Matthew Engelhard

Jimmy Hickey, Ricardo Henao, Daniel Wojdyla et al.

Recently developed survival analysis methods improve upon existing approaches by predicting the probability of event occurrence in each of a number pre-specified (discrete) time intervals. By avoiding placing strong parametric assumptions on the event density, this approach tends to improve prediction performance, particularly when data are plentiful. However, in clinical settings with limited available data, it is often preferable to judiciously partition the event time space into a limited number of intervals well suited to the prediction task at hand. In this work, we develop a method to learn from data a set of cut points defining such a partition. We show that in two simulated datasets, we are able to recover intervals that match the underlying generative model. We then demonstrate improved prediction performance on three real-world observational datasets, including a large, newly harmonized stroke risk prediction dataset. Finally, we argue that our approach facilitates clinical decision-making by suggesting time intervals that are most appropriate for each task, in the sense that they facilitate more accurate risk prediction.

Yuankang Zhao, Youngsoo Baek, Felipe A. Medeiros et al.

Scalable Bayesian inference for generalized linear mixed models (GLMMs) provides uncertainty-aware analysis of correlated longitudinal data, but existing scalable approaches largely assume low-dimensional tabular predictors and do not directly accommodate high-dimensional modalities such as images and text. We address this limitation by learning one or more modality-specific neural encoders jointly with a GLMM objective, then performing variance-corrected stochasticgradient MCMC for the GLMM parameters conditional on the learned representation. This conditional-Bayes design combines supervised representation learning with posterior uncertainty quantification for population-level effects, subjectspecific heterogeneity, and modality-level random slopes. The resulting model preserves interpretable fixed and random effects for structured covariates and learned modalities while scaling gracefully to large longitudinal datasets. In simulation studies, our method recovers posterior means and variance estimates from full-data MCMC benchmarks after covariance correction. We further evaluate uncertainty through parameter-level interval coverage in simulations and predictive calibration on held-out data. Applications to glaucoma progression and adolescent mental health demonstrate that the framework allows nuanced assessment of the relative importance of each modality on both individual and population levels without sacrificing predictive performance.

Minghui Sun, Matthew M. Engelhard, Benjamin A. Goldstein

Risk assessments for a pediatric population are often conducted across multiple stages. For example, clinicians may evaluate risks prenatally, at birth, and during Well-Child visits. Although predictions made at later stages typically achieve higher precision, it is clinically desirable to make reliable risk assessments as early as possible. Therefore, this study focuses on improving prediction performance in early-stage risk assessments. Our solution, \textbf{Borrowing From the Future (BFF)}, is a contrastive multi-modal framework that treats each time window as a distinct modality. In BFF, a model is trained on all available data throughout the time while performing a risk assessment using up-to-date information. This contrastive framework allows the model to ``borrow'' informative signals from later stages (e.g., Well-Child visits) to implicitly supervise the learning at earlier stages (e.g., prenatal/birth stages). We validate BFF on two real-world pediatric outcome prediction tasks, demonstrating consistent improvements in early risk assessments. The code is available at https://github.com/scotsun/bff.

Minghui Sun, Benjamin A. Goldstein, Matthew M. Engelhard

Learning representations unaffected by superficial characteristics is important to ensure that shifts in these characteristics at test time do not compromise downstream prediction performance. For instance, in healthcare applications, we might like to learn features that contain information about pathology yet are unaffected by race, sex, and other sources of physiologic variability, thereby ensuring predictions are equitable and generalizable across all demographics. Here we propose Contrastive LEarning with Anti-contrastive Regularization (CLEAR), an intuitive and easy-to-implement framework that effectively separates essential (i.e., task-relevant) characteristics from superficial (i.e., task-irrelevant) characteristics during training, leading to better performance when superficial characteristics shift at test time. We begin by supposing that data representations can be semantically separated into task-relevant content features, which contain information relevant to downstream tasks, and task-irrelevant style features, which encompass superficial attributes that are irrelevant to these tasks, yet may degrade performance due to associations with content present in training data that do not generalize. We then prove that our anti-contrastive penalty, which we call Pair-Switching (PS), minimizes the Mutual Information between the style attributes and content labels. Finally, we instantiate CLEAR in the latent space of a Variational Auto-Encoder (VAE), then perform experiments to quantitatively and qualitatively evaluate the resulting CLEAR-VAE over several image datasets. Our results show that CLEAR-VAE allows us to: (a) swap and interpolate content and style between any pair of samples, and (b) improve downstream classification performance in the presence of previously unseen combinations of content and style. Our code will be made publicly available.

