Towards Causality-Aware Inferring: A Sequential Discriminative Approach for Medical Diagnosis
This work addresses biases in medical diagnosis assistants for healthcare, but it is incremental as it builds on existing causal and sequential methods.
The paper tackles biases in medical diagnosis assistants caused by passively collected dialogue data, proposing a propensity-based patient simulator to address default-answer bias and a progressive assurance agent to mitigate distributional inquiry bias, resulting in improved generalization and diagnostic accuracy.
Medical diagnosis assistant (MDA) aims to build an interactive diagnostic agent to sequentially inquire about symptoms for discriminating diseases. However, since the dialogue records used to build a patient simulator are collected passively, the data might be deteriorated by some task-unrelated biases, such as the preference of the collectors. These biases might hinder the diagnostic agent to capture transportable knowledge from the simulator. This work attempts to address these critical issues in MDA by taking advantage of the causal diagram to identify and resolve two representative non-causal biases, i.e., (i) default-answer bias and (ii) distributional inquiry bias. Specifically, Bias (i) originates from the patient simulator which tries to answer the unrecorded inquiries with some biased default answers. Consequently, the diagnostic agents cannot fully demonstrate their advantages due to the biased answers. To eliminate this bias and inspired by the propensity score matching technique with causal diagram, we propose a propensity-based patient simulator to effectively answer unrecorded inquiry by drawing knowledge from the other records; Bias (ii) inherently comes along with the passively collected data, and is one of the key obstacles for training the agent towards "learning how" rather than "remembering what". For example, within the distribution of training data, if a symptom is highly coupled with a certain disease, the agent might learn to only inquire about that symptom to discriminate that disease, thus might not generalize to the out-of-distribution cases. To this end, we propose a progressive assurance agent, which includes the dual processes accounting for symptom inquiry and disease diagnosis respectively. The inquiry process is driven by the diagnosis process in a top-down manner to inquire about symptoms for enhancing diagnostic confidence.