Michael Moor

LG
h-index28
27papers
2,338citations
Novelty54%
AI Score60

27 Papers

CVJul 27, 2023Code
Med-Flamingo: a Multimodal Medical Few-shot Learner

Michael Moor, Qian Huang, Shirley Wu et al.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

LGJan 28, 2023
Zero-shot causal learning

Hamed Nilforoshan, Michael Moor, Yusuf Roohani et al.

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, its recipients, and its nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, \method's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

CLMar 1, 2023
Almanac: Retrieval-Augmented Language Models for Clinical Medicine

Cyril Zakka, Akash Chaurasia, Rohan Shad et al.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

AIOct 26, 2023
Style-Aware Radiology Report Generation with RadGraph and Few-Shot Prompting

Benjamin Yan, Ruochen Liu, David E. Kuo et al.

Automatically generated reports from medical images promise to improve the workflow of radiologists. Existing methods consider an image-to-report modeling task by directly generating a fully-fledged report from an image. However, this conflates the content of the report (e.g., findings and their attributes) with its style (e.g., format and choice of words), which can lead to clinically inaccurate reports. To address this, we propose a two-step approach for radiology report generation. First, we extract the content from an image; then, we verbalize the extracted content into a report that matches the style of a specific radiologist. For this, we leverage RadGraph -- a graph representation of reports -- together with large language models (LLMs). In our quantitative evaluations, we find that our approach leads to beneficial performance. Our human evaluation with clinical raters highlights that the AI-generated reports are indistinguishably tailored to the style of individual radiologist despite leveraging only a few examples as context.

CVMay 24
Universal Boosts, Specific Suppressors: Sparse Autoencoder Steering of Medical Vision-Language Models

Farhad Nooralahzadeh, Benjamin Gundersen, Nicolas Deperrois et al.

Medical vision-language models (VLMs) often hallucinate findings when generating chest X-ray reports: they fabricate findings that are not present in the image, miss important ones, or locate them incorrectly. We mitigate this without weight updates by decoding-time residual steering on a per-token sparse autoencoder (SAE) basis: Top-$K$ SAEs on late layers, causal steering against clinical errors, then combined suppress/boost intervention at inference time. On the MIMIC-CXR test split, our inference-only method improves the quality of generated reports for three radiology VLMs (RadVLM, LLaVA-Rad, and CheXOne), with relative improvements of +5.4%, +7.2%, and +17.0% in the clinical composite metric, and statistically significant GREEN gains on all backbones. A cross-model feature alignment shows that the quality-promoting (boost) directions overlap strongly across architectures, whereas hallucination-linked (suppress) directions are model-specific. Therefore, transferable steering must treat suppression per-backbone, rather than sharing a universal suppress list. The same recipe transfers zero-shot to IU-Xray (Green $+7.7\%$ rel.) without retraining, confirming that the identified features are properties of the model, not of the training corpus. We release causal feature sets and an interactive feature dashboard: https://cxr-sparse-feature-dashboard.netlify.app/.

AIApr 16
RadAgent: A tool-using AI agent for stepwise interpretation of chest computed tomography

Mélanie Roschewitz, Kenneth Styppa, Yitian Tao et al.

Vision-language models (VLM) have markedly advanced AI-driven interpretation and reporting of complex medical imaging, such as computed tomography (CT). Yet, existing methods largely relegate clinicians to passive observers of final outputs, offering no interpretable reasoning trace for them to inspect, validate, or refine. To address this, we introduce RadAgent, a tool-using AI agent that generates CT reports through a stepwise and interpretable process. Each resulting report is accompanied by a fully inspectable trace of intermediate decisions and tool interactions, allowing clinicians to examine how the reported findings are derived. In our experiments, we observe that RadAgent improves Chest CT report generation over its 3D VLM counterpart, CT-Chat, across three dimensions. Clinical accuracy improves by 6.0 points (36.4% relative) in macro-F1 and 5.4 points (19.6% relative) in micro-F1. Robustness under adversarial conditions improves by 24.7 points (41.9% relative). Furthermore, RadAgent achieves 37.0% in faithfulness, a new capability entirely absent in its 3D VLM counterpart. By structuring the interpretation of chest CT as an explicit, tool-augmented and iterative reasoning trace, RadAgent brings us closer toward transparent and reliable AI for radiology.

