On the Challenges of using Reinforcement Learning in Precision Drug Dosing: Delay and Prolongedness of Action Effects

Drug dosing is an important application of AI, which can be formulated as a Reinforcement Learning (RL) problem. In this paper, we identify two major challenges of using RL for drug dosing: delayed and prolonged effects of administering medications, which break the Markov assumption of the RL framework. We focus on prolongedness and define PAE-POMDP (Prolonged Action Effect-Partially Observable Markov Decision Process), a subclass of POMDPs in which the Markov assumption does not hold specifically due to prolonged effects of actions. Motivated by the pharmacology literature, we propose a simple and effective approach to converting drug dosing PAE-POMDPs into MDPs, enabling the use of the existing RL algorithms to solve such problems. We validate the proposed approach on a toy task, and a challenging glucose control task, for which we devise a clinically-inspired reward function. Our results demonstrate that: (1) the proposed method to restore the Markov assumption leads to significant improvements over a vanilla baseline; (2) the approach is competitive with recurrent policies which may inherently capture the prolonged effect of actions; (3) it is remarkably more time and memory efficient than the recurrent baseline and hence more suitable for real-time dosing control systems; and (4) it exhibits favorable qualitative behavior in our policy analysis.

Towards Safe Mechanical Ventilation Treatment Using Deep Offline Reinforcement Learning

Mechanical ventilation is a key form of life support for patients with pulmonary impairment. Healthcare workers are required to continuously adjust ventilator settings for each patient, a challenging and time consuming task. Hence, it would be beneficial to develop an automated decision support tool to optimize ventilation treatment. We present DeepVent, a Conservative Q-Learning (CQL) based offline Deep Reinforcement Learning (DRL) agent that learns to predict the optimal ventilator parameters for a patient to promote 90 day survival. We design a clinically relevant intermediate reward that encourages continuous improvement of the patient vitals as well as addresses the challenge of sparse reward in RL. We find that DeepVent recommends ventilation parameters within safe ranges, as outlined in recent clinical trials. The CQL algorithm offers additional safety by mitigating the overestimation of the value estimates of out-of-distribution states/actions. We evaluate our agent using Fitted Q Evaluation (FQE) and demonstrate that it outperforms physicians from the MIMIC-III dataset.

Active MR k-space Sampling with Reinforcement Learning

Deep learning approaches have recently shown great promise in accelerating magnetic resonance image (MRI) acquisition. The majority of existing work have focused on designing better reconstruction models given a pre-determined acquisition trajectory, ignoring the question of trajectory optimization. In this paper, we focus on learning acquisition trajectories given a fixed image reconstruction model. We formulate the problem as a sequential decision process and propose the use of reinforcement learning to solve it. Experiments on a large scale public MRI dataset of knees show that our proposed models significantly outperform the state-of-the-art in active MRI acquisition, over a large range of acceleration factors.

Option-critic in cooperative multi-agent systems

In this paper, we investigate learning temporal abstractions in cooperative multi-agent systems using the options framework (Sutton et al, 1999) and provide a model-free algorithm for this problem. First, we address the planning problem for the decentralized POMDP represented by the multi-agent system, by introducing a common information approach. We use common beliefs and broadcasting to solve an equivalent centralized POMDP problem. Then, we propose the Distributed Option Critic (DOC) algorithm, motivated by the work of Bacon et al (2017) in the single-agent setting. Our approach uses centralized option evaluation and decentralized intra-option improvement. We analyze theoretically the asymptotic convergence of DOC and validate its performance in grid-world environments, where we implement DOC using a deep neural network. Our experiments show that DOC performs competitively with state-of-the-art algorithms and that it is scalable when the number of agents increases.