Shounak Datta

Yuanfang Ren, Yanjun Li, Tyler J. Loftus et al.

Initial hours of hospital admission impact clinical trajectory, but early clinical decisions often suffer due to data paucity. With clustering analysis for vital signs within six hours of admission, patient phenotypes with distinct pathophysiological signatures and outcomes may support early clinical decisions. We created a single-center, longitudinal EHR dataset for 75,762 adults admitted to a tertiary care center for 6+ hours. We proposed a deep temporal interpolation and clustering network to extract latent representations from sparse, irregularly sampled vital sign data and derived distinct patient phenotypes in a training cohort (n=41,502). Model and hyper-parameters were chosen based on a validation cohort (n=17,415). Test cohort (n=16,845) was used to analyze reproducibility and correlation with biomarkers. The training, validation, and testing cohorts had similar distributions of age (54-55 yrs), sex (55% female), race, comorbidities, and illness severity. Four clusters were identified. Phenotype A (18%) had most comorbid disease with higher rate of prolonged respiratory insufficiency, acute kidney injury, sepsis, and three-year mortality. Phenotypes B (33%) and C (31%) had diffuse patterns of mild organ dysfunction. Phenotype B had favorable short-term outcomes but second-highest three-year mortality. Phenotype C had favorable clinical outcomes. Phenotype D (17%) had early/persistent hypotension, high rate of early surgery, and substantial biomarker rate of inflammation but second-lowest three-year mortality. After comparing phenotypes' SOFA scores, clustering results did not simply repeat other acuity assessments. In a heterogeneous cohort, four phenotypes with distinct categories of disease and outcomes were identified by a deep temporal interpolation and clustering network. This tool may impact triage decisions and clinical decision-support under time constraints.

Serge Assaad, Shuxi Zeng, Chenyang Tao et al.

A key to causal inference with observational data is achieving balance in predictive features associated with each treatment type. Recent literature has explored representation learning to achieve this goal. In this work, we discuss the pitfalls of these strategies - such as a steep trade-off between achieving balance and predictive power - and present a remedy via the integration of balancing weights in causal learning. Specifically, we theoretically link balance to the quality of propensity estimation, emphasize the importance of identifying a proper target population, and elaborate on the complementary roles of feature balancing and weight adjustments. Using these concepts, we then develop an algorithm for flexible, scalable and accurate estimation of causal effects. Finally, we show how the learned weighted representations may serve to facilitate alternative causal learning procedures with appealing statistical features. We conduct an extensive set of experiments on both synthetic examples and standard benchmarks, and report encouraging results relative to state-of-the-art baselines.

Shuxi Zeng, Serge Assaad, Chenyang Tao et al.

Causal inference, or counterfactual prediction, is central to decision making in healthcare, policy and social sciences. To de-bias causal estimators with high-dimensional data in observational studies, recent advances suggest the importance of combining machine learning models for both the propensity score and the outcome function. We propose a novel scalable method to learn double-robust representations for counterfactual predictions, leading to consistent causal estimation if the model for either the propensity score or the outcome, but not necessarily both, is correctly specified. Specifically, we use the entropy balancing method to learn the weights that minimize the Jensen-Shannon divergence of the representation between the treated and control groups, based on which we make robust and efficient counterfactual predictions for both individual and average treatment effects. We provide theoretical justifications for the proposed method. The algorithm shows competitive performance with the state-of-the-art on real world and synthetic data.

Yanjun Li, Yuanfang Ren, Tyler J. Loftus et al.

Background: During the early stages of hospital admission, clinicians must use limited information to make diagnostic and treatment decisions as patient acuity evolves. However, it is common that the time series vital sign information from patients to be both sparse and irregularly collected, which poses a significant challenge for machine / deep learning techniques to analyze and facilitate the clinicians to improve the human health outcome. To deal with this problem, We propose a novel deep interpolation network to extract latent representations from sparse and irregularly sampled time-series vital signs measured within six hours of hospital admission. Methods: We created a single-center longitudinal dataset of electronic health record data for all (n=75,762) adult patient admissions to a tertiary care center lasting six hours or longer, using 55% of the dataset for training, 23% for validation, and 22% for testing. All raw time series within six hours of hospital admission were extracted for six vital signs (systolic blood pressure, diastolic blood pressure, heart rate, temperature, blood oxygen saturation, and respiratory rate). A deep interpolation network is proposed to learn from such irregular and sparse multivariate time series data to extract the fixed low-dimensional latent patterns. We use k-means clustering algorithm to clusters the patient admissions resulting into 7 clusters. Findings: Training, validation, and testing cohorts had similar age (55-57 years), sex (55% female), and admission vital signs. Seven distinct clusters were identified. M Interpretation: In a heterogeneous cohort of hospitalized patients, a deep interpolation network extracted representations from vital sign data measured within six hours of hospital admission. This approach may have important implications for clinical decision-support under time constraints and uncertainty.

Arka Ghosh, Sankha Subhra Mullick, Shounak Datta et al.

Constructing adversarial perturbations for deep neural networks is an important direction of research. Crafting image-dependent adversarial perturbations using white-box feedback has hitherto been the norm for such adversarial attacks. However, black-box attacks are much more practical for real-world applications. Universal perturbations applicable across multiple images are gaining popularity due to their innate generalizability. There have also been efforts to restrict the perturbations to a few pixels in the image. This helps to retain visual similarity with the original images making such attacks hard to detect. This paper marks an important step which combines all these directions of research. We propose the DEceit algorithm for constructing effective universal pixel-restricted perturbations using only black-box feedback from the target network. We conduct empirical investigations using the ImageNet validation set on the state-of-the-art deep neural classifiers by varying the number of pixels to be perturbed from a meagre 10 pixels to as high as all pixels in the image. We find that perturbing only about 10% of the pixels in an image using DEceit achieves a commendable and highly transferable Fooling Rate while retaining the visual quality. We further demonstrate that DEceit can be successfully applied to image dependent attacks as well. In both sets of experiments, we outperformed several state-of-the-art methods.