LGDec 18, 2025
Meta-RL Induces Exploration in Language Agents

Yulun Jiang, Liangze Jiang, Damien Teney et al.

Reinforcement learning (RL) has enabled the training of large language model (LLM) agents to interact with the environment and to solve multi-turn long-horizon tasks. However, the RL-trained agents often struggle in tasks that require active exploration and fail to efficiently adapt from trial-and-error experiences. In this paper, we present LaMer, a general Meta-RL framework that enables LLM agents to actively explore and learn from the environment feedback at test time. LaMer consists of two key components: (i) a cross-episode training framework to encourage exploration and long-term rewards optimization; and (ii) in-context policy adaptation via reflection, allowing the agent to adapt their policy from task feedback signal without gradient update. Experiments across diverse environments show that LaMer significantly improves performance over RL baselines, with 11%, 14%, and 19% performance gains on Sokoban, MineSweeper and Webshop, respectively. Moreover, LaMer also demonstrates better generalization to more challenging or previously unseen tasks compared to the RL-trained agents. Overall, our results demonstrate that Meta-RL provides a principled approach to induce exploration in language agents, enabling more robust adaptation to novel environments through learned exploration strategies.

AIDec 11, 2025
Enhancing Radiology Report Generation and Visual Grounding using Reinforcement Learning

Benjamin Gundersen, Nicolas Deperrois, Samuel Ruiperez-Campillo et al.

Recent advances in vision-language models (VLMs) have improved Chest X-ray (CXR) interpretation in multiple aspects. However, many medical VLMs rely solely on supervised fine-tuning (SFT), which optimizes next-token prediction without evaluating answer quality. In contrast, reinforcement learning (RL) can incorporate task-specific feedback, and its combination with explicit intermediate reasoning ("thinking") has demonstrated substantial gains on verifiable math and coding tasks. To investigate the effects of RL and thinking in a CXR VLM, we perform large-scale SFT on CXR data to build an updated RadVLM based on Qwen3-VL, followed by a cold-start SFT stage that equips the model with basic thinking ability. We then apply Group Relative Policy Optimization (GRPO) with clinically grounded, task-specific rewards for report generation and visual grounding, and run matched RL experiments on both domain-specific and general-domain Qwen3-VL variants, with and without thinking. Across these settings, we find that while strong SFT remains crucial for high base performance, RL provides additional gains on both tasks, whereas explicit thinking does not appear to further improve results. Under a unified evaluation pipeline, the RL-optimized RadVLM models outperform their baseline counterparts and reach state-of-the-art performance on both report generation and grounding, highlighting clinically aligned RL as a powerful complement to SFT for medical VLMs.

CLJun 13, 2025Code
Med-PRM: Medical Reasoning Models with Stepwise, Guideline-verified Process Rewards

Jaehoon Yun, Jiwoong Sohn, Jungwoo Park et al.

Large language models have shown promise in clinical decision making, but current approaches struggle to localize and correct errors at specific steps of the reasoning process. This limitation is critical in medicine, where identifying and addressing reasoning errors is essential for accurate diagnosis and effective patient care. We introduce Med-PRM, a process reward modeling framework that leverages retrieval-augmented generation to verify each reasoning step against established medical knowledge bases. By verifying intermediate reasoning steps with evidence retrieved from clinical guidelines and literature, our model can precisely assess the reasoning quality in a fine-grained manner. Evaluations on five medical QA benchmarks and two open-ended diagnostic tasks demonstrate that Med-PRM achieves state-of-the-art performance, with improving the performance of base models by up to 13.50% using Med-PRM. Moreover, we demonstrate the generality of Med-PRM by integrating it in a plug-and-play fashion with strong policy models such as Meerkat, achieving over 80\% accuracy on MedQA for the first time using small-scale models of 8 billion parameters. Our code and data are available at: https://med-prm.github.io/

HCJan 8, 2025
Agent Laboratory: Using LLM Agents as Research Assistants

Samuel Schmidgall, Yusheng Su, Ze Wang et al.

