The ability to quickly and accurately identify covariate shift at test time is a critical and often overlooked component of safe machine learning systems deployed in high-risk domains. While methods exist for detecting when predictions should not be made on out-of-distribution test examples, identifying distributional level differences between training and test time can help determine when a model should be removed from the deployment setting and retrained. In this work, we define harmful covariate shift (HCS) as a change in distribution that may weaken the generalization of a predictive model. To detect HCS, we use the discordance between an ensemble of classifiers trained to agree on training data and disagree on test data. We derive a loss function for training this ensemble and show that the disagreement rate and entropy represent powerful discriminative statistics for HCS. Empirically, we demonstrate the ability of our method to detect harmful covariate shift with statistical certainty on a variety of high-dimensional datasets. Across numerous domains and modalities, we show state-of-the-art performance compared to existing methods, particularly when the number of observed test samples is small.
Checklists, while being only recently introduced in the medical domain, have become highly popular in daily clinical practice due to their combined effectiveness and great interpretability. Checklists are usually designed by expert clinicians that manually collect and analyze available evidence. However, the increasing quantity of available medical data is calling for a partially automated checklist design. Recent works have taken a step in that direction by learning predictive checklists from categorical data. In this work, we propose to extend this approach to accomodate learning checklists from continuous medical data using mixed-integer programming approach. We show that this extension outperforms a range of explainable machine learning baselines on the prediction of sepsis from intensive care clinical trajectories.
We consider the problem of partial identification, the estimation of bounds on the treatment effects from observational data. Although studied using discrete treatment variables or in specific causal graphs (e.g., instrumental variables), partial identification has been recently explored using tools from deep generative modeling. We propose a new method for partial identification of average treatment effects(ATEs) in general causal graphs using implicit generative models comprising continuous and discrete random variables. Since ATE with continuous treatment is generally non-regular, we leverage the partial derivatives of response functions to define a regular approximation of ATE, a quantity we call uniform average treatment derivative (UATD). We prove that our algorithm converges to tight bounds on ATE in linear structural causal models (SCMs). For nonlinear SCMs, we empirically show that using UATD leads to tighter and more stable bounds than methods that directly optimize the ATE.
There are several opportunities for automation in healthcare that can improve clinician throughput. One such example is assistive tools to document diagnosis codes when clinicians write notes. We study the automation of medical code prediction using curriculum learning, which is a training strategy for machine learning models that gradually increases the hardness of the learning tasks from easy to difficult. One of the challenges in curriculum learning is the design of curricula -- i.e., in the sequential design of tasks that gradually increase in difficulty. We propose Hierarchical Curriculum Learning (HiCu), an algorithm that uses graph structure in the space of outputs to design curricula for multi-label classification. We create curricula for multi-label classification models that predict ICD diagnosis and procedure codes from natural language descriptions of patients. By leveraging the hierarchy of ICD codes, which groups diagnosis codes based on various organ systems in the human body, we find that our proposed curricula improve the generalization of neural network-based predictive models across recurrent, convolutional, and transformer-based architectures. Our code is available at https://github.com/wren93/HiCu-ICD.
Vision Transformers (ViTs) and their multi-scale and hierarchical variations have been successful at capturing image representations but their use has been generally studied for low-resolution images (e.g. - 256x256, 384384). For gigapixel whole-slide imaging (WSI) in computational pathology, WSIs can be as large as 150000x150000 pixels at 20X magnification and exhibit a hierarchical structure of visual tokens across varying resolutions: from 16x16 images capture spatial patterns among cells, to 4096x4096 images characterizing interactions within the tissue microenvironment. We introduce a new ViT architecture called the Hierarchical Image Pyramid Transformer (HIPT), which leverages the natural hierarchical structure inherent in WSIs using two levels of self-supervised learning to learn high-resolution image representations. HIPT is pretrained across 33 cancer types using 10,678 gigapixel WSIs, 408,218 4096x4096 images, and 104M 256x256 images. We benchmark HIPT representations on 9 slide-level tasks, and demonstrate that: 1) HIPT with hierarchical pretraining outperforms current state-of-the-art methods for cancer subtyping and survival prediction, 2) self-supervised ViTs are able to model important inductive biases about the hierarchical structure of phenotypes in the tumor microenvironment.
