Optimizing pessimism in dynamic treatment regimes: a Bayesian learning approach

In this article, we propose a novel pessimismbased Bayesian learning method for optimal dynamic treatment regimes in the offline setting. When the coverage condition does not hold, which is common for offline data, the existing solutions would produce sub-optimal policies. The pessimism principle addresses this issue by discouraging recommendation of actions that are less explored conditioning on the state. However, nearly all pessimism-based methods rely on a key hyper-parameter that quantifies the degree of pessimism, and the performance of the methods can be highly sensitive to the choice of this parameter. We propose to integrate the pessimism principle with Thompson sampling and Bayesian machine learning for optimizing the degree of pessimism. We derive a credible set whose boundary uniformly lower bounds the optimal Q-function, and thus we do not require additional tuning of the degree of pessimism. We develop a general Bayesian learning method that works with a range of models, from Bayesian linear basis model to Bayesian neural network model. We develop the computational algorithm based on variational inference, which is highly efficient and scalable. We establish the theoretical guarantees of the proposed method, and show empirically that it outperforms the existing state-of-theart solutions through both simulations and a real data example

Testing for the Markov Property in Time Series via Deep Conditional Generative Learning

The Markov property is widely imposed in analysis of time series data. Correspondingly, testing the Markov property, and relatedly, inferring the order of a Markov model, are of paramount importance. In this article, we propose a nonparametric test for the Markov property in high-dimensional time series via deep conditional generative learning. We also apply the test sequentially to determine the order of the Markov model. We show that the test controls the type-I error asymptotically, and has the power approaching one. Our proposal makes novel contributions in several ways. We utilize and extend state-of-the-art deep generative learning to estimate the conditional density functions, and establish a sharp upper bound on the approximation error of the estimators. We derive a doubly robust test statistic, which employs a nonparametric estimation but achieves a parametric convergence rate. We further adopt sample splitting and cross-fitting to minimize the conditions required to ensure the consistency of the test. We demonstrate the efficacy of the test through both simulations and the three data applications

Sparse Multi-Response Tensor Regression for Alzheimer's Disease Study With Multivariate Clinical Assessments

Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disorder that has recently seen serious increase in the number of affected subjects. In the last decade, neuroimaging has been shown to be a useful tool to understand AD and its prodromal stage, amnestic mild cognitive impairment (MCI). The majority of AD/MCI studies have focused on disease diagnosis, by formulating the problem as classification with a binary outcome of AD/MCI or healthy controls. There have recently emerged studies that associate image scans with continuous clinical scores that are expected to contain richer information than a binary outcome. However, very few studies aim at modeling multiple clinical scores simultaneously, even though it is commonly conceived that multivariate outcomes provide correlated and complementary information about the disease pathology. In this article, we propose a sparse multi-response tensor regression method to model multiple outcomes jointly as well as to model multiple voxels of an image jointly. The proposed method is particularly useful to both infer clinical scores and thus disease diagnosis, and to identify brain subregions that are highly relevant to the disease outcomes. We conducted experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, and showed that the proposed method enhances the performance and clearly outperforms the competing solutions

Tensor Regression with Applications in Neuroimaging Data Analysis

Classical regression methods treat covariates as a vector and estimate a corresponding vector of regression coefficients. Modern applications in medical imaging generate covariates of more complex form such as multidimensional arrays (tensors). Traditional statistical and computational methods are proving insufficient for analysis of these high-throughput data due to their ultrahigh dimensionality as well as complex structure. In this article, we propose a new family of tensor regression models that efficiently exploit the special structure of tensor covariates. Under this framework, ultrahigh dimensionality is reduced to a manageable level, resulting in efficient estimation and prediction. A fast and highly scalable estimation algorithm is proposed for maximum likelihood estimation and its associated asymptotic properties are studied. Effectiveness of the new methods is demonstrated on both synthetic and real MRI imaging data

Subphenotyping of Mexican Patients With COVID-19 at Preadmission To Anticipate Severity Stratification: Age-Sex Unbiased Meta-Clustering Technique