Historically, scientific discovery has been a lengthy and costly process, demanding substantial time and resources from initial conception to final results. To accelerate scientific discovery, reduce research costs, and improve research quality, we introduce Agent Laboratory, an autonomous LLM-based framework capable of completing the entire research process. This framework accepts a human-provided research idea and progresses through three stages--literature review, experimentation, and report writing to produce comprehensive research outputs, including a code repository and a research report, while enabling users to provide feedback and guidance at each stage. We deploy Agent Laboratory with various state-of-the-art LLMs and invite multiple researchers to assess its quality by participating in a survey, providing human feedback to guide the research process, and then evaluate the final paper. We found that: (1) Agent Laboratory driven by o1-preview generates the best research outcomes; (2) The generated machine learning code is able to achieve state-of-the-art performance compared to existing methods; (3) Human involvement, providing feedback at each stage, significantly improves the overall quality of research; (4) Agent Laboratory significantly reduces research expenses, achieving an 84% decrease compared to previous autonomous research methods. We hope Agent Laboratory enables researchers to allocate more effort toward creative ideation rather than low-level coding and writing, ultimately accelerating scientific discovery.

HCMay 13, 2024
AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments

Samuel Schmidgall, Rojin Ziaei, Carl Harris et al.

Evaluating large language models (LLM) in clinical scenarios is crucial to assessing their potential clinical utility. Existing benchmarks rely heavily on static question-answering, which does not accurately depict the complex, sequential nature of clinical decision-making. Here, we introduce AgentClinic, a multimodal agent benchmark for evaluating LLMs in simulated clinical environments that include patient interactions, multimodal data collection under incomplete information, and the usage of various tools, resulting in an in-depth evaluation across nine medical specialties and seven languages. We find that solving MedQA problems in the sequential decision-making format of AgentClinic is considerably more challenging, resulting in diagnostic accuracies that can drop to below a tenth of the original accuracy. Overall, we observe that agents sourced from Claude-3.5 outperform other LLM backbones in most settings. Nevertheless, we see stark differences in the LLMs' ability to make use of tools, such as experiential learning, adaptive retrieval, and reflection cycles. Strikingly, Llama-3 shows up to 92% relative improvements with the notebook tool that allows for writing and editing notes that persist across cases. To further scrutinize our clinical simulations, we leverage real-world electronic health records, perform a clinical reader study, perturb agents with biases, and explore novel patient-centric metrics that this interactive environment firstly enables.

AIMar 23, 2025
AgentRxiv: Towards Collaborative Autonomous Research

Samuel Schmidgall, Michael Moor

Progress in scientific discovery is rarely the result of a single "Eureka" moment, but is rather the product of hundreds of scientists incrementally working together toward a common goal. While existing agent workflows are capable of producing research autonomously, they do so in isolation, without the ability to continuously improve upon prior research results. To address these challenges, we introduce AgentRxiv-a framework that lets LLM agent laboratories upload and retrieve reports from a shared preprint server in order to collaborate, share insights, and iteratively build on each other's research. We task agent laboratories to develop new reasoning and prompting techniques and find that agents with access to their prior research achieve higher performance improvements compared to agents operating in isolation (11.4% relative improvement over baseline on MATH-500). We find that the best performing strategy generalizes to benchmarks in other domains (improving on average by 3.3%). Multiple agent laboratories sharing research through AgentRxiv are able to work together towards a common goal, progressing more rapidly than isolated laboratories, achieving higher overall accuracy (13.7% relative improvement over baseline on MATH-500). These findings suggest that autonomous agents may play a role in designing future AI systems alongside humans. We hope that AgentRxiv allows agents to collaborate toward research goals and enables researchers to accelerate discovery.

AIApr 30, 2024
Almanac Copilot: Towards Autonomous Electronic Health Record Navigation

Cyril Zakka, Joseph Cho, Gracia Fahed et al.