Scarcity of labeled histopathology data limits the applicability of deep learning methods to under-profiled cancer types and labels. Transfer learning allows researchers to overcome the limitations of small datasets by pre-training machine learning models on larger datasets similar to the small target dataset. However, similarity between datasets is often determined heuristically. In this paper, we propose a principled notion of distance between histopathology datasets based on a hierarchical generalization of optimal transport distances. Our method does not require any training, is agnostic to model type, and preserves much of the hierarchical structure in histopathology datasets imposed by tiling. We apply our method to H&E stained slides from The Cancer Genome Atlas from six different cancer types. We show that our method outperforms a baseline distance in a cancer-type prediction task. Our results also show that our optimal transport distance predicts difficulty of transferability in a tumor vs.normal prediction setting.
Machine learning systems are often deployed in domains that entail data from multiple modalities, for example, phenotypic and genotypic characteristics describe patients in healthcare. Previous works have developed multimodal variational autoencoders (VAEs) that generate several modalities. We consider subjective data, where single datapoints from one modality (such as class labels) describe multiple datapoints from another modality (such as images). We theoretically and empirically demonstrate that multimodal VAEs with a mixture of experts posterior can struggle to capture variability in such surjective data.
Tissue phenotyping is a fundamental task in learning objective characterizations of histopathologic biomarkers within the tumor-immune microenvironment in cancer pathology. However, whole-slide imaging (WSI) is a complex computer vision in which: 1) WSIs have enormous image resolutions with precludes large-scale pixel-level efforts in data curation, and 2) diversity of morphological phenotypes results in inter- and intra-observer variability in tissue labeling. To address these limitations, current efforts have proposed using pretrained image encoders (transfer learning from ImageNet, self-supervised pretraining) in extracting morphological features from pathology, but have not been extensively validated. In this work, we conduct a search for good representations in pathology by training a variety of self-supervised models with validation on a variety of weakly-supervised and patch-level tasks. Our key finding is in discovering that Vision Transformers using DINO-based knowledge distillation are able to learn data-efficient and interpretable features in histology images wherein the different attention heads learn distinct morphological phenotypes. We make evaluation code and pretrained weights publicly-available at: https://github.com/Richarizardd/Self-Supervised-ViT-Path.
We study prediction of future outcomes with supervised models that use privileged information during learning. The privileged information comprises samples of time series observed between the baseline time of prediction and the future outcome; this information is only available at training time which differs from the traditional supervised learning. Our question is when using this privileged data leads to more sample-efficient learning of models that use only baseline data for predictions at test time. We give an algorithm for this setting and prove that when the time series are drawn from a non-stationary Gaussian-linear dynamical system of fixed horizon, learning with privileged information is more efficient than learning without it. On synthetic data, we test the limits of our algorithm and theory, both when our assumptions hold and when they are violated. On three diverse real-world datasets, we show that our approach is generally preferable to classical learning, particularly when data is scarce. Finally, we relate our estimator to a distillation approach both theoretically and empirically.
Modeling the time-series of high-dimensional, longitudinal data is important for predicting patient disease progression. However, existing neural network based approaches that learn representations of patient state, while very flexible, are susceptible to overfitting. We propose a deep generative model that makes use of a novel attention-based neural architecture inspired by the physics of how treatments affect disease state. The result is a scalable and accurate model of high-dimensional patient biomarkers as they vary over time. Our proposed model yields significant improvements in generalization and, on real-world clinical data, provides interpretable insights into the dynamics of cancer progression.