Joshua C. Chang

Hongjing Xia, Joshua C. Chang, Sarah Nowak et al.

We used survival analysis to quantify the impact of postdischarge evaluation and management (E/M) services in preventing hospital readmission or death. Our approach avoids a specific pitfall of applying machine learning to this problem, which is an inflated estimate of the effect of interventions, due to survivors bias -- where the magnitude of inflation may be conditional on heterogeneous confounders in the population. This bias arises simply because in order to receive an intervention after discharge, a person must not have been readmitted in the intervening period. After deriving an expression for this phantom effect, we controlled for this and other biases within an inherently interpretable Bayesian survival framework. We identified case management services as being the most impactful for reducing readmissions overall.

Joshua C. Chang, Carson C. Chow, Julia Porcino

The Work Disability Functional Assessment Battery (WD-FAB) is a multidimensional item response theory (IRT) instrument designed for assessing work-related mental and physical function based on responses to an item bank. In prior iterations it was developed using traditional means -- linear factorization and null hypothesis statistical testing for item partitioning/selection, and finally, posthoc calibration of disjoint unidimensional IRT models. As a result, the WD-FAB, like many other IRT instruments, is a posthoc model. Its item partitioning, based on exploratory factor analysis, is blind to the final nonlinear IRT model and is not performed in a manner consistent with goodness of fit to the final model. In this manuscript, we develop a Bayesian hierarchical model for self-consistently performing the following simultaneous tasks: scale factorization, item selection, parameter identification, and response scoring. This method uses sparsity-based shrinkage to obviate the linear factorization and null hypothesis statistical tests that are usually required for developing multidimensional IRT models, so that item partitioning is consistent with the ultimate nonlinear factor model. We also analogize our multidimensional IRT model to probabilistic autoencoders, specifying an encoder function that amortizes the inference of ability parameters from item responses. The encoder function is equivalent to the "VBE" step in a stochastic variational Bayesian expectation maximization (VBEM) procedure that we use for approxiamte Bayesian inference on the entire model. We use the method on a sample of WD-FAB item responses and compare the resulting item discriminations to those obtained using the traditional posthoc method.

Joshua C. Chang, Ted L. Chang, Carson C. Chow et al.

We developed an inherently interpretable multilevel Bayesian framework for representing variation in regression coefficients that mimics the piecewise linearity of ReLU-activated deep neural networks. We used the framework to formulate a survival model for using medical claims to predict hospital readmission and death that focuses on discharge placement, adjusting for confounding in estimating causal local average treatment effects. We trained the model on a 5% sample of Medicare beneficiaries from 2008 and 2011, based on their 2009--2011 inpatient episodes, and then tested the model on 2012 episodes. The model scored an AUROC of approximately 0.76 on predicting all-cause readmissions -- defined using official Centers for Medicare and Medicaid Services (CMS) methodology -- or death within 30-days of discharge, being competitive against XGBoost and a Bayesian deep neural network, demonstrating that one need-not sacrifice interpretability for accuracy. Crucially, as a regression model, we provide what blackboxes cannot -- the exact gold-standard global interpretation of the model, identifying relative risk factors and quantifying the effect of discharge placement. We also show that the posthoc explainer SHAP fails to provide accurate explanations.

Joshua C. Chang

We formally introduce a class of models inspired by renormalization group (RG) theory, built on additive hierarchical expansions analogous to those appearing in functional ANOVA and mixed-effects models. Like ReLU convolutional neural networks, they are almost everywhere locally linear; unlike ReLU networks, their partition structure is explicit, interpretable, and easy to modify or constrain. In these models, one defines a multidimensional lattice partition of the input space and uses it to scaffold variations in regression parameters. Each dimension of the lattice corresponds to an attribute by which the statistics of the problem may vary. The parameters are themselves expressed in the form of an expansion, where each term captures variations relative to a lower (coarser) interaction scale. These models admit multiple equivalent interpretations: as piecewise GLMs, as hierarchical mixed-effects regressions, or as regression trees with structured parameter sharing. Since RG motivates the design of these models, we use techniques from statistical physics -- specifically replica analysis -- to study their generalization properties. Specifically, we analyze the behavior of the Watanabe-Akaike Information Criterion (WAIC) as a proxy for generalization loss. This analysis yields two practical results: (i) guidance on the lattice design as a function of dataset size and predictor dimensionality; and (ii) a principled scaling law for the regularization prior when adding higher-order terms to the expansion so that one can increase model complexity without an expected increase in generalization loss. We evaluate the methodology on public datasets and find performance competitive against both blackbox methods and other intrinsically interpretable approaches.