Clinicians spend large amounts of time on clinical documentation, and inefficiencies impact quality of care and increase clinician burnout. Despite the promise of electronic medical records (EMR), the transition from paper-based records has been negatively associated with clinician wellness, in part due to poor user experience, increased burden of documentation, and alert fatigue. In this study, we present Almanac Copilot, an autonomous agent capable of assisting clinicians with EMR-specific tasks such as information retrieval and order placement. On EHR-QA, a synthetic evaluation dataset of 300 common EHR queries based on real patient data, Almanac Copilot obtains a successful task completion rate of 74% (n = 221 tasks) with a mean score of 2.45 over 3 (95% CI:2.34-2.56). By automating routine tasks and streamlining the documentation process, our findings highlight the significant potential of autonomous agents to mitigate the cognitive load imposed on clinicians by current EMR systems.

AIApr 10
Process Reward Agents for Steering Knowledge-Intensive Reasoning

Jiwoong Sohn, Tomasz Sternal, Kenneth Styppa et al.

Reasoning in knowledge-intensive domains remains challenging as intermediate steps are often not locally verifiable: unlike math or code, evaluating step correctness may require synthesizing clues across large external knowledge sources. As a result, subtle errors can propagate through reasoning traces, potentially never to be detected. Prior work has proposed process reward models (PRMs), including retrieval-augmented variants, but these methods operate post hoc, scoring completed trajectories, which prevents their integration into dynamic inference procedures. Here, we introduce Process Reward Agents (PRA), a test-time method for providing domain-grounded, online, step-wise rewards to a frozen policy. In contrast to prior retrieval-augmented PRMs, PRA enables search-based decoding to rank and prune candidate trajectories at every generation step. Experiments on multiple medical reasoning benchmarks demonstrate that PRA consistently outperforms strong baselines, achieving 80.8% accuracy on MedQA with Qwen3-4B, a new state of the art at the 4B scale. Importantly, PRA generalizes to unseen frozen policy models ranging from 0.5B to 8B parameters, improving their accuracy by up to 25.7% without any policy model updates. More broadly, PRA suggests a paradigm in which frozen reasoners are decoupled from domain-specific reward modules, allowing the deployment of new backbones in complex domains without retraining.

LGJun 26, 2025
SMMILE: An Expert-Driven Benchmark for Multimodal Medical In-Context Learning

Melanie Rieff, Maya Varma, Ossian Rabow et al.

Multimodal in-context learning (ICL) remains underexplored despite significant potential for domains such as medicine. Clinicians routinely encounter diverse, specialized tasks requiring adaptation from limited examples, such as drawing insights from a few relevant prior cases or considering a constrained set of differential diagnoses. While multimodal large language models (MLLMs) have shown advances in medical visual question answering (VQA), their ability to learn multimodal tasks from context is largely unknown. We introduce SMMILE, the first expert-driven multimodal ICL benchmark for medical tasks. Eleven medical experts curated problems, each including a multimodal query and multimodal in-context examples as task demonstrations. SMMILE encompasses 111 problems (517 question-image-answer triplets) covering 6 medical specialties and 13 imaging modalities. We further introduce SMMILE++, an augmented variant with 1038 permuted problems. A comprehensive evaluation of 15 MLLMs demonstrates that most models exhibit moderate to poor multimodal ICL ability in medical tasks. In open-ended evaluations, ICL contributes only an 8% average improvement over zero-shot on SMMILE and 9.4% on SMMILE++. We observe a susceptibility for irrelevant in-context examples: even a single noisy or irrelevant example can degrade performance by up to 9.5%. Moreover, we observe that MLLMs are affected by a recency bias, where placing the most relevant example last can lead to substantial performance improvements of up to 71%. Our findings highlight critical limitations and biases in current MLLMs when learning multimodal medical tasks from context. SMMILE is available at https://smmile-benchmark.github.io.

LGNov 25, 2025
MTBBench: A Multimodal Sequential Clinical Decision-Making Benchmark in Oncology

Kiril Vasilev, Alexandre Misrahi, Eeshaan Jain et al.

