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Published work

32 published item(s)

preprint2026arXiv

$\texttt{AMEND++}$: Benchmarking Eligibility Criteria Amendments in Clinical Trials

Clinical trial amendments frequently introduce delays, increased costs, and administrative burden, with eligibility criteria being the most commonly amended component. We introduce \textit{eligibility criteria amendment prediction}, a novel NLP task that aims to forecast whether the eligibility criteria of an initial trial protocol will undergo future amendments. To support this task, we release $\texttt{AMEND++}$, a benchmark suite comprising two datasets: $\texttt{AMEND}$, which captures eligibility-criteria version histories and amendment labels from public clinical trials, and $\verb|AMEND_LLM|$, a refined subset curated using an LLM-based denoising pipeline to isolate substantive changes. We further propose $\textit{Change-Aware Masked Language Modeling}$ (CAMLM), a revision-aware pretraining strategy that leverages historical edits to learn amendment-sensitive representations. Experiments across diverse baselines show that CAMLM consistently improves amendment prediction, enabling more robust and cost-effective clinical trial design.

preprint2026arXiv

EpiGraph: Building Generalists for Evidence-Intensive Epilepsy Reasoning in the Wild

Epilepsy diagnosis and treatment require evidence-intensive reasoning across heterogeneous clinical knowledge, including biosignal patterns, genetic mechanisms, pharmacogenomics, treatment strategies, and patient outcomes. In this work, we present \textsc{EpiGraph}, a large-scale epilepsy knowledge graph and benchmark for evaluating knowledge-augmented clinical reasoning. \textsc{EpiGraph} integrates 48,166 peer-reviewed papers and seven clinical resources into a heterogeneous graph containing 24,324 entities and 32,009 evidence-grounded triplets across five clinical layers. Built upon this graph, \textsc{EpiBench} defines five clinically motivated tasks spanning clinical decision-making, EEG report generation, pharmacogenomic precision medicine, treatment recommendation, and deep research planning. We evaluate six LLMs under both standard and Graph-RAG settings. Results show that integrating \textsc{EpiGraph} consistently improves performance across all tasks, with the largest gains observed in pharmacogenomic reasoning (+30--41\%). Our findings demonstrate that structured epilepsy knowledge substantially enhances evidence-grounded clinical reasoning and provides a practical benchmark framework for evaluating knowledge-augmented LLMs in real-world neurological settings. Our code is available at: https://github.com/LabRAI/EEG-KG.

preprint2025arXiv

DeepEvidence: Empowering Biomedical Discovery with Deep Knowledge Graph Research

Biomedical knowledge graphs (KGs) encode vast, heterogeneous information spanning literature, genes, pathways, drugs, diseases, and clinical trials, but leveraging them collectively for scientific discovery remains difficult. Their structural differences, continual evolution, and limited cross-resource alignment require substantial manual integration, limiting the depth and scale of knowledge exploration. We introduce DeepEvidence, an AI-agent framework designed to perform Deep Research across various heterogeneous biomedical KGs. Unlike generic Deep Research systems that rely primarily on internet-scale text, DeepEvidence incorporates specialized knowledge-graph tooling and coordinated exploration strategies to systematically bridge heterogeneous resources. At its core is an orchestrator that directs two complementary agents: Breadth-First ReSearch (BFRS) for broad, multi-graph entity search, and Depth-First ReSearch (DFRS) for multi-hop, evidence-focused reasoning. An internal, incrementally built evidence graph provides a structured record of retrieved entities, relations, and supporting evidence. To operate at scale, DeepEvidence includes unified interfaces for querying diverse biomedical APIs and an execution sandbox that enables programmatic data retrieval, extraction, and analysis. Across established deep-reasoning benchmarks and four key stages of the biomedical discovery lifecycle: drug discovery, pre-clinical experimentation, clinical trial development, and evidence-based medicine, DeepEvidence demonstrates substantial gains in systematic exploration and evidence synthesis. These results highlight the potential of knowledge-graph-driven Deep Research to accelerate biomedical discovery.

preprint2025arXiv

MIMIC-RD: Can LLMs differentially diagnose rare diseases in real-world clinical settings?

