounders.
problem Evaluating and optimizing policies in the presence of unobserved confounders.
method Characterized settings and algorithms for consistent value estimates and lower bounds, with sample complexity guarantees.
result Proved local convergence guarantees for offline policy improvement.
Objective: Predict patient-specific vitals deemed medically acceptable for discharge from a pediatric intensive care unit (ICU). Design: The means of each patient's hr, sbp and dbp measurements between their medical and physical discharge from the ICU were computed as a proxy for their physiologically acceptable state …
Study investigates how machine learning models degrade over time, leading to patient safety issues.
problem Overtime degradation of machine learning models in clinical settings.
method Used MIMIC-IV dataset to train models replicating commercial approaches, observing and analyzing degradation over a decade.
result An RNN model built on Epic features degrades from 0.729 AUC to 0.525 AUC over a decade, highlighting technical and clinical drift as root causes.
A ML-based method reconstructs 3D organ doses from 2D radiographs for pediatric abdominal radiotherapy.
problem Reconstructing detailed 3D dose distributions for childhood cancer survivors using limited 2D radiographs.
method Surrogate-free ML approach using 142 abdominal planning CTs, 300 artificial plans, and evolutionary algorithm.
result Accurate 3D dose reconstructions with MAEs ≤ 1.7 Gy for edge organs, validated on independent dataset.
Machine learning models trained on indirect data labels can fail on real-world examples.
problem Validity issues in machine learning when target labels are indirectly defined.
method Identification of problematic datasets and models using a general procedure.
result Machine learning models trained on indirect data labels will fail on real-world examples.
Sepsis is a life-threatening disease and one of the major causes of death in hospitals. Imaging of microcirculatory dysfunction is a promising approach for automated diagnosis of sepsis. We report a machine learning classifier capable of distinguishing non-septic and septic images from dark field microcirculation video…
DCEM algorithm reduces bias in machine learning models trained on selective labels.
problem Bias in machine learning models trained on selective labels.
method Disparate Censorship Expectation-Maximization (DCEM) algorithm.
result DCEM improves bias mitigation without sacrificing discriminative performance.
Estimates individualized treatment effects using shared RBF-net neurons.
problem Identifying differential treatment effects based on covariates.
method Non-parametric radial basis function (RBF)-nets with shared hidden neurons in a Bayesian framework.
result Demonstrated through simulations and real data, the method identifies interesting treatment effects.
A TCL framework improves causal effect estimation in limited data.
problem Improving causal effect estimation accuracy in limited data.
method Transfer Learning (TCL) with ℓ1 regularization for nuisance models.
result Non-asymptotic recovery guarantees for exttt{ℓ1-TCL} in high-dimensional settings. Proposes a method to estimate personalized treatments from high-dimensional data.
problem Estimating individualized treatment regimes (ITRs) from high-dimensional covariates.
method Directly targets the contrast between potential outcomes, using dimension-reduced outcome-weighted learning.
result Achieves universal consistency, converging to the Bayes risk under mild conditions.
Study analyzes sensitivity of RL algorithm for ICU hemodynamic management.
problem Evaluating safety and reliability of RL in clinical settings.
method Sensitivity analysis of Duel-DDQN on ICU sepsis patients.
result RL policies are sensitive to various implementation factors.
Causal thinking improves healthcare decisions from EHRs.
problem Shortcuts in data lead to biased healthcare decisions.
method Step-by-step framework for valid decision making from EHRs.
result Valid decision making requires careful analysis of EHR data.
New method identifies proxies for causal effects on multiple outcomes.
problem Estimating causal effects in scenarios with multiple outcomes and treatments.
method Causal discovery method leveraging multiple outcomes as proxies for each treatment effect.
result Parallel studies of multiple outcomes can assist in causal identification.
New method estimates policy performance under unobserved confounding.
problem Estimating policy performance when decisions depend on unobserved variables.
method Developed worst-case bounds for robust OPE under unobserved confounding.
result Efficient procedure for computing worst-case bounds, proving statistical consistency.
PRL improves off-policy evaluation in partially observed MDPs.
problem Confounding and bias in offline reinforcement learning with unobserved state factors.
method Extends proximal causal inference to POMDPs, identifying and estimating target policy value.
result Semiparametrically efficient estimators for PRL in partially observed MDPs.
Objective: Predict individual septic children's personalized physiologic responses to vasoactive titrations by training a Recurrent Neural Network (RNN) using EMR data. Materials and Methods: This study retrospectively analyzed EMR of patients admitted to a pediatric ICU from 2009 to 2017. Data included charted time se…
Framework improves clinical timeline reconstruction from text and tables.
problem Temporal precision and event timing in clinical narratives and EHRs.
method Retrieval-augmented multimodal alignment framework.
result Consistently improves absolute timestamp accuracy and temporal concordance.
We demonstrate a simple strategy to cope with missing data in sequential inputs, addressing the task of multilabel classification of diagnoses given clinical time series. Collected from the pediatric intensive care unit (PICU) at Children's Hospital Los Angeles, our data consists of multivariate time series of observat…
The lack of interpretability remains a key barrier to the adoption of deep models in many applications. In this work, we explicitly regularize deep models so human users might step through the process behind their predictions in little time. Specifically, we train deep time-series models so their class-probability pred…