Multimodal Large Language Models (LLMs) hold promise for biomedical reasoning, but current benchmarks fail to capture the complexity of real-world clinical workflows. Existing evaluations primarily assess unimodal, decontextualized question-answering, overlooking multi-agent decision-making environments such as Molecular Tumor Boards (MTBs). MTBs bring together diverse experts in oncology, where diagnostic and prognostic tasks require integrating heterogeneous data and evolving insights over time. Current benchmarks lack this longitudinal and multimodal complexity. We introduce MTBBench, an agentic benchmark simulating MTB-style decision-making through clinically challenging, multimodal, and longitudinal oncology questions. Ground truth annotations are validated by clinicians via a co-developed app, ensuring clinical relevance. We benchmark multiple open and closed-source LLMs and show that, even at scale, they lack reliability -- frequently hallucinating, struggling with reasoning from time-resolved data, and failing to reconcile conflicting evidence or different modalities. To address these limitations, MTBBench goes beyond benchmarking by providing an agentic framework with foundation model-based tools that enhance multi-modal and longitudinal reasoning, leading to task-level performance gains of up to 9.0% and 11.2%, respectively. Overall, MTBBench offers a challenging and realistic testbed for advancing multimodal LLM reasoning, reliability, and tool-use with a focus on MTB environments in precision oncology.

AIOct 10, 2025
Agentic Systems in Radiology: Design, Applications, Evaluation, and Challenges

Christian Bluethgen, Dave Van Veen, Daniel Truhn et al.

Building agents, systems that perceive and act upon their environment with a degree of autonomy, has long been a focus of AI research. This pursuit has recently become vastly more practical with the emergence of large language models (LLMs) capable of using natural language to integrate information, follow instructions, and perform forms of "reasoning" and planning across a wide range of tasks. With its multimodal data streams and orchestrated workflows spanning multiple systems, radiology is uniquely suited to benefit from agents that can adapt to context and automate repetitive yet complex tasks. In radiology, LLMs and their multimodal variants have already demonstrated promising performance for individual tasks such as information extraction and report summarization. However, using LLMs in isolation underutilizes their potential to support complex, multi-step workflows where decisions depend on evolving context from multiple information sources. Equipping LLMs with external tools and feedback mechanisms enables them to drive systems that exhibit a spectrum of autonomy, ranging from semi-automated workflows to more adaptive agents capable of managing complex processes. This review examines the design of such LLM-driven agentic systems, highlights key applications, discusses evaluation methods for planning and tool use, and outlines challenges such as error cascades, tool-use efficiency, and health IT integration.

AIJun 28, 2025
MARBLE: A Hard Benchmark for Multimodal Spatial Reasoning and Planning

Yulun Jiang, Yekun Chai, Maria Brbić et al.

The ability to process information from multiple modalities and to reason through it step-by-step remains a critical challenge in advancing artificial intelligence. However, existing reasoning benchmarks focus on text-only reasoning, or employ multimodal questions that can be answered by directly retrieving information from a non-text modality. Thus, complex reasoning remains poorly understood in multimodal domains. Here, we present MARBLE, a challenging multimodal reasoning benchmark that is designed to scrutinize multimodal language models (MLLMs) in their ability to carefully reason step-by-step through complex multimodal problems and environments. MARBLE is composed of two highly challenging tasks, M-Portal and M-Cube, that require the crafting and understanding of multistep plans under spatial, visual, and physical constraints. We find that current MLLMs perform poorly on MARBLE -- all the 12 advanced models obtain near-random performance on M-Portal and 0% accuracy on M-Cube. Only in simplified subtasks some models outperform the random baseline, indicating that complex reasoning is still a challenge for existing MLLMs. Moreover, we show that perception remains a bottleneck, where MLLMs occasionally fail to extract information from the visual inputs. By shedding a light on the limitations of MLLMs, we hope that MARBLE will spur the development of the next generation of models with the ability to reason and plan across many, multimodal reasoning steps.

LGJul 12, 2021
Predicting sepsis in multi-site, multi-national intensive care cohorts using deep learning

Michael Moor, Nicolas Bennet, Drago Plecko et al.