Despite rare diseases affecting 1 in 10 Americans, their differential diagnosis remains challenging. Due to their impressive recall abilities, large language models (LLMs) have been recently explored for differential diagnosis. Existing approaches to evaluating LLM-based rare disease diagnosis suffer from two critical limitations: they rely on idealized clinical case studies that fail to capture real-world clinical complexity, or they use ICD codes as disease labels, which significantly undercounts rare diseases since many lack direct mappings to comprehensive rare disease databases like Orphanet. To address these limitations, we explore MIMIC-RD, a rare disease differential diagnosis benchmark constructed by directly mapping clinical text entities to Orphanet. Our methodology involved an initial LLM-based mining process followed by validation from four medical annotators to confirm identified entities were genuine rare diseases. We evaluated various models on our dataset of 145 patients and found that current state-of-the-art LLMs perform poorly on rare disease differential diagnosis, highlighting the substantial gap between existing capabilities and clinical needs. From our findings, we outline several future steps towards improving differential diagnosis of rare diseases.

preprint2025arXiv

Social Determinants of Health Prediction for ICD-9 Code with Reasoning Models

Social Determinants of Health correlate with patient outcomes but are rarely captured in structured data. Recent attention has been given to automatically extracting these markers from clinical text to supplement diagnostic systems with knowledge of patients' social circumstances. Large language models demonstrate strong performance in identifying Social Determinants of Health labels from sentences. However, prediction in large admissions or longitudinal notes is challenging given long distance dependencies. In this paper, we explore hospital admission multi-label Social Determinants of Health ICD-9 code classification on the MIMIC-III dataset using reasoning models and traditional large language models. We exploit existing ICD-9 codes for prediction on admissions, which achieved an 89% F1. Our contributions include our findings, missing SDoH codes in 139 admissions, and code to reproduce the results.

preprint2022arXiv

Clinical trial site matching with improved diversity using fair policy learning

The ongoing pandemic has highlighted the importance of reliable and efficient clinical trials in healthcare. Trial sites, where the trials are conducted, are chosen mainly based on feasibility in terms of medical expertise and access to a large group of patients. More recently, the issue of diversity and inclusion in clinical trials is gaining importance. Different patient groups may experience the effects of a medical drug/ treatment differently and hence need to be included in the clinical trials. These groups could be based on ethnicity, co-morbidities, age, or economic factors. Thus, designing a method for trial site selection that accounts for both feasibility and diversity is a crucial and urgent goal. In this paper, we formulate this problem as a ranking problem with fairness constraints. Using principles of fairness in machine learning, we learn a model that maps a clinical trial description to a ranked list of potential trial sites. Unlike existing fairness frameworks, the group membership of each trial site is non-binary: each trial site may have access to patients from multiple groups. We propose fairness criteria based on demographic parity to address such a multi-group membership scenario. We test our method on 480 real-world clinical trials and show that our model results in a list of potential trial sites that provides access to a diverse set of patients while also ensuing a high number of enrolled patients.

preprint2022arXiv

Conformal Prediction with Temporal Quantile Adjustments

We develop Temporal Quantile Adjustment (TQA), a general method to construct efficient and valid prediction intervals (PIs) for regression on cross-sectional time series data. Such data is common in many domains, including econometrics and healthcare. A canonical example in healthcare is predicting patient outcomes using physiological time-series data, where a population of patients composes a cross-section. Reliable PI estimators in this setting must address two distinct notions of coverage: cross-sectional coverage across a cross-sectional slice, and longitudinal coverage along the temporal dimension for each time series. Recent works have explored adapting Conformal Prediction (CP) to obtain PIs in the time series context. However, none handles both notions of coverage simultaneously. CP methods typically query a pre-specified quantile from the distribution of nonconformity scores on a calibration set. TQA adjusts the quantile to query in CP at each time $t$, accounting for both cross-sectional and longitudinal coverage in a theoretically-grounded manner. The post-hoc nature of TQA facilitates its use as a general wrapper around any time series regression model. We validate TQA's performance through extensive experimentation: TQA generally obtains efficient PIs and improves longitudinal coverage while preserving cross-sectional coverage.

preprint2022arXiv

Differentiable Scaffolding Tree for Molecular Optimization

The structural design of functional molecules, also called molecular optimization, is an essential chemical science and engineering task with important applications, such as drug discovery. Deep generative models and combinatorial optimization methods achieve initial success but still struggle with directly modeling discrete chemical structures and often heavily rely on brute-force enumeration. The challenge comes from the discrete and non-differentiable nature of molecule structures. To address this, we propose differentiable scaffolding tree (DST) that utilizes a learned knowledge network to convert discrete chemical structures to locally differentiable ones. DST enables a gradient-based optimization on a chemical graph structure by back-propagating the derivatives from the target properties through a graph neural network (GNN). Our empirical studies show the gradient-based molecular optimizations are both effective and sample efficient. Furthermore, the learned graph parameters can also provide an explanation that helps domain experts understand the model output.