Tina Su, Edison Choe, Joshua C. Chang

Computer Adaptive Testing (CAT) aims to accurately estimate an individual's ability using only a subset of an Item Response Theory (IRT) instrument. Many applications also require diverse item exposure across testing sessions, preventing any single item from being over- or underutilized. In CAT, items are selected sequentially based on a running estimate of a respondent's ability. Prior methods almost universally see item selection through an optimization lens, motivating greedy item selection procedures. While efficient, these deterministic methods tend to have poor item exposure. Existing stochastic methods for item selection are ad-hoc, with item sampling weights that lack theoretical justification. We formulate stochastic CAT as a Bayesian model averaging problem. We seek item sampling probabilities, treated in the long-run frequentist sense, that perform optimal model averaging for the ability estimate in a Bayesian sense. The derivation yields an information criterion for optimal stochastic mixing: the expected entropy of the next posterior. We tested our method on seven publicly available psychometric instruments spanning personality, social attitudes, narcissism, and work preferences, in addition to the eight scales of the Work Disability Functional Assessment Battery. Across all instruments, accuracy differences between selection methods at a given test length are varied but minimal relative to the natural noise in ability estimation; however, the stochastic selector achieves full item bank exposure, resolving the longstanding tradeoff between measurement efficiency and item security at negligible accuracy cost.

Joshua C. Chang, Patrick Fletcher, Jungmin Han et al.

Dimensionality reduction methods for count data are critical to a wide range of applications in medical informatics and other fields where model interpretability is paramount. For such data, hierarchical Poisson matrix factorization (HPF) and other sparse probabilistic non-negative matrix factorization (NMF) methods are considered to be interpretable generative models. They consist of sparse transformations for decoding their learned representations into predictions. However, sparsity in representation decoding does not necessarily imply sparsity in the encoding of representations from the original data features. HPF is often incorrectly interpreted in the literature as if it possesses encoder sparsity. The distinction between decoder sparsity and encoder sparsity is subtle but important. Due to the lack of encoder sparsity, HPF does not possess the column-clustering property of classical NMF -- the factor loading matrix does not sufficiently define how each factor is formed from the original features. We address this deficiency by self-consistently enforcing encoder sparsity, using a generalized additive model (GAM), thereby allowing one to relate each representation coordinate to a subset of the original data features. In doing so, the method also gains the ability to perform feature selection. We demonstrate our method on simulated data and give an example of how encoder sparsity is of practical use in a concrete application of representing inpatient comorbidities in Medicare patients.

Joshua C. Chang, Shashaank Vattikuti, Carson C. Chow

Item response theory (IRT) is a non-linear generative probabilistic paradigm for using exams to identify, quantify, and compare latent traits of individuals, relative to their peers, within a population of interest. In pre-existing multidimensional IRT methods, one requires a factorization of the test items. For this task, linear exploratory factor analysis is used, making IRT a posthoc model. We propose skipping the initial factor analysis by using a sparsity-promoting horseshoe prior to perform factorization directly within the IRT model so that all training occurs in a single self-consistent step. Being a hierarchical Bayesian model, we adapt the WAIC to the problem of dimensionality selection. IRT models are analogous to probabilistic autoencoders. By binding the generative IRT model to a Bayesian neural network (forming a probabilistic autoencoder), one obtains a scoring algorithm consistent with the interpretable Bayesian model. In some IRT applications the black-box nature of a neural network scoring machine is desirable. In this manuscript, we demonstrate within-IRT factorization and comment on scoring approaches.

Joshua C. Chang

Consider the problem of modeling hysteresis for finite-state random walks using higher-order Markov chains. This Letter introduces a Bayesian framework to determine, from data, the number of prior states of recent history upon which a trajectory is statistically dependent. The general recommendation is to use leave-one-out cross validation, using an easily-computable formula that is provided in closed form. Importantly, Bayes factors using flat model priors are biased in favor of too-complex a model (more hysteresis) when a large amount of data is present and the Akaike information criterion (AIC) is biased in favor of too-sparse a model (less hysteresis) when few data are present.

Joshua C. Chang, Tom Chou

Shape-based regularization has proven to be a useful method for delineating objects within noisy images where one has prior knowledge of the shape of the targeted object. When a collection of possible shapes is available, the specification of a shape prior using kernel density estimation is a natural technique. Unfortunately, energy functionals arising from kernel density estimation are of a form that makes them impossible to directly minimize using efficient optimization algorithms such as graph cuts. Our main contribution is to show how one may recast the energy functional into a form that is minimizable iteratively and efficiently using graph cuts.