Gregory R. Madden

Jing Ma, Chen Chen, Anil Vullikanti et al.

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria resistant to certain antibiotics, making it difficult to prevent MRSA infections. Among decades of efforts to conquer infectious diseases caused by MRSA, many studies have been proposed to estimate the causal effects of close contact (treatment) on MRSA infection (outcome) from observational data. In this problem, the treatment assignment mechanism plays a key role as it determines the patterns of missing counterfactuals -- the fundamental challenge of causal effect estimation. Most existing observational studies for causal effect learning assume that the treatment is assigned individually for each unit. However, on many occasions, the treatments are pairwisely assigned for units that are connected in graphs, i.e., the treatments of different units are entangled. Neglecting the entangled treatments can impede the causal effect estimation. In this paper, we study the problem of causal effect estimation with treatment entangled in a graph. Despite a few explorations for entangled treatments, this problem still remains challenging due to the following challenges: (1) the entanglement brings difficulties in modeling and leveraging the unknown treatment assignment mechanism; (2) there may exist hidden confounders which lead to confounding biases in causal effect estimation; (3) the observational data is often time-varying. To tackle these challenges, we propose a novel method NEAT, which explicitly leverages the graph structure to model the treatment assignment mechanism, and mitigates confounding biases based on the treatment assignment modeling. We also extend our method into a dynamic setting to handle time-varying observational data. Experiments on both synthetic datasets and a real-world MRSA dataset validate the effectiveness of the proposed method, and provide insights for future applications.

Rituparna Datta, Methun Kamruzzaman, Eili Y. Klein et al.

The US Centers for Disease Control and Prevention (CDC), in 2019, designated Methicillin-resistant Staphylococcus aureus (MRSA) as a serious antimicrobial resistance threat. The risk of acquiring MRSA and suffering life-threatening consequences due to it remains especially high for hospitalized patients due to a unique combination of factors, including: co-morbid conditions, immuno suppression, antibiotic use, and risk of contact with contaminated hospital workers and equipment. In this paper, we present a novel generative probabilistic model, GenHAI, for modeling sequences of MRSA test results outcomes for patients during a single hospitalization. This model can be used to answer many important questions from the perspectives of hospital administrators for mitigating the risk of MRSA infections. Our model is based on the probabilistic programming paradigm, and can be used to approximately answer a variety of predictive, causal, and counterfactual questions. We demonstrate the efficacy of our model by comparing it against discriminative and generative machine learning models using two real-world datasets.

Rituparna Datta, Jiaming Cui, Gregory R. Madden et al.

Methicillin-resistant Staphylococcus aureus (MRSA) is a critical public health threat within hospitals as well as long-term care facilities. Better understanding of MRSA risks, evaluation of interventions and forecasting MRSA rates are important public health problems. Existing forecasting models rely on statistical or neural network approaches, which lack epidemiological interpretability, and have limited performance. Mechanistic epidemic models are difficult to calibrate and limited in incorporating diverse datasets. We present CALYPSO, a hybrid framework that integrates neural networks with mechanistic metapopulation models to capture the spread dynamics of infectious diseases (i.e., MRSA) across healthcare and community settings. Our model leverages patient-level insurance claims, commuting data, and healthcare transfer patterns to learn region- and time-specific parameters governing MRSA spread. This enables accurate, interpretable forecasts at multiple spatial resolutions (county, healthcare facility, region, state) and supports counterfactual analyses of infection control policies and outbreak risks. We also show that CALYPSO improves statewide forecasting performance by over 4.5% compared to machine learning baselines, while also identifying high-risk regions and cost-effective strategies for allocating infection prevention resources.

Rituparna Datta, Jiaming Cui, Zihan Guan et al.

Accurate prediction of clinical outcomes using Electronic Health Records (EHRs) is critical for early intervention, efficient resource allocation, and improved patient care. EHRs contain multimodal data, including both structured data and unstructured clinical notes that provide rich, context-specific information. In this work, we introduce a unified framework that seamlessly integrates these diverse modalities, leveraging all relevant available information through a two-stage architecture for clinical risk prediction. In the first stage, a fine-tuned Large Language Model (LLM) extracts crucial, task-relevant information from clinical notes, which is enhanced by graph-based retrieval of external domain knowledge from sources such as a medical corpus like PubMed, grounding the LLM's understanding. The second stage combines both unstructured representations and features derived from the structured data to generate the final predictions. This approach supports a wide range of clinical tasks. Here, we demonstrate its effectiveness on 30-day readmission and in-hospital mortality prediction. Experimental results show that our framework achieves strong performance, with AUC scores of $0.84$ and $0.92$, respectively, despite these tasks involving severely imbalanced datasets, with positive rates ranging from approximately $4\%$ to $13\%$. Moreover, it outperforms all existing baselines and clinical practices, including established risk scoring systems. To the best of our knowledge, this is one of the first frameworks for healthcare prediction which enhances the power of an LLM-based graph-guided knowledge retrieval method by combining it with structured data for improved clinical outcome prediction.

Xingbo Fu, Chen Chen, Yushun Dong et al.

An antibiogram is a periodic summary of antibiotic resistance results of organisms from infected patients to selected antimicrobial drugs. Antibiograms help clinicians to understand regional resistance rates and select appropriate antibiotics in prescriptions. In practice, significant combinations of antibiotic resistance may appear in different antibiograms, forming antibiogram patterns. Such patterns may imply the prevalence of some infectious diseases in certain regions. Thus it is of crucial importance to monitor antibiotic resistance trends and track the spread of multi-drug resistant organisms. In this paper, we propose a novel problem of antibiogram pattern prediction that aims to predict which patterns will appear in the future. Despite its importance, tackling this problem encounters a series of challenges and has not yet been explored in the literature. First of all, antibiogram patterns are not i.i.d as they may have strong relations with each other due to genomic similarities of the underlying organisms. Second, antibiogram patterns are often temporally dependent on the ones that are previously detected. Furthermore, the spread of antibiotic resistance can be significantly influenced by nearby or similar regions. To address the above challenges, we propose a novel Spatial-Temporal Antibiogram Pattern Prediction framework, STAPP, that can effectively leverage the pattern correlations and exploit the temporal and spatial information. We conduct extensive experiments on a real-world dataset with antibiogram reports of patients from 1999 to 2012 for 203 cities in the United States. The experimental results show the superiority of STAPP against several competitive baselines.