preprint2022arXiv

GOCPT: Generalized Online Canonical Polyadic Tensor Factorization and Completion

Low-rank tensor factorization or completion is well-studied and applied in various online settings, such as online tensor factorization (where the temporal mode grows) and online tensor completion (where incomplete slices arrive gradually). However, in many real-world settings, tensors may have more complex evolving patterns: (i) one or more modes can grow; (ii) missing entries may be filled; (iii) existing tensor elements can change. Existing methods cannot support such complex scenarios. To fill the gap, this paper proposes a Generalized Online Canonical Polyadic (CP) Tensor factorization and completion framework (named GOCPT) for this general setting, where we maintain the CP structure of such dynamic tensors during the evolution. We show that existing online tensor factorization and completion setups can be unified under the GOCPT framework. Furthermore, we propose a variant, named GOCPTE, to deal with cases where historical tensor elements are unavailable (e.g., privacy protection), which achieves similar fitness as GOCPT but with much less computational cost. Experimental results demonstrate that our GOCPT can improve fitness by up to 2:8% on the JHU Covid data and 9:2% on a proprietary patient claim dataset over baselines. Our variant GOCPTE shows up to 1:2% and 5:5% fitness improvement on two datasets with about 20% speedup compared to the best model.

preprint2022arXiv

HINT: Hierarchical Interaction Network for Trial Outcome Prediction Leveraging Web Data

Clinical trials are crucial for drug development but are time consuming, expensive, and often burdensome on patients. More importantly, clinical trials face uncertain outcomes due to issues with efficacy, safety, or problems with patient recruitment. If we were better at predicting the results of clinical trials, we could avoid having to run trials that will inevitably fail more resources could be devoted to trials that are likely to succeed. In this paper, we propose Hierarchical INteraction Network (HINT) for more general, clinical trial outcome predictions for all diseases based on a comprehensive and diverse set of web data including molecule information of the drugs, target disease information, trial protocol and biomedical knowledge. HINT first encode these multi-modal data into latent embeddings, where an imputation module is designed to handle missing data. Next, these embeddings will be fed into the knowledge embedding module to generate knowledge embeddings that are pretrained using external knowledge on pharmaco-kinetic properties and trial risk from the web. Then the interaction graph module will connect all the embedding via domain knowledge to fully capture various trial components and their complex relations as well as their influences on trial outcomes. Finally, HINT learns a dynamic attentive graph neural network to predict trial outcome. Comprehensive experimental results show that HINT achieves strong predictive performance, obtaining 0.772, 0.607, 0.623, 0.703 on PR-AUC for Phase I, II, III, and indication outcome prediction, respectively. It also consistently outperforms the best baseline method by up to 12.4\% on PR-AUC.

preprint2022arXiv

JULIA: Joint Multi-linear and Nonlinear Identification for Tensor Completion

Tensor completion aims at imputing missing entries from a partially observed tensor. Existing tensor completion methods often assume either multi-linear or nonlinear relationships between latent components. However, real-world tensors have much more complex patterns where both multi-linear and nonlinear relationships may coexist. In such cases, the existing methods are insufficient to describe the data structure. This paper proposes a Joint mUlti-linear and nonLinear IdentificAtion (JULIA) framework for large-scale tensor completion. JULIA unifies the multi-linear and nonlinear tensor completion models with several advantages over the existing methods: 1) Flexible model selection, i.e., it fits a tensor by assigning its values as a combination of multi-linear and nonlinear components; 2) Compatible with existing nonlinear tensor completion methods; 3) Efficient training based on a well-designed alternating optimization approach. Experiments on six real large-scale tensors demonstrate that JULIA outperforms many existing tensor completion algorithms. Furthermore, JULIA can improve the performance of a class of nonlinear tensor completion methods. The results show that in some large-scale tensor completion scenarios, baseline methods with JULIA are able to obtain up to 55% lower root mean-squared-error and save 67% computational complexity.

preprint2022arXiv

MedML: Fusing Medical Knowledge and Machine Learning Models for Early Pediatric COVID-19 Hospitalization and Severity Prediction