Yuankang Zhao, Matthew Engelhard

The Hawkes process (HP) is commonly used to model event sequences with self-reinforcing dynamics, including electronic health records (EHRs). Traditional HPs capture self-reinforcement via parametric impact functions that can be inspected to understand how each event modulates the intensity of others. Neural network-based HPs offer greater flexibility, resulting in improved fit and prediction performance, but at the cost of interpretability, which is often critical in healthcare. In this work, we aim to understand and improve upon this tradeoff. We propose a novel HP formulation in which impact functions are modeled by defining a flexible impact kernel, instantiated as a neural network, in event embedding space, which allows us to model large-scale event sequences with many event types. This approach is more flexible than traditional HPs yet more interpretable than other neural network approaches, and allows us to explicitly trade flexibility for interpretability by adding transformer encoder layers to further contextualize the event embeddings. Results show that our method accurately recovers impact functions in simulations, achieves competitive performance on MIMIC-IV procedure dataset, and gains clinically meaningful interpretation on Duke-EHR with children diagnosis dataset even without transformer layers. This suggests that our flexible impact kernel is often sufficient to capture self-reinforcing dynamics in EHRs and other data effectively, implying that interpretability can be maintained without loss of performance.

Mingxuan Liu, Yilin Ning, Haoyuan Wang et al.

As machine learning models become increasingly integrated into healthcare, structural inequities and social biases embedded in clinical data can be perpetuated or even amplified by data-driven models. In survival analysis, censoring and time dynamics can further add complexity to fair model development. Additionally, algorithmic fairness approaches often overlook disparities in cross-group rankings, e.g., high-risk Black patients may be ranked below lower-risk White patients who do not experience the event of mortality. Such misranking can reinforce biological essentialism and undermine equitable care. We propose a Fairness-Aware Survival Modeling (FASM), designed to mitigate algorithmic bias regarding both intra-group and cross-group risk rankings over time. Using breast cancer prognosis as a representative case and applying FASM to SEER breast cancer data, we show that FASM substantially improves fairness while preserving discrimination performance comparable to fairness-unaware survival models. Time-stratified evaluations show that FASM maintains stable fairness over a 10-year horizon, with the greatest improvements observed during the mid-term of follow-up. Our approach enables the development of survival models that prioritize both accuracy and equity in clinical decision-making, advancing fairness as a core principle in clinical care.

Emily Alsentzer, Marie-Laure Charpignon, Bill Chen et al.

The 6th Annual Conference on Health, Inference, and Learning (CHIL 2025), hosted by the Association for Health Learning and Inference (AHLI), was held in person on June 25-27, 2025, at the University of California, Berkeley, in Berkeley, California, USA. As part of this year's program, we hosted Research Roundtables to catalyze collaborative, small-group dialogue around critical, timely topics at the intersection of machine learning and healthcare. Each roundtable was moderated by a team of senior and junior chairs who fostered open exchange, intellectual curiosity, and inclusive engagement. The sessions emphasized rigorous discussion of key challenges, exploration of emerging opportunities, and collective ideation toward actionable directions in the field. In total, eight roundtables were held by 19 roundtable chairs on topics of "Explainability, Interpretability, and Transparency," "Uncertainty, Bias, and Fairness," "Causality," "Domain Adaptation," "Foundation Models," "Learning from Small Medical Data," "Multimodal Methods," and "Scalable, Translational Healthcare Solutions."

