Shashaank Vattikuti

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, 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.