The COVID-19 pandemic has caused devastating economic and social disruption, straining the resources of healthcare institutions worldwide. This has led to a nationwide call for models to predict hospitalization and severe illness in patients with COVID-19 to inform distribution of limited healthcare resources. We respond to one of these calls specific to the pediatric population. To address this challenge, we study two prediction tasks for the pediatric population using electronic health records: 1) predicting which children are more likely to be hospitalized, and 2) among hospitalized children, which individuals are more likely to develop severe symptoms. We respond to the national Pediatric COVID-19 data challenge with a novel machine learning model, MedML. MedML extracts the most predictive features based on medical knowledge and propensity scores from over 6 million medical concepts and incorporates the inter-feature relationships between heterogeneous medical features via graph neural networks (GNN). We evaluate MedML across 143,605 patients for the hospitalization prediction task and 11,465 patients for the severity prediction task using data from the National Cohort Collaborative (N3C) dataset. We also report detailed group-level and individual-level feature importance analyses to evaluate the model interpretability. MedML achieves up to a 7% higher AUROC score and up to a 14% higher AUPRC score compared to the best baseline machine learning models and performs well across all nine national geographic regions and over all three-month spans since the start of the pandemic. Our cross-disciplinary research team has developed a method of incorporating clinical domain knowledge as the framework for a new type of machine learning model that is more predictive and explainable than current state-of-the-art data-driven feature selection methods.

preprint2022arXiv

MolGenSurvey: A Systematic Survey in Machine Learning Models for Molecule Design

Molecule design is a fundamental problem in molecular science and has critical applications in a variety of areas, such as drug discovery, material science, etc. However, due to the large searching space, it is impossible for human experts to enumerate and test all molecules in wet-lab experiments. Recently, with the rapid development of machine learning methods, especially generative methods, molecule design has achieved great progress by leveraging machine learning models to generate candidate molecules. In this paper, we systematically review the most relevant work in machine learning models for molecule design. We start with a brief review of the mainstream molecule featurization and representation methods (including 1D string, 2D graph, and 3D geometry) and general generative methods (deep generative and combinatorial optimization methods). Then we summarize all the existing molecule design problems into several venues according to the problem setup, including input, output types and goals. Finally, we conclude with the open challenges and point out future opportunities of machine learning models for molecule design in real-world applications.

preprint2022arXiv

PAC-Bayes Information Bottleneck

Understanding the source of the superior generalization ability of NNs remains one of the most important problems in ML research. There have been a series of theoretical works trying to derive non-vacuous bounds for NNs. Recently, the compression of information stored in weights (IIW) is proved to play a key role in NNs generalization based on the PAC-Bayes theorem. However, no solution of IIW has ever been provided, which builds a barrier for further investigation of the IIW's property and its potential in practical deep learning. In this paper, we propose an algorithm for the efficient approximation of IIW. Then, we build an IIW-based information bottleneck on the trade-off between accuracy and information complexity of NNs, namely PIB. From PIB, we can empirically identify the fitting to compressing phase transition during NNs' training and the concrete connection between the IIW compression and the generalization. Besides, we verify that IIW is able to explain NNs in broad cases, e.g., varying batch sizes, over-parameterization, and noisy labels. Moreover, we propose an MCMC-based algorithm to sample from the optimal weight posterior characterized by PIB, which fulfills the potential of IIW in enhancing NNs in practice.

preprint2022arXiv

PopNet: Real-Time Population-Level Disease Prediction with Data Latency

Population-level disease prediction estimates the number of potential patients of particular diseases in some location at a future time based on (frequently updated) historical disease statistics. Existing approaches often assume the existing disease statistics are reliable and will not change. However, in practice, data collection is often time-consuming and has time delays, with both historical and current disease statistics being updated continuously. In this work, we propose a real-time population-level disease prediction model which captures data latency (PopNet) and incorporates the updated data for improved predictions. To achieve this goal, PopNet models real-time data and updated data using two separate systems, each capturing spatial and temporal effects using hybrid graph attention networks and recurrent neural networks. PopNet then fuses the two systems using both spatial and temporal latency-aware attentions in an end-to-end manner. We evaluate PopNet on real-world disease datasets and show that PopNet consistently outperforms all baseline disease prediction and general spatial-temporal prediction models, achieving up to 47% lower root mean squared error and 24% lower mean absolute error compared with the best baselines.

preprint2022arXiv

SafeDrug: Dual Molecular Graph Encoders for Recommending Effective and Safe Drug Combinations

