Aishwarya Mandyam

Aishwarya Mandyam, Matthew Jörke, William Denton et al.

Promoting healthy lifestyle behaviors remains a major public health concern, particularly due to their crucial role in preventing chronic conditions such as cancer, heart disease, and type 2 diabetes. Mobile health applications present a promising avenue for low-cost, scalable health behavior change promotion. Researchers are increasingly exploring adaptive algorithms that personalize interventions to each person's unique context. However, in empirical studies, mobile health applications often suffer from small effect sizes and low adherence rates, particularly in comparison to human coaching. Tailoring advice to a person's unique goals, preferences, and life circumstances is a critical component of health coaching that has been underutilized in adaptive algorithms for mobile health interventions. To address this, we introduce a new Thompson sampling algorithm that can accommodate personalized reward functions (i.e., goals, preferences, and constraints), while also leveraging data sharing across individuals to more quickly be able to provide effective recommendations. We prove that our modification incurs only a constant penalty on cumulative regret while preserving the sample complexity benefits of data sharing. We present empirical results on synthetic and semi-synthetic physical activity simulators, where in the latter we conducted an online survey to solicit preference data relating to physical activity, which we use to construct realistic reward models that leverages historical data from another study. Our algorithm achieves substantial performance improvements compared to baselines that do not share data or do not optimize for individualized rewards.

Aishwarya Mandyam, Didong Li, Jiayu Yao et al.

Inverse reinforcement learning (IRL) methods infer an agent's reward function using demonstrations of expert behavior. A Bayesian IRL approach models a distribution over candidate reward functions, capturing a degree of uncertainty in the inferred reward function. This is critical in some applications, such as those involving clinical data. Typically, Bayesian IRL algorithms require large demonstration datasets, which may not be available in practice. In this work, we incorporate existing domain-specific data to achieve better posterior concentration rates. We study a common setting in clinical and biological applications where we have access to expert demonstrations and known reward functions for a set of training tasks. Our aim is to learn the reward function of a new test task given limited expert demonstrations. Existing Bayesian IRL methods impose restrictions on the form of input data, thus limiting the incorporation of training task data. To better leverage information from training tasks, we introduce kernel density Bayesian inverse reinforcement learning (KD-BIRL). Our approach employs a conditional kernel density estimator, which uses the known reward functions of the training tasks to improve the likelihood estimation across a range of reward functions and demonstration samples. Our empirical results highlight KD-BIRL's faster concentration rate in comparison to baselines, particularly in low test task expert demonstration data regimes. Additionally, we are the first to provide theoretical guarantees of posterior concentration for a Bayesian IRL algorithm. Taken together, this work introduces a principled and theoretically grounded framework that enables Bayesian IRL to be applied across a variety of domains.

Aishwarya Mandyam, Jason Meng, Ge Gao et al.

Off-policy evaluation (OPE) methods aim to estimate the value of a new reinforcement learning (RL) policy prior to deployment. Recent advances have shown that leveraging auxiliary datasets, such as those synthesized by generative models, can improve the accuracy of these value estimates. Unfortunately, such auxiliary datasets may also be biased, and existing methods for using data augmentation for OPE in RL lack principled uncertainty quantification. In high stakes settings like healthcare, reliable uncertainty estimates are important for comparing policy value estimates. In this work, we propose two approaches to construct valid confidence intervals for OPE when using data augmentation. The first provides a confidence interval over the policy performance conditioned on a particular initial state $V^π(s_0)$-- such intervals are particularly important for human-centered applications. To do so we introduce a new conformal prediction method for high dimensional state MDPs. Second, we consider the more common task of estimating the average policy performance over many initial states; to do so we draw on ideas from doubly robust estimation and prediction powered inference. Across simulators spanning robotics, healthcare and inventory management, and a real healthcare dataset from MIMIC-IV, we find that our methods can use augmented data and still consistently produce intervals that cover the ground truth values, unlike previously proposed methods.

