Xiaohui Yin

Xiaohui Yin, Jun Jin, Shane J. Sacco et al.

Transfer learning is a natural strategy when a target population has limited data but multiple related auxiliary sources are available. A central difficulty is source heterogeneity: auxiliary sources may not be equally useful, and their usefulness may vary in a structured, cluster-like fashion. Existing transfer-learning methods often reduce source selection to a binary informative/non-informative decision, overlooking subgroups of sources with differential transferability. Motivated by a suicide-risk study using data from the Connecticut Hospital Information Management Exchange (CHIME), comprising 636,758 patients across 27 hospitals, we propose Trans-GLMC, a cluster-structured transfer-learning procedure for generalized linear models. The CHIME setting illustrates the core challenge: hospital-specific risk models are unstable because suicide attempts are rare at any single facility, whereas indiscriminate pooling across hospitals can obscure facility-level differences in patient mix and risk profiles. Trans-GLMC first constructs a coefficient-based distance among the target and candidate sources to recover latent source clusters. It then combines global fusion, within-cluster refinement, and target debiasing to produce an estimator that adapts to the detected structure. We establish a non-asymptotic error bound that improves over its unclustered counterpart whenever a meaningful target cluster exists and matches the unclustered rate up to constants otherwise. In simulations and in the CHIME study, Trans-GLMC improves facility-specific prediction, identifies interpretable communities of hospitals with mutual transferability, and recovers clinically coherent suicide-risk factors.

Xiaohui Yin, Avijit Mitra, Ying Zhou et al.

Estimating the causal effect of time-varying treatments on survival outcomes in large observational studies is computationally demanding, particularly when outcomes are rare. While g-formula-based methods such as the iterative conditional expectation (ICE) estimator provide a principled framework for longitudinal causal inference, they become computationally expensive, especially when bootstrap-based variance estimation is required. In addition, outcome rarity at each time point induces severe class imbalance, leading to instability and convergence issues in logistic regression and related models. To address these challenges, we propose a principled subsampling and reweighting strategy for longitudinal survival data that can be applied to a range of existing causal effect estimators in this setting, including the ICE estimator. The proposed method substantially reduces computational burden while preserving consistency and improving estimation stability in rare-outcome settings. We evaluate the method through simulations and validate it using a large-scale EHR cohort study on social and behavioral determinants of health (SBDH) and suicide risk, demonstrating its effectiveness for modeling rare outcomes in longitudinal data.

Xiaohui Yin, Shane Sacco, Robert H. Aseltine et al.

The vast repositories of Electronic Health Records (EHR) and medical claims hold untapped potential for studying rare but critical events, such as suicide attempt. Conventional setups often model suicide attempt as a univariate outcome and also exclude any ``single-record'' patients with a single documented encounter due to a lack of historical information. However, patients who were diagnosed with suicide attempts at the only encounter could, to some surprise, represent a substantial proportion of all attempt cases in the data, as high as 70--80%. We innovate a hybrid and integrative learning framework to leverage concurrent outcomes as surrogates and harness the forbidden yet precious information from single-record data. Our approach employs a supervised learning component to learn the latent variables that connect primary (e.g., suicide) and surrogate outcomes (e.g., mental disorders) to historical information. It simultaneously employs an unsupervised learning component to utilize the single-record data, through the shared latent variables. As such, our approach offers a general strategy for information integration that is crucial to modeling rare conditions and events. With hospital inpatient data from Connecticut, we demonstrate that single-record data and concurrent diagnoses indeed carry valuable information, and utilizing them can substantially improve suicide risk modeling.