Medication recommendation is an essential task of AI for healthcare. Existing works focused on recommending drug combinations for patients with complex health conditions solely based on their electronic health records. Thus, they have the following limitations: (1) some important data such as drug molecule structures have not been utilized in the recommendation process. (2) drug-drug interactions (DDI) are modeled implicitly, which can lead to sub-optimal results. To address these limitations, we propose a DDI-controllable drug recommendation model named SafeDrug to leverage drugs' molecule structures and model DDIs explicitly. SafeDrug is equipped with a global message passing neural network (MPNN) module and a local bipartite learning module to fully encode the connectivity and functionality of drug molecules. SafeDrug also has a controllable loss function to control DDI levels in the recommended drug combinations effectively. On a benchmark dataset, our SafeDrug is relatively shown to reduce DDI by 19.43% and improves 2.88% on Jaccard similarity between recommended and actually prescribed drug combinations over previous approaches. Moreover, SafeDrug also requires much fewer parameters than previous deep learning-based approaches, leading to faster training by about 14% and around 2x speed-up in inference.

preprint2022arXiv

SurvTRACE: Transformers for Survival Analysis with Competing Events

In medicine, survival analysis studies the time duration to events of interest such as mortality. One major challenge is how to deal with multiple competing events (e.g., multiple disease diagnoses). In this work, we propose a transformer-based model that does not make the assumption for the underlying survival distribution and is capable of handling competing events, namely SurvTRACE. We account for the implicit \emph{confounders} in the observational setting in multi-events scenarios, which causes selection bias as the predicted survival probability is influenced by irrelevant factors. To sufficiently utilize the survival data to train transformers from scratch, multiple auxiliary tasks are designed for multi-task learning. The model hence learns a strong shared representation from all these tasks and in turn serves for better survival analysis. We further demonstrate how to inspect the covariate relevance and importance through interpretable attention mechanisms of SurvTRACE, which suffices to great potential in enhancing clinical trial design and new treatment development. Experiments on METABRIC, SUPPORT, and SEER data with 470k patients validate the all-around superiority of our method.

preprint2021arXiv

EMIXER: End-to-end Multimodal X-ray Generation via Self-supervision

Deep generative models have enabled the automated synthesis of high-quality data for diverse applications. However, the most effective generative models are specialized to data from a single domain (e.g., images or text). Real-world applications such as healthcare require multi-modal data from multiple domains (e.g., both images and corresponding text), which are difficult to acquire due to limited availability and privacy concerns and are much harder to synthesize. To tackle this joint synthesis challenge, we propose an End-to-end MultImodal X-ray genERative model (EMIXER) for jointly synthesizing x-ray images and corresponding free-text reports, all conditional on diagnosis labels. EMIXER is an conditional generative adversarial model by 1) generating an image based on a label, 2) encoding the image to a hidden embedding, 3) producing the corresponding text via a hierarchical decoder from the image embedding, and 4) a joint discriminator for assessing both the image and the corresponding text. EMIXER also enables self-supervision to leverage vast amount of unlabeled data. Extensive experiments with real X-ray reports data illustrate how data augmentation using synthesized multimodal samples can improve the performance of a variety of supervised tasks including COVID-19 X-ray classification with very limited samples. The quality of generated images and reports are also confirmed by radiologists. We quantitatively show that EMIXER generated synthetic datasets can augment X-ray image classification, report generation models to achieve 5.94% and 6.9% improvement on models trained only on real data samples. Taken together, our results highlight the promise of state of generative models to advance clinical machine learning.

preprint2021arXiv

PyHealth: A Python Library for Health Predictive Models

Despite the explosion of interest in healthcare AI research, the reproducibility and benchmarking of those research works are often limited due to the lack of standard benchmark datasets and diverse evaluation metrics. To address this reproducibility challenge, we develop PyHealth, an open-source Python toolbox for developing various predictive models on healthcare data. PyHealth consists of data preprocessing module, predictive modeling module, and evaluation module. The target users of PyHealth are both computer science researchers and healthcare data scientists. With PyHealth, they can conduct complex machine learning pipelines on healthcare datasets with fewer than ten lines of code. The data preprocessing module enables the transformation of complex healthcare datasets such as longitudinal electronic health records, medical images, continuous signals (e.g., electrocardiogram), and clinical notes into machine learning friendly formats. The predictive modeling module provides more than 30 machine learning models, including established ensemble trees and deep neural network-based approaches, via a unified but extendable API designed for both researchers and practitioners. The evaluation module provides various evaluation strategies (e.g., cross-validation and train-validation-test split) and predictive model metrics. With robustness and scalability in mind, best practices such as unit testing, continuous integration, code coverage, and interactive examples are introduced in the library's development. PyHealth can be installed through the Python Package Index (PyPI) or https://github.com/yzhao062/PyHealth .

