Subscribe to the gold package and get unlimited access to Shamra Academy
Register a new userOffline reinforcement learning with uncertainty for treatment strategies in sepsis
119
0
0.0
(
0
)
Added by
Ran Liu
Publication date
2021
fields
Informatics Engineering
and research's language is
English
Ask ChatGPT about the research
No Arabic abstract
Guideline-based treatment for sepsis and septic shock is difficult because sepsis is a disparate range of life-threatening organ dysfunctions whose pathophysiology is not fully understood. Early intervention in sepsis is crucial for patient outcome, yet those interventions have adverse effects and are frequently overadministered. Greater personalization is necessary, as no single action is suitable for all patients. We present a novel application of reinforcement learning in which we identify optimal recommendations for sepsis treatment from data, estimate their confidence level, and identify treatment options infrequently observed in training data. Rather than a single recommendation, our method can present several treatment options. We examine learned policies and discover that reinforcement learning is biased against aggressive intervention due to the confounding relationship between mortality and level of treatment received. We mitigate this bias using subspace learning, and develop methodology that can yield more accurate learning policies across healthcare applications.
rate research
Read More
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 model-based reinforcement learning (RL) to discover high-quality treatment policies for sepsis patients. Our quantitative evaluation reveals that by blending the treatment strategy discovered with RL with what clinicians follow, we can obtain improved policies, potentially allowing for better medical treatment for sepsis.
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 to personalize sepsis treatment. The mixture model selectively alternates between neighbor-based (kernel) and deep reinforcement learning (DRL) experts depending on patients current history. On a large retrospective cohort, this mixture-based approach outperforms physician, kernel only, and DRL-only experts.
Sepsis is a leading cause of mortality in intensive care units and costs hospitals billions annually. Treating a septic patient 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 propose an approach to deduce treatment policies for septic patients by using continuous state-space models and deep reinforcement learning. Our model learns clinically interpretable treatment policies, similar in important aspects to the treatment policies of physicians. The learned policies could be used to aid intensive care clinicians in medical decision making and improve the likelihood of patient survival.
Offline Reinforcement Learning promises to learn effective policies from previously-collected, static datasets without the need for exploration. However, existing Q-learning and actor-critic based off-policy RL algorithms fail when bootstrapping from out-of-distribution (OOD) actions or states. We hypothesize that a key missing ingredient from the existing methods is a proper treatment of uncertainty in the offline setting. We propose Uncertainty Weighted Actor-Critic (UWAC), an algorithm that detects OOD state-action pairs and down-weights their contribution in the training objectives accordingly. Implementation-wise, we adopt a practical and effective dropout-based uncertainty estimation method that introduces very little overhead over existing RL algorithms. Empirically, we observe that UWAC substantially improves model stability during training. In addition, UWAC out-performs existing offline RL methods on a variety of competitive tasks, and achieves significant performance gains over the state-of-the-art baseline on datasets with sparse demonstrations collected from human experts.
Offline reinforcement learning (RL purely from logged data) is an important avenue for deploying RL techniques in real-world scenarios. However, existing hyperparameter selection methods for offline RL break the offline assumption by evaluating policies corresponding to each hyperparameter setting in the environment. This online execution is often infeasible and hence undermines the main aim of offline RL. Therefore, in this work, we focus on textit{offline hyperparameter selection}, i.e. methods for choosing the best policy from a set of many policies trained using different hyperparameters, given only logged data. Through large-scale empirical evaluation we show that: 1) offline RL algorithms are not robust to hyperparameter choices, 2) factors such as the offline RL algorithm and method for estimating Q values can have a big impact on hyperparameter selection, and 3) when we control those factors carefully, we can reliably rank policies across hyperparameter choices, and therefore choose policies which are close to the best policy in the set. Overall, our results present an optimistic view that offline hyperparameter selection is within reach, even in challenging tasks with pixel observations, high dimensional action spaces, and long horizon.
suggested questions
Log in to be able to interact and post comments
comments
Fetching comments
Sign in to be able to follow your search criteria