Despite decades of clinical research, sepsis remains a global public health crisis with high mortality, and morbidity. Currently, when sepsis is detected and the underlying pathogen is identified, organ damage may have already progressed to irreversible stages. Effective sepsis management is therefore highly time-sensitive. By systematically analysing trends in the plethora of clinical data available in the intensive care unit (ICU), an early prediction of sepsis could lead to earlier pathogen identification, resistance testing, and effective antibiotic and supportive treatment, and thereby become a life-saving measure. Here, we developed and validated a machine learning (ML) system for the prediction of sepsis in the ICU. Our analysis represents the largest multi-national, multi-centre in-ICU study for sepsis prediction using ML to date. Our dataset contains $156,309$ unique ICU admissions, which represent a refined and harmonised subset of five large ICU databases originating from three countries. Using the international consensus definition Sepsis-3, we derived hourly-resolved sepsis label annotations, amounting to $26,734$ ($17.1\%$) septic stays. We compared our approach, a deep self-attention model, to several clinical baselines as well as ML baselines and performed an extensive internal and external validation within and across databases. On average, our model was able to predict sepsis with an AUROC of $0.847 \pm 0.050$ (internal out-of sample validation) and $0.761 \pm 0.052$ (external validation). For a harmonised prevalence of $17\%$, at $80\%$ recall our model detects septic patients with $39\%$ precision 3.7 hours in advance.

LGFeb 15, 2021
Topological Graph Neural Networks

Max Horn, Edward De Brouwer, Michael Moor et al.

Graph neural networks (GNNs) are a powerful architecture for tackling graph learning tasks, yet have been shown to be oblivious to eminent substructures such as cycles. We present TOGL, a novel layer that incorporates global topological information of a graph using persistent homology. TOGL can be easily integrated into any type of GNN and is strictly more expressive (in terms the Weisfeiler--Lehman graph isomorphism test) than message-passing GNNs. Augmenting GNNs with TOGL leads to improved predictive performance for graph and node classification tasks, both on synthetic data sets, which can be classified by humans using their topology but not by ordinary GNNs, and on real-world data.

LGJul 2, 2020
Learning Individualized Treatment Rules with Estimated Translated Inverse Propensity Score

Zhiliang Wu, Yinchong Yang, Yunpu Ma et al.

Randomized controlled trials typically analyze the effectiveness of treatments with the goal of making treatment recommendations for patient subgroups. With the advance of electronic health records, a great variety of data has been collected in clinical practice, enabling the evaluation of treatments and treatment policies based on observational data. In this paper, we focus on learning individualized treatment rules (ITRs) to derive a treatment policy that is expected to generate a better outcome for an individual patient. In our framework, we cast ITRs learning as a contextual bandit problem and minimize the expected risk of the treatment policy. We conduct experiments with the proposed framework both in a simulation study and based on a real-world dataset. In the latter case, we apply our proposed method to learn the optimal ITRs for the administration of intravenous (IV) fluids and vasopressors (VP). Based on various offline evaluation methods, we could show that the policy derived in our framework demonstrates better performance compared to both the physicians and other baselines, including a simple treatment prediction approach. As a long-term goal, our derived policy might eventually lead to better clinical guidelines for the administration of IV and VP.

LGMay 25, 2020
Path Imputation Strategies for Signature Models of Irregular Time Series

Michael Moor, Max Horn, Christian Bock et al.

The signature transform is a 'universal nonlinearity' on the space of continuous vector-valued paths, and has received attention for use in machine learning on time series. However, real-world temporal data is typically observed at discrete points in time, and must first be transformed into a continuous path before signature techniques can be applied. We make this step explicit by characterising it as an imputation problem, and empirically assess the impact of various imputation strategies when applying signature-based neural nets to irregular time series data. For one of these strategies, Gaussian process (GP) adapters, we propose an extension~(GP-PoM) that makes uncertainty information directly available to the subsequent classifier while at the same time preventing costly Monte-Carlo (MC) sampling. In our experiments, we find that the choice of imputation drastically affects shallow signature models, whereas deeper architectures are more robust. Next, we observe that uncertainty-aware predictions (based on GP-PoM or indicator imputations) are beneficial for predictive performance, even compared to the uncertainty-aware training of conventional GP adapters. In conclusion, we have demonstrated that the path construction is indeed crucial for signature models and that our proposed strategy leads to competitive performance in general, while improving robustness of signature models in particular.

LGSep 26, 2019
Set Functions for Time Series

Max Horn, Michael Moor, Christian Bock et al.