[EN] Background: The COVID-19 pandemic has led to an unprecedented global health care challenge for both medical institutions and researchers. Recognizing different COVID-19 subphenotypes-the division of populations of patients into more meaningful subgroups driven by clinical features-and their severity characterization may assist clinicians during the clinical course, the vaccination process, research efforts, the surveillance system, and the allocation of limited resources. Objective: We aimed to discover age-sex unbiased COVID-19 patient subphenotypes based on easily available phenotypical data before admission, such as pre-existing comorbidities, lifestyle habits, and demographic features, to study the potential early severity stratification capabilities of the discovered subgroups through characterizing their severity patterns, including prognostic, intensive care unit (ICU), and morbimortality outcomes. Methods: We used the Mexican Government COVID-19 open data, including 778,692 SARS-CoV-2 population-based patient-level data as of September 2020. We applied a meta-clustering technique that consists of a 2-stage clustering approach combining dimensionality reduction (ie, principal components analysis and multiple correspondence analysis) and hierarchical clustering using the Ward minimum variance method with Euclidean squared distance. Results: In the independent age-sex clustering analyses, 56 clusters supported 11 clinically distinguishable meta-clusters (MCs). MCs 1-3 showed high recovery rates (90.27%-95.22%), including healthy patients of all ages, children with comorbidities and priority in receiving medical resources (ie, higher rates of hospitalization, intubation, and ICU admission) compared with other adult subgroups that have similar conditions, and young obese smokers. MCs 4-5 showed moderate recovery rates (81.30%-82.81%), including patients with hypertension or diabetes of all ages and obese patients with pneumonia, hypertension, and diabetes. MCs 6-11 showed low recovery rates (53.96%-66.94%), including immunosuppressed patients with high comorbidity rates, patients with chronic kidney disease with a poor survival length and probability of recovery, older smokers with chronic obstructive pulmonary disease, older adults with severe diabetes and hypertension, and the oldest obese smokers with chronic obstructive pulmonary disease and mild cardiovascular disease. Group outcomes conformed to the recent literature on dedicated age-sex groups. Mexican states and several types of clinical institutions showed relevant heterogeneity regarding severity, potentially linked to socioeconomic or health inequalities. Conclusions: The proposed 2-stage cluster analysis methodology produced a discriminative characterization of the sample and explainability over age and sex. These results can potentially help in understanding the clinical patient and their stratification for automated early triage before further tests and laboratory results are available and even in locations where additional tests are not available or to help decide resource allocation among vulnerable subgroups such as to prioritize vaccination or treatments.We sincerely thank the different types of clinical institutions and the Mexican government, which made a huge effort to make these data publicly available. We also thank the clinicians and epidemiologists from the Servicios de Salud de Nayarit for the useful discussions on specific aspects of the medical attention to hospitalized patients and the reporting of epidemiological data processes related to COVID-19. Furthermore, we would also like to thank Francisco Tomas Garcia Ruiz for his valuable help in data visualization design. This work was supported by Universitat Politecnica de Valencia contract no. UPV-SUB.2-1302 and FONDO SUPERA COVID-19 by CRUE-Santander Bank grant: "Severity Subgroup Discovery and Classification on COVID-19 Real World Data through Machine Learning and Data Quality assessment (SUBCOVERWD-19) ." The authors thank the Institute for Information and Communication Technologies (ITACA) at the Universitat Politecnica de Valencia for its support in the publication of this manuscript.Zhou, L.; Romero-Garcia, N.; Martínez-Miranda, J.; Conejero, JA.; Garcia-Gomez, JM.; Sáez Silvestre, C. (2022). Subphenotyping of Mexican Patients With COVID-19 at Preadmission To Anticipate Severity Stratification: Age-Sex Unbiased Meta-Clustering Technique. JMIR Public Health and Surveillance. 8(3):1-21. https://doi.org/10.2196/300321218

A framework for categorising AI evaluation instruments

The current and future capabilities of Artificial Intelligence (AI) are typically assessed with an ever increasing number of benchmarks, competitions, tests and evaluation standards, which are meant to work as AI evaluation instruments (EI). These EIs are not only increasing in number, but also in complexity and diversity, making it hard to understand this evaluation landscape in a meaningful way. In this paper we present an approach for categorising EIs using a set of 18 facets, accompanied by a rubric to allow anyone to apply the framework to any existing or new EI. We apply the rubric to 23 EIs in different domains through a team of raters, and analyse how consistent the rubric is and how well it works to distinguish between EIs and map the evaluation landscape in AI