A Knowledge Distillation Approach for Sepsis Outcome Prediction from Multivariate Clinical Time Series

Sepsis is a life-threatening condition triggered by an extreme infection response. Our objective is to forecast sepsis patient outcomes using their medical history and treatments, while learning interpretable state representations to assess patients' risks in developing various adverse outcomes. While neural networks excel in outcome prediction, their limited interpretability remains a key issue. In this work, we use knowledge distillation via constrained variational inference to distill the knowledge of a powerful "teacher" neural network model with high predictive power to train a "student" latent variable model to learn interpretable hidden state representations to achieve high predictive performance for sepsis outcome prediction. Using real-world data from the MIMIC-IV database, we trained an LSTM as the "teacher" model to predict mortality for sepsis patients, given information about their recent history of vital signs, lab values and treatments. For our student model, we use an autoregressive hidden Markov model (AR-HMM) to learn interpretable hidden states from patients' clinical time series, and use the posterior distribution of the learned state representations to predict various downstream outcomes, including hospital mortality, pulmonary edema, need for diuretics, dialysis, and mechanical ventilation. Our results show that our approach successfully incorporates the constraint to achieve high predictive power similar to the teacher model, while maintaining the generative performance.

CAFE: Conflict-Aware Feature-wise Explanations

Feature attribution methods are widely used to explain neural models by determining the influence of individual input features on the models' outputs. We propose a novel feature attribution method, CAFE (Conflict-Aware Feature-wise Explanations), that addresses three limitations of the existing methods: their disregard for the impact of conflicting features, their lack of consideration for the influence of bias terms, and an overly high sensitivity to local variations in the underpinning activation functions. Unlike other methods, CAFE provides safeguards against overestimating the effects of neuron inputs and separately traces positive and negative influences of input features and biases, resulting in enhanced robustness and increased ability to surface feature conflicts. We show experimentally that CAFE is better able to identify conflicting features on synthetic tabular data and exhibits the best overall fidelity on several real-world tabular datasets, while being highly computationally efficient.

RadGraph2: Modeling Disease Progression in Radiology Reports via Hierarchical Information Extraction

We present RadGraph2, a novel dataset for extracting information from radiology reports that focuses on capturing changes in disease state and device placement over time. We introduce a hierarchical schema that organizes entities based on their relationships and show that using this hierarchy during training improves the performance of an information extraction model. Specifically, we propose a modification to the DyGIE++ framework, resulting in our model HGIE, which outperforms previous models in entity and relation extraction tasks. We demonstrate that RadGraph2 enables models to capture a wider variety of findings and perform better at relation extraction compared to those trained on the original RadGraph dataset. Our work provides the foundation for developing automated systems that can track disease progression over time and develop information extraction models that leverage the natural hierarchy of labels in the medical domain.

Treatment-RSPN: Recurrent Sum-Product Networks for Sequential Treatment Regimes

Sum-product networks (SPNs) have recently emerged as a novel deep learning architecture enabling highly efficient probabilistic inference. Since their introduction, SPNs have been applied to a wide range of data modalities and extended to time-sequence data. In this paper, we propose a general framework for modelling sequential treatment decision-making behaviour and treatment response using recurrent sum-product networks (RSPNs). Models developed using our framework benefit from the full range of RSPN capabilities, including the abilities to model the full distribution of the data, to seamlessly handle latent variables, missing values and categorical data, and to efficiently perform marginal and conditional inference. Our methodology is complemented by a novel variant of the expectation-maximization algorithm for RSPNs, enabling efficient training of our models. We evaluate our approach on a synthetic dataset as well as real-world data from the MIMIC-IV intensive care unit medical database. Our evaluation demonstrates that our approach can closely match the ground-truth data generation process on synthetic data and achieve results close to neural and probabilistic baselines while using a tractable and interpretable model.