Aishwarya Mandyam, Shengpu Tang, Jiayu Yao et al.

Off-policy evaluation (OPE) provides safety guarantees by estimating the performance of a policy before deployment. Recent work introduced IS+, an importance sampling (IS) estimator that uses expert-annotated counterfactual samples to improve behavior dataset coverage. However, IS estimators are known to have high variance; furthermore, the performance of IS+ deteriorates when annotations are imperfect. In this work, we propose a family of OPE estimators inspired by the doubly robust (DR) principle. A DR estimator combines IS with a reward model estimate, known as the direct method (DM), and offers favorable statistical guarantees. We propose three strategies for incorporating counterfactual annotations into a DR-inspired estimator and analyze their properties under various realistic settings. We prove that using imperfect annotations in the DM part of the estimator best leverages the annotations, as opposed to using them in the IS part. To support our theoretical findings, we evaluate the proposed estimators in three contextual bandit environments. Our empirical results show that when the reward model is misspecified and the annotations are imperfect, it is most beneficial to use the annotations only in the DM portion of a DR estimator. Based on these theoretical and empirical insights, we provide a practical guide for using counterfactual annotations in different realistic settings.

Aishwarya Mandyam, Kalyani Limaye, Barbara E. Engelhardt et al.

Off-policy evaluation (OPE) estimates the value of a contextual bandit policy prior to deployment. As such, OPE plays a critical role in ensuring safety in high-stakes domains such as healthcare. However, standard OPE approaches are limited by the size and coverage of the behavior dataset. While previous work has explored using expert-labeled counterfactual annotations to enhance dataset coverage, obtaining such annotations is expensive, limiting the scalability of prior approaches. We propose leveraging large language models (LLMs) to generate counterfactual annotations for OPE in medical domains. Our method uses domain knowledge to guide LLMs in predicting how key clinical features evolve under alternate treatments. These predicted features can then be transformed using known reward functions to create counterfactual annotations. We first evaluate the ability of several LLMs to predict clinical features across two patient subsets in MIMIC-IV, finding that state-of-the-art LLMs achieve comparable performance. Building on this capacity to predict clinical features, we generate LLM-based counterfactual annotations and incorporate them into an OPE estimator. Our empirical results analyze the benefits of counterfactual annotations under varying degrees of shift between the behavior and target policies. We find that in most cases, the LLM-based counterfactual annotations significantly improve OPE estimates up to a point. We provide an entropy-based metric to identify when additional annotations cease to be useful. Our results demonstrate that LLM-based counterfactual annotations offer a scalable approach for addressing coverage limitations in healthcare datasets, enabling safer deployment of decision-making policies in clinical settings.

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."

Aishwarya Mandyam, Andrew Jones, Jiayu Yao et al.

Reinforcement learning (RL) is an effective framework for solving sequential decision-making tasks. However, applying RL methods in medical care settings is challenging in part due to heterogeneity in treatment response among patients. Some patients can be treated with standard protocols whereas others, such as those with chronic diseases, need personalized treatment planning. Traditional RL methods often fail to account for this heterogeneity, because they assume that all patients respond to the treatment in the same way (i.e., transition dynamics are shared). We introduce Compositional Fitted $Q$-iteration (CFQI), which uses a compositional task structure to represent heterogeneous treatment responses in medical care settings. A compositional task consists of several variations of the same task, each progressing in difficulty; solving simpler variants of the task can enable efficient solving of harder variants. CFQI uses a compositional $Q$-value function with separate modules for each task variant, allowing it to take advantage of shared knowledge while learning distinct policies for each variant. We validate CFQI's performance using a Cartpole environment and use CFQI to recommend electrolyte repletion for patients with and without renal disease. Our results demonstrate that CFQI is robust even in the presence of class imbalance, enabling effective information usage across patient sub-populations. CFQI exhibits great promise for clinical applications in scenarios characterized by known compositional structures.