Learning Optimal Treatment Strategies for Sepsis Using Offline Reinforcement Learning in Continuous Space

Sepsis is a leading cause of death in the ICU. It is a disease requiring complex interventions in a short period of time, but its optimal treatment strategy remains uncertain. Evidence suggests that the practices of currently used treatment strategies are problematic and may cause harm to patients. To address this decision problem, we propose a new medical decision model based on historical data to help clinicians recommend the best reference option for real-time treatment. Our model combines offline reinforcement learning with deep reinforcement learning to address the problem that traditional reinforcement learning in healthcare cannot interact with the environment, enabling our model to make decisions in a continuous state-action space. We demonstrate that, on average, the treatments recommended by the model are more valuable and reliable than those recommended by clinicians. In a large validation dataset, we found that patients whose actual doses from clinicians matched the AI's decisions had the lowest mortality rates. Our model provides personalized, clinically interpretable treatment decisions for sepsis that can improve patient care.