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Health-related data is noisy and stochastic in implying the true physiological states of patients, limiting information contained in single-moment observations for sequential clinical decision making. We model patient-clinician interactions as partially observable Markov decision processes (POMDPs) and optimize sequential treatment based on belief states inferred from history sequence. To facilitate inference, we build a variational generative model and boost state representation with a recurrent neural network (RNN), incorporating an auxiliary loss from sequence auto-encoding. Meanwhile, we optimize a continuous policy of drug levels with an actor-critic method where policy gradients are obtained from a stablized off-policy estimate of advantage function, with the value of belief state backed up by parallel best-first suffix trees. We exploit our methodology in optimizing dosages of vasopressor and intravenous fluid for sepsis patients using a retrospective intensive care dataset and evaluate the learned policy with off-policy policy evaluation (OPPE). The results demonstrate that modelling as POMDPs yields better performance than MDPs, and that incorporating heuristic search improves sample efficiency.
The use of a policy and a heuristic function for guiding search can be quite effective in adversarial problems, as demonstrated by AlphaGo and its successors, which are based on the PUCT search algorithm. While PUCT can also be used to solve single-a
A* search is an informed search algorithm that uses a heuristic function to guide the order in which nodes are expanded. Since the computation required to expand a node and compute the heuristic values for all of its generated children grows linearly
Nurse rostering is a complex scheduling problem that affects hospital personnel on a daily basis all over the world. This paper presents a new component-based approach with evolutionary eliminations, for a nurse scheduling problem arising at a major
We introduce and analyze two parameter-free linear-memory tree search algorithms. Under mild assumptions we prove our algorithms are guaranteed to perform only a logarithmic factor more node expansions than A* when the search space is a tree. Previou
Monte Carlo Tree Search (MCTS) has improved the performance of game engines in domains such as Go, Hex, and general game playing. MCTS has been shown to outperform classic alpha-beta search in games where good heuristic evaluations are difficult to o