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…
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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.
Sepsis, a dysregulated immune system response to infection, is among the leading causes of morbidity, mortality, and cost overruns in the Intensive Care Unit (ICU). Early prediction of sepsis can improve situational awareness amongst clinicians and facilitate timely, protective interventions. While the application of p…
Sepsis is the leading cause of death in non-coronary intensive care units. Moreover, a delay of antibiotic treatment of patients with severe sepsis by only few hours is associated with increased mortality. This insight makes accurate models for early prediction of sepsis a key task in machine learning for healthcare. P…
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…
Current machine learning models aiming to predict sepsis from Electronic Health Records (EHR) do not account for the heterogeneity of the condition, despite its emerging importance in prognosis and treatment. This work demonstrates the added value of stratifying the types of organ dysfunction observed in patients who d…
Background: While machine learning (ML) models are rapidly emerging as promising screening tools in critical care medicine, the identification of homogeneous subphenotypes within populations with heterogeneous conditions such as pediatric sepsis may facilitate attainment of high-predictive performance of these prognost…
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.
With a mortality rate of 5.4 million lives worldwide every year and a healthcare cost of more than 16 billion dollars in the USA alone, sepsis is one of the leading causes of hospital mortality and an increasing concern in the ageing western world. Recently, medical and technological advances have helped re-define the …
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.
An Improved Multi-Output Gaussian Process RNN with Real-Time Validation for Early Sepsis Detectionstat.ML
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 a life-threatening condition caused by the body's response to an infection. In order to treat patients with sepsis, physicians must control varying dosages of various antibiotics, fluids, and vasopressors based on a large number of variables in an emergency setting. In this project we employ a "world model" m…
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…
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…
Sepsis is a life-threatening condition that seriously endangers millions of people over the world. Hopefully, with the widespread availability of electronic health records (EHR), predictive models that can effectively deal with clinical sequential data increase the possibility to predict sepsis and take early preventiv…
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…
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…
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.
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.
Validity problems in clinical machine learning by indirect data labeling using consensus definitionscs.LG
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.
Improving Sepsis Treatment Strategies by Combining Deep and Kernel-Based Reinforcement Learningcs.LG
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 …
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.
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…
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.
Predictive models are finding an increasing number of applications in many industries. As a result, a practical means for trading-off the cost of deploying a model versus its effectiveness is needed. Our work is motivated by risk prediction problems in healthcare. Cost-structures in domains such as healthcare are quite…
Bayesian model for multi-environment prediction with latent variable changes.
problem Prediction in environments with changing latent variable distributions.
method Bayesian model with empirical Bayes prior and amortized variational algorithm.
result Method outperforms previous approaches in new environments.
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{-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.
This paper introduces a new method for uncertainty quantification in prediction models.
problem Quantifying uncertainty in high-stakes applications like medicine and finance.
method Confidence sets for outcome excursions, focusing on identifying subsets of features where outcomes exceed a threshold.
result Theoretical guarantees for the probability that confidence sets contain the true feature subset, both asymptotically and for finite sample sizes.
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.
SAFER improves personalized treatment recommendations for dynamic clinical contexts.
problem Personalized treatment optimization in evolving clinical contexts with safety concerns.
method Integrates structured EHR and clinical notes, uses conformal prediction for safe recommendations.
result SAFER outperforms state-of-the-art baselines in recommendation metrics and mortality rates.
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.
Novel model improves clinical risk prediction by transferring knowledge between tasks over time.
problem Negative transfer in multi-task learning for clinical risk prediction.
method Temporal Probabilistic Asymmetric Multi-Task Learning (TPAMTL).
result Significantly outperforms various deep learning models for time-series prediction.
New framework models time-uncertain point processes for better event prediction.
problem Uncertainty in event times in point processes.
method Formulated and discretized continuous-time Hawkes processes with time grid, enabling optimization methods for inference.
result Parameter recovery with convergence rate using gradient descent and VI.
Febrile neutropenia (FN) has been associated with high mortality, especially among adults with cancer. Understanding the patient and provider level heterogeneity in FN hospital admissions has potential to inform personalized interventions focused on increasing survival of individuals with FN. We leverage machine learni…
Paper detects bias in AI medical models using CART.
problem Ensuring fairness in AI medical decision support systems.
method Uses Classification and Regression Trees (CART) algorithm to identify bias.
result Validated the CART approach in both synthetic and real-world data.
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.
Advances in deep learning for spatio-temporal event modeling.
problem Limitations of traditional parametric models in capturing nonstationary dynamics.
method Integration of deep neural architectures to model conditional intensity function and influence kernels.
result Deep influence kernel approach enhances expressiveness and statistical explainability.
Estimating the causal effects of an intervention from high-dimensional observational data is difficult due to the presence of confounding. The task is often complicated by the fact that we may have a systematic missingness in our data at test time. Our approach uses the information bottleneck to perform a low-dimension…
We introduce an off-policy evaluation procedure for highlighting episodes where applying a reinforcement learned (RL) policy is likely to have produced a substantially different outcome than the observed policy. In particular, we introduce a class of structural causal models (SCMs) for generating counterfactual traject…
We introduce a novel apprenticeship learning algorithm to learn an expert's underlying reward structure in off-policy model-free \emph{batch} settings. Unlike existing methods that require a dynamics model or additional data acquisition for on-policy evaluation, our algorithm requires only the batch data of observed ex…
A new method explains RNNs by decision lists over skipgrams, improving explanation fidelity and interpretability.
problem Lack of understanding how input segments combine to form patterns in neural network outputs.
method Proposes a pipeline to explain RNNs using decision lists over skipgrams, creating synthetic and real-world datasets for evaluation.
result Persistently achieves high explanation fidelity and interpretable rules.