Helen Zhou

Helen Zhou, Sivaraman Balakrishnan, Zachary C. Lipton

Rates of missing data often depend on record-keeping policies and thus may change across times and locations, even when the underlying features are comparatively stable. In this paper, we introduce the problem of Domain Adaptation under Missingness Shift (DAMS). Here, (labeled) source data and (unlabeled) target data would be exchangeable but for different missing data mechanisms. We show that if missing data indicators are available, DAMS reduces to covariate shift. Addressing cases where such indicators are absent, we establish the following theoretical results for underreporting completely at random: (i) covariate shift is violated (adaptation is required); (ii) the optimal linear source predictor can perform arbitrarily worse on the target domain than always predicting the mean; (iii) the optimal target predictor can be identified, even when the missingness rates themselves are not; and (iv) for linear models, a simple analytic adjustment yields consistent estimates of the optimal target parameters. In experiments on synthetic and semi-synthetic data, we demonstrate the promise of our methods when assumptions hold. Finally, we discuss a rich family of future extensions.

Helen Zhou, Yuwen Chen, Zachary C. Lipton

Machine learning models deployed in healthcare systems face data drawn from continually evolving environments. However, researchers proposing such models typically evaluate them in a time-agnostic manner, with train and test splits sampling patients throughout the entire study period. We introduce the Evaluation on Medical Datasets Over Time (EMDOT) framework and Python package, which evaluates the performance of a model class over time. Across five medical datasets and a variety of models, we compare two training strategies: (1) using all historical data, and (2) using a window of the most recent data. We note changes in performance over time, and identify possible explanations for these shocks.

Helen Zhou, Sercan O. Arik, Jingtao Wang

Time-series forecasts play a critical role in business planning. However, forecasters typically optimize objectives that are agnostic to downstream business goals and thus can produce forecasts misaligned with business preferences. In this work, we demonstrate that optimization of conventional forecasting metrics can often lead to sub-optimal downstream business performance. Focusing on the inventory management setting, we derive an efficient procedure for computing and optimizing proxies of common downstream business metrics in an end-to-end differentiable manner. We explore a wide range of plausible cost trade-off scenarios, and empirically demonstrate that end-to-end optimization often outperforms optimization of standard business-agnostic forecasting metrics (by up to 45.7% for a simple scaling model, and up to 54.0% for an LSTM encoder-decoder model). Finally, we discuss how our findings could benefit other business contexts.

Yuwen Chen, Helen Zhou, Zachary C. Lipton

Medical imaging data is often siloed within hospitals, limiting the amount of data available for specialized model development. With limited in-domain data, one might hope to leverage larger datasets from related domains. In this paper, we analyze the benefit of transferring self-supervised contrastive representations from moment contrast (MoCo) pretraining on out-of-distribution data to settings with limited data. We consider two X-ray datasets which image different parts of the body, and compare transferring from each other to transferring from ImageNet. We find that depending on quantity of labeled and unlabeled data, contrastive pretraining on larger out-of-distribution datasets can perform nearly as well or better than MoCo pretraining in-domain, and pretraining on related domains leads to higher performance than if one were to use the ImageNet pretrained weights. Finally, we provide a preliminary way of quantifying similarity between datasets.

Helen Zhou, Cheng Cheng, Kelly J. Shields et al.

With COVID-19 now pervasive, identification of high-risk individuals is crucial. Using data from a major healthcare provider in Southwestern Pennsylvania, we develop survival models predicting severe COVID-19 progression. In this endeavor, we face a tradeoff between more accurate models relying on many features and less accurate models relying on a few features aligned with clinician intuition. Complicating matters, many EHR features tend to be under-coded, degrading the accuracy of smaller models. In this study, we develop two sets of high-performance risk scores: (i) an unconstrained model built from all available features; and (ii) a pipeline that learns a small set of clinical concepts before training a risk predictor. Learned concepts boost performance over the corresponding features (C-index 0.858 vs. 0.844) and demonstrate improvements over (i) when evaluated out-of-sample (subsequent time periods). Our models outperform previous works (C-index 0.844-0.872 vs. 0.598-0.810).

Ee Wei Seah, Yongsen Zheng, Naga Nikshith et al.

