An Adversarial Domain Separation Framework for Septic Shock Early Prediction Across EHR Systems

Modeling patient disease progression using Electronic Health Records (EHRs) is critical to assist clinical decision making. While most of prior work has mainly focused on developing effective disease progression models using EHRs collected from an individual medical system, relatively little work has investigated building robust yet generalizable diagnosis models across different systems. In this work, we propose a general domain adaptation (DA) framework that tackles two categories of discrepancies in EHRs collected from different medical systems: one is caused by heterogeneous patient populations (covariate shift) and the other is caused by variations in data collection procedures (systematic bias). Prior research in DA has mainly focused on addressing covariate shift but not systematic bias. In this work, we propose an adversarial domain separation framework that addresses both categories of discrepancies by maintaining one globally-shared invariant latent representation across all systems} through an adversarial learning process, while also allocating a domain-specific model for each system to extract local latent representations that cannot and should not be unified across systems. Moreover, our proposed framework is based on variational recurrent neural network (VRNN) because of its ability to capture complex temporal dependencies and handling missing values in time-series data. We evaluate our framework for early diagnosis of an extremely challenging condition, septic shock, using two real-world EHRs from distinct medical systems in the U.S. The results show that by separating globally-shared from domain-specific representations, our framework significantly improves septic shock early prediction performance in both EHRs and outperforms the current state-of-the-art DA models.Comment: to be published in 2020 IEEE International Conference on Big Dat

Bayesian Learning of LF-MMI Trained Time Delay Neural Networks for Speech Recognition

Discriminative training techniques define state-of-the-art performance for automatic speech recognition systems. However, they are inherently prone to overfitting, leading to poor generalization performance when using limited training data. In order to address this issue, this paper presents a full Bayesian framework to account for model uncertainty in sequence discriminative training of factored TDNN acoustic models. Several Bayesian learning based TDNN variant systems are proposed to model the uncertainty over weight parameters and choices of hidden activation functions, or the hidden layer outputs. Efficient variational inference approaches using a few as one single parameter sample ensure their computational cost in both training and evaluation time comparable to that of the baseline TDNN systems. Statistically significant word error rate (WER) reductions of 0.4%-1.8% absolute (5%-11% relative) were obtained over a state-of-the-art 900 hour speed perturbed Switchboard corpus trained baseline LF-MMI factored TDNN system using multiple regularization methods including F-smoothing, L2 norm penalty, natural gradient, model averaging and dropout, in addition to i-Vector plus learning hidden unit contribution (LHUC) based speaker adaptation and RNNLM rescoring. Consistent performance improvements were also obtained on a 450 hour HKUST conversational Mandarin telephone speech recognition task. On a third cross domain adaptation task requiring rapidly porting a 1000 hour LibriSpeech data trained system to a small DementiaBank elderly speech corpus, the proposed Bayesian TDNN LF-MMI systems outperformed the baseline system using direct weight fine-tuning by up to 2.5\% absolute WER reduction.Comment: submitted to TASL