Despite the eminent successes of deep neural networks, many architectures are often hard to transfer to irregularly-sampled and asynchronous time series that commonly occur in real-world datasets, especially in healthcare applications. This paper proposes a novel approach for classifying irregularly-sampled time series with unaligned measurements, focusing on high scalability and data efficiency. Our method SeFT (Set Functions for Time Series) is based on recent advances in differentiable set function learning, extremely parallelizable with a beneficial memory footprint, thus scaling well to large datasets of long time series and online monitoring scenarios. Furthermore, our approach permits quantifying per-observation contributions to the classification outcome. We extensively compare our method with existing algorithms on multiple healthcare time series datasets and demonstrate that it performs competitively whilst significantly reducing runtime.

LGJun 3, 2019
Topological Autoencoders

Michael Moor, Max Horn, Bastian Rieck et al.

We propose a novel approach for preserving topological structures of the input space in latent representations of autoencoders. Using persistent homology, a technique from topological data analysis, we calculate topological signatures of both the input and latent space to derive a topological loss term. Under weak theoretical assumptions, we construct this loss in a differentiable manner, such that the encoding learns to retain multi-scale connectivity information. We show that our approach is theoretically well-founded and that it exhibits favourable latent representations on a synthetic manifold as well as on real-world image data sets, while preserving low reconstruction errors.

LGApr 16, 2019
Machine learning for early prediction of circulatory failure in the intensive care unit

Stephanie L. Hyland, Martin Faltys, Matthias Hüser et al.

Intensive care clinicians are presented with large quantities of patient information and measurements from a multitude of monitoring systems. The limited ability of humans to process such complex information hinders physicians to readily recognize and act on early signs of patient deterioration. We used machine learning to develop an early warning system for circulatory failure based on a high-resolution ICU database with 240 patient years of data. This automatic system predicts 90.0% of circulatory failure events (prevalence 3.1%), with 81.8% identified more than two hours in advance, resulting in an area under the receiver operating characteristic curve of 94.0% and area under the precision-recall curve of 63.0%. The model was externally validated in a large independent patient cohort.

LGFeb 5, 2019
Early Recognition of Sepsis with Gaussian Process Temporal Convolutional Networks and Dynamic Time Warping

Michael Moor, Max Horn, Bastian Rieck et al.

Sepsis is a life-threatening host response to infection associated with high mortality, morbidity, and health costs. Its management is highly time-sensitive since each hour of delayed treatment increases mortality due to irreversible organ damage. Meanwhile, despite decades of clinical research, robust biomarkers for sepsis are missing. Therefore, detecting sepsis early by utilizing the affluence of high-resolution intensive care records has become a challenging machine learning problem. Recent advances in deep learning and data mining promise to deliver a powerful set of tools to efficiently address this task. This empirical study proposes two novel approaches for the early detection of sepsis: a deep learning model and a lazy learner based on time series distances. Our deep learning model employs a temporal convolutional network that is embedded in a Multi-task Gaussian Process Adapter framework, making it directly applicable to irregularly-spaced time series data. Our lazy learner, by contrast, is an ensemble approach that employs dynamic time warping. We frame the timely detection of sepsis as a supervised time series classification task. For this, we derive the most recent sepsis definition in an hourly resolution to provide the first fully accessible early sepsis detection environment. Seven hours before sepsis onset, our methods improve area under the precision--recall curve from 0.25 to 0.35/0.40 over the state of the art. This demonstrates that they are well-suited for detecting sepsis in the crucial earlier stages when management is most effective.

LGDec 23, 2018
Neural Persistence: A Complexity Measure for Deep Neural Networks Using Algebraic Topology

Bastian Rieck, Matteo Togninalli, Christian Bock et al.

While many approaches to make neural networks more fathomable have been proposed, they are restricted to interrogating the network with input data. Measures for characterizing and monitoring structural properties, however, have not been developed. In this work, we propose neural persistence, a complexity measure for neural network architectures based on topological data analysis on weighted stratified graphs. To demonstrate the usefulness of our approach, we show that neural persistence reflects best practices developed in the deep learning community such as dropout and batch normalization. Moreover, we derive a neural persistence-based stopping criterion that shortens the training process while achieving comparable accuracies as early stopping based on validation loss.