The rapid rise of autonomous AI systems and advancements in agent capabilities are introducing new risks due to reduced oversight of real-world interactions. Yet agent testing remains nascent and is still a developing science. As AI agents begin to be deployed globally, it is important that they handle different languages and cultures accurately and securely. To address this, participants from The International Network for Advanced AI Measurement, Evaluation and Science, including representatives from Singapore, Japan, Australia, Canada, the European Commission, France, Kenya, South Korea, and the United Kingdom have come together to align approaches to agentic evaluations. This is the third exercise, building on insights from two earlier joint testing exercises conducted by the Network in November 2024 and February 2025. The objective is to further refine best practices for testing advanced AI systems. The exercise was split into two strands: (1) common risks, including leakage of sensitive information and fraud, led by Singapore AISI; and (2) cybersecurity, led by UK AISI. A mix of open and closed-weight models were evaluated against tasks from various public agentic benchmarks. Given the nascency of agentic testing, our primary focus was on understanding methodological issues in conducting such tests, rather than examining test results or model capabilities. This collaboration marks an important step forward as participants work together to advance the science of agentic evaluations.

Yu-Neng Chuang, Prathusha Kameswara Sarma, Parikshit Gopalan et al.

Large language models (LLMs) have demonstrated impressive performance on several tasks and are increasingly deployed in real-world applications. However, especially in high-stakes settings, it becomes vital to know when the output of an LLM may be unreliable. Depending on whether an answer is trustworthy, a system can then choose to route the question to another expert, or otherwise fall back on a safe default behavior. In this work, we study the extent to which LLMs can reliably indicate confidence in their answers, and how this notion of confidence can translate into downstream accuracy gains. We propose Self-Reflection with Error-based Feedback (Self-REF), a lightweight training strategy to teach LLMs to express confidence in whether their answers are correct in a reliable manner. Self-REF introduces confidence tokens into the LLM, from which a confidence score can be extracted. Compared to conventional approaches such as verbalizing confidence and examining token probabilities, we demonstrate empirically that confidence tokens show significant improvements in downstream routing and rejection learning tasks.

Hyewon Jeong, Sarah Jabbour, Yuzhe Yang et al. · uw

The third ML4H symposium was held in person on December 10, 2023, in New Orleans, Louisiana, USA. The symposium included research roundtable sessions to foster discussions between participants and senior researchers on timely and relevant topics for the \ac{ML4H} community. Encouraged by the successful virtual roundtables in the previous year, we organized eleven in-person roundtables and four virtual roundtables at ML4H 2022. The organization of the research roundtables at the conference involved 17 Senior Chairs and 19 Junior Chairs across 11 tables. Each roundtable session included invited senior chairs (with substantial experience in the field), junior chairs (responsible for facilitating the discussion), and attendees from diverse backgrounds with interest in the session's topic. Herein we detail the organization process and compile takeaways from these roundtable discussions, including recent advances, applications, and open challenges for each topic. We conclude with a summary and lessons learned across all roundtables. This document serves as a comprehensive review paper, summarizing the recent advancements in machine learning for healthcare as contributed by foremost researchers in the field.

Stefan Hegselmann, Helen Zhou, Elizabeth Healey et al.

A collection of the accepted Findings papers that were presented at the 4th Machine Learning for Health symposium (ML4H 2024), which was held on December 15-16, 2024, in Vancouver, BC, Canada. ML4H 2024 invited high-quality submissions describing innovative research in a variety of health-related disciplines including healthcare, biomedicine, and public health. Works could be submitted to either the archival Proceedings track, or the non-archival Findings track. The Proceedings track targeted mature, cohesive works with technical sophistication and high-impact relevance to health. The Findings track promoted works that would spark new insights, collaborations, and discussions at ML4H. Both tracks were given the opportunity to share their work through the in-person poster session. All the manuscripts submitted to ML4H Symposium underwent a double-blind peer-review process.

Helen Zhou, Yuwen Chen, Zachary C. Lipton

Machine learning (ML) models deployed in healthcare systems must face data drawn from continually evolving environments. However, researchers proposing such models typically evaluate them in a time-agnostic manner, splitting datasets according to patients sampled randomly throughout the entire study time period. This work proposes the Evaluation on Medical Datasets Over Time (EMDOT) framework, which evaluates the performance of a model class across time. Inspired by the concept of backtesting, EMDOT simulates possible training procedures that practitioners might have been able to execute at each point in time and evaluates the resulting models on all future time points. Evaluating both linear and more complex models on six distinct medical data sources (tabular and imaging), we show how depending on the dataset, using all historical data may be ideal in many cases, whereas using a window of the most recent data could be advantageous in others. In datasets where models suffer from sudden degradations in performance, we investigate plausible explanations for these shocks. We release the EMDOT package to help facilitate further works in deployment-oriented evaluation over time.