Ya-Yun Huang, Joseph McClernon, Jason A. Oliver et al.

Daily environments have profound influence on our health and behavior. Recent work has shown that digital envirotyping, where computer vision is applied to images of daily environments taken during ecological momentary assessment (EMA), can be used to identify meaningful relationships between environmental features and health outcomes of interest. To systematically study such effects on an individual level, it is helpful to group images into distinct environments encountered in an individual's daily life; these may then be analyzed, further grouped into related environments with similar features, and linked to health outcomes. Here we introduce infinite hierarchical contrastive clustering to address this challenge. Building on the established contrastive clustering framework, our method a) allows an arbitrary number of clusters without requiring the full Dirichlet Process machinery by placing a stick-breaking prior on predicted cluster probabilities; and b) encourages distinct environments to form well-defined sub-clusters within each cluster of related environments by incorporating a participant-specific prediction loss. Our experiments show that our model effectively identifies distinct personal environments and groups these environments into meaningful environment types. We then illustrate how the resulting clusters can be linked to various health outcomes, highlighting the potential of our approach to advance the envirotyping paradigm.

Boyao Li, Alexander J. Thomson, Houssam Nassif et al.

Deep neural networks (DNNs) lack the precise semantics and definitive probabilistic interpretation of probabilistic graphical models (PGMs). In this paper, we propose an innovative solution by constructing infinite tree-structured PGMs that correspond exactly to neural networks. Our research reveals that DNNs, during forward propagation, indeed perform approximations of PGM inference that are precise in this alternative PGM structure. Not only does our research complement existing studies that describe neural networks as kernel machines or infinite-sized Gaussian processes, it also elucidates a more direct approximation that DNNs make to exact inference in PGMs. Potential benefits include improved pedagogy and interpretation of DNNs, and algorithms that can merge the strengths of PGMs and DNNs.

Matthew Engelhard, Samuel Berchuck, Joshua D'Arcy et al.

Event time models predict occurrence times of an event of interest based on known features. Recent work has demonstrated that neural networks achieve state-of-the-art event time predictions in a variety of settings. However, standard event time models suppose that the event occurs, eventually, in all cases. Consequently, no distinction is made between a) the probability of event occurrence, and b) the predicted time of occurrence. This distinction is critical when predicting medical diagnoses, equipment defects, social media posts, and other events that or may not occur, and for which the features affecting a) may be different from those affecting b). In this work, we develop a conditional event time model that distinguishes between these components, implement it as a neural network with a binary stochastic layer representing finite event occurrence, and show how it may be learned from right-censored event times via maximum likelihood estimation. Results demonstrate superior event occurrence and event time predictions on synthetic data, medical events (MIMIC-III), and social media posts (Reddit), comprising 21 total prediction tasks.

Matthew Engelhard, Hongteng Xu, Lawrence Carin et al.

Health risks from cigarette smoking -- the leading cause of preventable death in the United States -- can be substantially reduced by quitting. Although most smokers are motivated to quit, the majority of quit attempts fail. A number of studies have explored the role of self-reported symptoms, physiologic measurements, and environmental context on smoking risk, but less work has focused on the temporal dynamics of smoking events, including daily patterns and related nicotine effects. In this work, we examine these dynamics and improve risk prediction by modeling smoking as a self-triggering process, in which previous smoking events modify current risk. Specifically, we fit smoking events self-reported by 42 smokers to a time-varying semi-parametric Hawkes process (TV-SPHP) developed for this purpose. Results show that the TV-SPHP achieves superior prediction performance compared to related and existing models, with the incorporation of time-varying predictors having greatest benefit over longer prediction windows. Moreover, the impact function illustrates previously unknown temporal dynamics of smoking, with possible connections to nicotine metabolism to be explored in future work through a randomized study design. By more effectively predicting smoking events and exploring a self-triggering component of smoking risk, this work supports development of novel or improved cessation interventions that aim to reduce death from smoking.