preprint2021arXiv

SCRIB: Set-classifier with Class-specific Risk Bounds for Blackbox Models

Despite deep learning (DL) success in classification problems, DL classifiers do not provide a sound mechanism to decide when to refrain from predicting. Recent works tried to control the overall prediction risk with classification with rejection options. However, existing works overlook the different significance of different classes. We introduce Set-classifier with Class-specific RIsk Bounds (SCRIB) to tackle this problem, assigning multiple labels to each example. Given the output of a black-box model on the validation set, SCRIB constructs a set-classifier that controls the class-specific prediction risks with a theoretical guarantee. The key idea is to reject when the set classifier returns more than one label. We validated SCRIB on several medical applications, including sleep staging on electroencephalogram (EEG) data, X-ray COVID image classification, and atrial fibrillation detection based on electrocardiogram (ECG) data. SCRIB obtained desirable class-specific risks, which are 35\%-88\% closer to the target risks than baseline methods.

preprint2021arXiv

SUOD: Accelerating Large-Scale Unsupervised Heterogeneous Outlier Detection

Outlier detection (OD) is a key machine learning (ML) task for identifying abnormal objects from general samples with numerous high-stake applications including fraud detection and intrusion detection. Due to the lack of ground truth labels, practitioners often have to build a large number of unsupervised, heterogeneous models (i.e., different algorithms with varying hyperparameters) for further combination and analysis, rather than relying on a single model. How to accelerate the training and scoring on new-coming samples by outlyingness (referred as prediction throughout the paper) with a large number of unsupervised, heterogeneous OD models? In this study, we propose a modular acceleration system, called SUOD, to address it. The proposed system focuses on three complementary acceleration aspects (data reduction for high-dimensional data, approximation for costly models, and taskload imbalance optimization for distributed environment), while maintaining performance accuracy. Extensive experiments on more than 20 benchmark datasets demonstrate SUOD's effectiveness in heterogeneous OD acceleration, along with a real-world deployment case on fraudulent claim analysis at IQVIA, a leading healthcare firm. We open-source SUOD for reproducibility and accessibility.

preprint2020arXiv

CHEER: Rich Model Helps Poor Model via Knowledge Infusion

There is a growing interest in applying deep learning (DL) to healthcare, driven by the availability of data with multiple feature channels in rich-data environments (e.g., intensive care units). However, in many other practical situations, we can only access data with much fewer feature channels in a poor-data environments (e.g., at home), which often results in predictive models with poor performance. How can we boost the performance of models learned from such poor-data environment by leveraging knowledge extracted from existing models trained using rich data in a related environment? To address this question, we develop a knowledge infusion framework named CHEER that can succinctly summarize such rich model into transferable representations, which can be incorporated into the poor model to improve its performance. The infused model is analyzed theoretically and evaluated empirically on several datasets. Our empirical results showed that CHEER outperformed baselines by 5.60% to 46.80% in terms of the macro-F1 score on multiple physiological datasets.

preprint2020arXiv

CLARA: Clinical Report Auto-completion

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

preprint2020arXiv

COMPOSE: Cross-Modal Pseudo-Siamese Network for Patient Trial Matching

Clinical trials play important roles in drug development but often suffer from expensive, inaccurate and insufficient patient recruitment. The availability of massive electronic health records (EHR) data and trial eligibility criteria (EC) bring a new opportunity to data driven patient recruitment. One key task named patient-trial matching is to find qualified patients for clinical trials given structured EHR and unstructured EC text (both inclusion and exclusion criteria). How to match complex EC text with longitudinal patient EHRs? How to embed many-to-many relationships between patients and trials? How to explicitly handle the difference between inclusion and exclusion criteria? In this paper, we proposed CrOss-Modal PseudO-SiamEse network (COMPOSE) to address these challenges for patient-trial matching. One path of the network encodes EC using convolutional highway network. The other path processes EHR with multi-granularity memory network that encodes structured patient records into multiple levels based on medical ontology. Using the EC embedding as query, COMPOSE performs attentional record alignment and thus enables dynamic patient-trial matching. COMPOSE also introduces a composite loss term to maximize the similarity between patient records and inclusion criteria while minimize the similarity to the exclusion criteria. Experiment results show COMPOSE can reach 98.0% AUC on patient-criteria matching and 83.7% accuracy on patient-trial matching, which leads 24.3% improvement over the best baseline on real-world patient-trial matching tasks.