Helen Zhou, Cheng Cheng, Zachary C. Lipton et al.

Respiratory complications due to coronavirus disease COVID-19 have claimed tens of thousands of lives in 2020. Many cases of COVID-19 escalate from Severe Acute Respiratory Syndrome (SARS-CoV-2) to viral pneumonia to acute respiratory distress syndrome (ARDS) to death. Extracorporeal membranous oxygenation (ECMO) is a life-sustaining oxygenation and ventilation therapy that may be used for patients with severe ARDS when mechanical ventilation is insufficient to sustain life. While early planning and surgical cannulation for ECMO can increase survival, clinicians report the lack of a risk score hinders these efforts. In this work, we leverage machine learning techniques to develop the PEER score, used to highlight critically ill patients with viral or unspecified pneumonia at high risk of mortality or decompensation in a subpopulation eligible for ECMO. The PEER score is validated on two large, publicly available critical care databases and predicts mortality at least as well as other existing risk scores. Stratifying our cohorts into low-risk and high-risk groups, we find that the high-risk group also has a higher proportion of decompensation indicators such as vasopressor and ventilator use. Finally, the PEER score is provided in the form of a nomogram for direct calculation of patient risk, and can be used to highlight at-risk patients among critical care patients eligible for ECMO.

Soorajnath Boominathan, Michael Oberst, Helen Zhou et al.

In several medical decision-making problems, such as antibiotic prescription, laboratory testing can provide precise indications for how a patient will respond to different treatment options. This enables us to "fully observe" all potential treatment outcomes, but while present in historical data, these results are infeasible to produce in real-time at the point of the initial treatment decision. Moreover, treatment policies in these settings often need to trade off between multiple competing objectives, such as effectiveness of treatment and harmful side effects. We present, compare, and evaluate three approaches for learning individualized treatment policies in this setting: First, we consider two indirect approaches, which use predictive models of treatment response to construct policies optimal for different trade-offs between objectives. Second, we consider a direct approach that constructs such a set of policies without intermediate models of outcomes. Using a medical dataset of Urinary Tract Infection (UTI) patients, we show that all approaches learn policies that achieve strictly better performance on all outcomes than clinicians, while also trading off between different objectives. We demonstrate additional benefits of the direct approach, including flexibly incorporating other goals such as deferral to physicians on simple cases.

Soroush Vosoughi, Helen Zhou, Deb Roy

The rise in popularity and ubiquity of Twitter has made sentiment analysis of tweets an important and well-covered area of research. However, the 140 character limit imposed on tweets makes it hard to use standard linguistic methods for sentiment classification. On the other hand, what tweets lack in structure they make up with sheer volume and rich metadata. This metadata includes geolocation, temporal and author information. We hypothesize that sentiment is dependent on all these contextual factors. Different locations, times and authors have different emotional valences. In this paper, we explored this hypothesis by utilizing distant supervision to collect millions of labelled tweets from different locations, times and authors. We used this data to analyse the variation of tweet sentiments across different authors, times and locations. Once we explored and understood the relationship between these variables and sentiment, we used a Bayesian approach to combine these variables with more standard linguistic features such as n-grams to create a Twitter sentiment classifier. This combined classifier outperforms the purely linguistic classifier, showing that integrating the rich contextual information available on Twitter into sentiment classification is a promising direction of research.

Soroush Vosoughi, Helen Zhou, Deb Roy

There is an ever growing number of users with accounts on multiple social media and networking sites. Consequently, there is increasing interest in matching user accounts and profiles across different social networks in order to create aggregate profiles of users. In this paper, we present models for Digital Stylometry, which is a method for matching users through stylometry inspired techniques. We experimented with linguistic, temporal, and combined temporal-linguistic models for matching user accounts, using standard and novel techniques. Using publicly available data, our best model, a combined temporal-linguistic one, was able to correctly match the accounts of 31% of 5,612 distinct users across Twitter and Facebook.