No Arabic abstract
With the introduction of the Electric Health Records, large amounts of digital data become available for analysis and decision support. When physicians are prescribing treatments to a patient, they need to consider a large range of data variety and volume, making decisions increasingly complex. Machine learning based Clinical Decision Support systems can be a solution to the data challenges. In this work we focus on a class of decision support in which the physicians decision is directly predicted. Concretely, the model would assign higher probabilities to decisions that it presumes the physician are more likely to make. Thus the CDS system can provide physicians with rational recommendations. We also address the problem of correlation in target features: Often a physician is required to make multiple (sub-)decisions in a block, and that these decisions are mutually dependent. We propose a solution to the target correlation problem using a tensor factorization model. In order to handle the patients historical information as sequential data, we apply the so-called Encoder-Decoder-Framework which is based on Recurrent Neural Networks (RNN) as encoders and a tensor factorization model as a decoder, a combination which is novel in machine learning. With experiments with real-world datasets we show that the proposed model does achieve better prediction performances.
The pervasive application of algorithmic decision-making is raising concerns on the risk of unintended bias in AI systems deployed in critical settings such as healthcare. The detection and mitigation of biased models is a very delicate task which should be tackled with care and involving domain experts in the loop. In this paper we introduce FairLens, a methodology for discovering and explaining biases. We show how our tool can be used to audit a fictional commercial black-box model acting as a clinical decision support system. In this scenario, the healthcare facility experts can use FairLens on their own historical data to discover the models biases before incorporating it into the clinical decision flow. FairLens first stratifies the available patient data according to attributes such as age, ethnicity, gender and insurance; it then assesses the model performance on such subgroups of patients identifying those in need of expert evaluation. Finally, building on recent state-of-the-art XAI (eXplainable Artificial Intelligence) techniques, FairLens explains which elements in patients clinical history drive the model error in the selected subgroup. Therefore, FairLens allows experts to investigate whether to trust the model and to spotlight group-specific biases that might constitute potential fairness issues.
Owe to the recent advancements in Artificial Intelligence especially deep learning, many data-driven decision support systems have been implemented to facilitate medical doctors in delivering personalized care. We focus on the deep reinforcement learning (DRL) models in this paper. DRL models have demonstrated human-level or even superior performance in the tasks of computer vision and game playings, such as Go and Atari game. However, the adoption of deep reinforcement learning techniques in clinical decision optimization is still rare. We present the first survey that summarizes reinforcement learning algorithms with Deep Neural Networks (DNN) on clinical decision support. We also discuss some case studies, where different DRL algorithms were applied to address various clinical challenges. We further compare and contrast the advantages and limitations of various DRL algorithms and present a preliminary guide on how to choose the appropriate DRL algorithm for particular clinical applications.
In this study, we present a novel clinical decision support system and discuss its interpretability-related properties. It combines a decision set of rules with a machine learning scheme to offer global and local interpretability. More specifically, machine learning is used to predict the likelihood of each of those rules to be correct for a particular patient, which may also contribute to better predictive performances. Moreover, the reliability analysis of individual predictions is also addressed, contributing to further personalized interpretability. The combination of these several elements may be crucial to obtain the clinical stakeholders trust, leading to a better assessment of patients conditions and improvement of the physicians decision-making.
In this short paper, we present early insights from a Decision Support System for Customer Support Agents (CSAs) serving customers of a leading accounting software. The system is under development and is designed to provide suggestions to CSAs to make them more productive. A unique aspect of the solution is the use of bandit algorithms to create a tractable human-in-the-loop system that can learn from CSAs in an online fashion. In addition to discussing the ML aspects, we also bring out important insights we gleaned from early feedback from CSAs. These insights motivate our future work and also might be of wider interest to ML practitioners.
Clinical decision support systems (CDSS) will play an in-creasing role in improving the quality of medical care for critically ill patients. However, due to limitations in current informatics infrastructure, CDSS do not always have com-plete information on state of supporting physiologic monitor-ing devices, which can limit the input data available to CDSS. This is especially true in the use case of mechanical ventilation (MV), where current CDSS have no knowledge of critical ventilation settings, such as ventilation mode. To enable MV CDSS to make accurate recommendations related to ventilator mode, we developed a highly performant ma-chine learning model that is able to perform per-breath clas-sification of 5 of the most widely used ventilation modes in the USA with an average F1-score of 97.52%. We also show how our approach makes methodologic improvements over previous work and that it is highly robust to missing data caused by software/sensor error.