preprint2020arXiv

ELF: An Early-Exiting Framework for Long-Tailed Classification

The natural world often follows a long-tailed data distribution where only a few classes account for most of the examples. This long-tail causes classifiers to overfit to the majority class. To mitigate this, prior solutions commonly adopt class rebalancing strategies such as data resampling and loss reshaping. However, by treating each example within a class equally, these methods fail to account for the important notion of example hardness, i.e., within each class some examples are easier to classify than others. To incorporate this notion of hardness into the learning process, we propose the EarLy-exiting Framework(ELF). During training, ELF learns to early-exit easy examples through auxiliary branches attached to a backbone network. This offers a dual benefit-(1) the neural network increasingly focuses on hard examples, since they contribute more to the overall network loss; and (2) it frees up additional model capacity to distinguish difficult examples. Experimental results on two large-scale datasets, ImageNet LT and iNaturalist'18, demonstrate that ELF can improve state-of-the-art accuracy by more than 3 percent. This comes with the additional benefit of reducing up to 20 percent of inference time FLOPS. ELF is complementary to prior work and can naturally integrate with a variety of existing methods to tackle the challenge of long-tailed distributions.

preprint2020arXiv

HOLMES: Health OnLine Model Ensemble Serving for Deep Learning Models in Intensive Care Units

Deep learning models have achieved expert-level performance in healthcare with an exclusive focus on training accurate models. However, in many clinical environments such as intensive care unit (ICU), real-time model serving is equally if not more important than accuracy, because in ICU patient care is simultaneously more urgent and more expensive. Clinical decisions and their timeliness, therefore, directly affect both the patient outcome and the cost of care. To make timely decisions, we argue the underlying serving system must be latency-aware. To compound the challenge, health analytic applications often require a combination of models instead of a single model, to better specialize individual models for different targets, multi-modal data, different prediction windows, and potentially personalized predictions. To address these challenges, we propose HOLMES-an online model ensemble serving framework for healthcare applications. HOLMES dynamically identifies the best performing set of models to ensemble for highest accuracy, while also satisfying sub-second latency constraints on end-to-end prediction. We demonstrate that HOLMES is able to navigate the accuracy/latency tradeoff efficiently, compose the ensemble, and serve the model ensemble pipeline, scaling to simultaneously streaming data from 100 patients, each producing waveform data at 250~Hz. HOLMES outperforms the conventional offline batch-processed inference for the same clinical task in terms of accuracy and latency (by order of magnitude). HOLMES is tested on risk prediction task on pediatric cardio ICU data with above 95% prediction accuracy and sub-second latency on 64-bed simulation.

preprint2020arXiv

Opportunities and Challenges of Deep Learning Methods for Electrocardiogram Data: A Systematic Review

Background:The electrocardiogram (ECG) is one of the most commonly used diagnostic tools in medicine and healthcare. Deep learning methods have achieved promising results on predictive healthcare tasks using ECG signals. Objective:This paper presents a systematic review of deep learning methods for ECG data from both modeling and application perspectives. Methods:We extracted papers that applied deep learning (deep neural network) models to ECG data that were published between Jan. 1st of 2010 and Feb. 29th of 2020 from Google Scholar, PubMed, and the DBLP. We then analyzed each article according to three factors: tasks, models, and data. Finally, we discuss open challenges and unsolved problems in this area. Results: The total number of papers extracted was 191. Among these papers, 108 were published after 2019. Different deep learning architectures have been used in various ECG analytics tasks, such as disease detection/classification, annotation/localization, sleep staging, biometric human identification, and denoising. Conclusion: The number of works on deep learning for ECG data has grown explosively in recent years. Such works have achieved accuracy comparable to that of traditional feature-based approaches and ensembles of multiple approaches can achieve even better results. Specifically, we found that a hybrid architecture of a convolutional neural network and recurrent neural network ensemble using expert features yields the best results. However, there are some new challenges and problems related to interpretability, scalability, and efficiency that must be addressed. Furthermore, it is also worth investigating new applications from the perspectives of datasets and methods. Significance: This paper summarizes existing deep learning research using ECG data from multiple perspectives and highlights existing challenges and problems to identify potential future research directions.

preprint2020arXiv

REST: Robust and Efficient Neural Networks for Sleep Monitoring in the Wild

In recent years, significant attention has been devoted towards integrating deep learning technologies in the healthcare domain. However, to safely and practically deploy deep learning models for home health monitoring, two significant challenges must be addressed: the models should be (1) robust against noise; and (2) compact and energy-efficient. We propose REST, a new method that simultaneously tackles both issues via 1) adversarial training and controlling the Lipschitz constant of the neural network through spectral regularization while 2) enabling neural network compression through sparsity regularization. We demonstrate that REST produces highly-robust and efficient models that substantially outperform the original full-sized models in the presence of noise. For the sleep staging task over single-channel electroencephalogram (EEG), the REST model achieves a macro-F1 score of 0.67 vs. 0.39 achieved by a state-of-the-art model in the presence of Gaussian noise while obtaining 19x parameter reduction and 15x MFLOPS reduction on two large, real-world EEG datasets. By deploying these models to an Android application on a smartphone, we quantitatively observe that REST allows models to achieve up to 17x energy reduction and 9x faster inference. We open-source the code repository with this paper: https://github.com/duggalrahul/REST.

preprint2020arXiv

SDE-Net: Equipping Deep Neural Networks with Uncertainty Estimates

Uncertainty quantification is a fundamental yet unsolved problem for deep learning. The Bayesian framework provides a principled way of uncertainty estimation but is often not scalable to modern deep neural nets (DNNs) that have a large number of parameters. Non-Bayesian methods are simple to implement but often conflate different sources of uncertainties and require huge computing resources. We propose a new method for quantifying uncertainties of DNNs from a dynamical system perspective. The core of our method is to view DNN transformations as state evolution of a stochastic dynamical system and introduce a Brownian motion term for capturing epistemic uncertainty. Based on this perspective, we propose a neural stochastic differential equation model (SDE-Net) which consists of (1) a drift net that controls the system to fit the predictive function; and (2) a diffusion net that captures epistemic uncertainty. We theoretically analyze the existence and uniqueness of the solution to SDE-Net. Our experiments demonstrate that the SDE-Net model can outperform existing uncertainty estimation methods across a series of tasks where uncertainty plays a fundamental role.

preprint2020arXiv

StageNet: Stage-Aware Neural Networks for Health Risk Prediction

Deep learning has demonstrated success in health risk prediction especially for patients with chronic and progressing conditions. Most existing works focus on learning disease Network (StageNet) model to extract disease stage information from patient data and integrate it into risk prediction. StageNet is enabled by (1) a stage-aware long short-term memory (LSTM) module that extracts health stage variations unsupervisedly; (2) a stage-adaptive convolutional module that incorporates stage-related progression patterns into risk prediction. We evaluate StageNet on two real-world datasets and show that StageNet outperforms state-of-the-art models in risk prediction task and patient subtyping task. Compared to the best baseline model, StageNet achieves up to 12% higher AUPRC for risk prediction task on two real-world patient datasets. StageNet also achieves over 58% higher Calinski-Harabasz score (a cluster quality metric) for a patient subtyping task.

preprint2020arXiv

STEAM: Self-Supervised Taxonomy Expansion with Mini-Paths

Taxonomies are important knowledge ontologies that underpin numerous applications on a daily basis, but many taxonomies used in practice suffer from the low coverage issue. We study the taxonomy expansion problem, which aims to expand existing taxonomies with new concept terms. We propose a self-supervised taxonomy expansion model named STEAM, which leverages natural supervision in the existing taxonomy for expansion. To generate natural self-supervision signals, STEAM samples mini-paths from the existing taxonomy, and formulates a node attachment prediction task between anchor mini-paths and query terms. To solve the node attachment task, it learns feature representations for query-anchor pairs from multiple views and performs multi-view co-training for prediction. Extensive experiments show that STEAM outperforms state-of-the-art methods for taxonomy expansion by 11.6\% in accuracy and 7.0\% in mean reciprocal rank on three public benchmarks. The implementation of STEAM can be found at \url{https://github.com/yueyu1030/STEAM}.

preprint2019arXiv

SLEEPER: interpretable Sleep staging via Prototypes from Expert Rules

Sleep staging is a crucial task for diagnosing sleep disorders. It is tedious and complex as it can take a trained expert several hours to annotate just one patient's polysomnogram (PSG) from a single night. Although deep learning models have demonstrated state-of-the-art performance in automating sleep staging, interpretability which defines other desiderata, has largely remained unexplored. In this study, we propose Sleep staging via Prototypes from Expert Rules (SLEEPER), which combines deep learning models with expert defined rules using a prototype learning framework to generate simple interpretable models. In particular, SLEEPER utilizes sleep scoring rules and expert defined features to derive prototypes which are embeddings of PSG data fragments via convolutional neural networks. The final models are simple interpretable models like a shallow decision tree defined over those phenotypes. We evaluated SLEEPER using two PSG datasets collected from sleep studies and demonstrated that SLEEPER could provide accurate sleep stage classification comparable to human experts and deep neural networks with about 85% ROC-AUC and .7 kappa.