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The rapid digitization of real-world data offers an unprecedented opportunity for optimizing healthcare delivery and accelerating biomedical discovery. In practice, however, such data is most abundantly available in unstructured forms, such as clinical notes in electronic medical records (EMRs), and it is generally plagued by confounders. In this paper, we present TRIALSCOPE, a unifying framework for distilling real-world evidence from population-level observational data. TRIALSCOPE leverages biomedical language models to structure clinical text at scale, employs advanced probabilistic modeling for denoising and imputation, and incorporates state-of-the-art causal inference techniques to combat common confounders. Using clinical trial specification as generic representation, TRIALSCOPE provides a turn-key solution to generate and reason with clinical hypotheses using observational data. In extensive experiments and analyses on a large-scale real-world dataset with over one million cancer patients from a large US healthcare network, we show that TRIALSCOPE can produce high-quality structuring of real-world data and generates comparable results to marquee cancer trials. In addition to facilitating in-silicon clinical trial design and optimization, TRIALSCOPE may be used to empower synthetic controls, pragmatic trials, post-market surveillance, as well as support fine-grained patient-like-me reasoning in precision diagnosis and treatment.

The acuity state of patients in the intensive care unit (ICU) can quickly change from stable to unstable, sometimes leading to life-threatening conditions. Early detection of deteriorating conditions can result in providing more timely interventions and improved survival rates. Current approaches rely on manual daily assessments. Some data-driven approaches have been developed, that use mortality as a proxy of acuity in the ICU. However, these methods do not integrate acuity states to determine the stability of a patient or the need for life-sustaining therapies. In this study, we propose APRICOT (Acuity Prediction in Intensive Care Unit), a Transformer-based neural network to predict acuity state in real-time in ICU patients. We develop and extensively validate externally, temporally, and prospectively the APRICOT model on three large datasets: University of Florida Health (UFH), eICU Collaborative Research Database (eICU), and Medical Information Mart for Intensive Care (MIMIC)-IV. The performance of APRICOT shows comparable results to state-of-the-art mortality prediction models (external AUROC 0.93-0.93, temporal AUROC 0.96-0.98, and prospective AUROC 0.98) as well as acuity prediction models (external AUROC 0.80-0.81, temporal AUROC 0.77-0.78, and prospective AUROC 0.87). Furthermore, APRICOT can make predictions for the need for life-sustaining therapies, showing comparable results to state-of-the-art ventilation prediction models (external AUROC 0.80-0.81, temporal AUROC 0.87-0.88, and prospective AUROC 0.85), and vasopressor prediction models (external AUROC 0.82-0.83, temporal AUROC 0.73-0.75, prospective AUROC 0.87). This tool allows for real-time acuity monitoring of a patient and can provide helpful information to clinicians to make timely interventions. Furthermore, the model can suggest life-sustaining therapies that the patient might need in the next hours in the ICU.

In many applications, e.g. in healthcare and e-commerce, the goal of a contextual bandit may be to learn an optimal treatment assignment policy at the end of the experiment. That is, to minimize simple regret. However, this objective remains understudied. We propose a new family of computationally efficient bandit algorithms for the stochastic contextual bandit setting, where a tuning parameter determines the weight placed on cumulative regret minimization (where we establish near-optimal minimax guarantees) versus simple regret minimization (where we establish state-of-the-art guarantees). Our algorithms work with any function class, are robust to model misspecification, and can be used in continuous arm settings. This flexibility comes from constructing and relying on "conformal arm sets" (CASs). CASs provide a set of arms for every context, encompassing the context-specific optimal arm with a certain probability across the context distribution. Our positive results on simple and cumulative regret guarantees are contrasted with a negative result, which shows that no algorithm can achieve instance-dependent simple regret guarantees while simultaneously achieving minimax optimal cumulative regret guarantees.

This paper studies inference in randomized controlled trials with multiple treatments, where treatment status is determined according to a "matched tuples" design. Here, by a matched tuples design, we mean an experimental design where units are sampled i.i.d. from the population of interest, grouped into "homogeneous" blocks with cardinality equal to the number of treatments, and finally, within each block, each treatment is assigned exactly once uniformly at random. We first study estimation and inference for matched tuples designs in the general setting where the parameter of interest is a vector of linear contrasts over the collection of average potential outcomes for each treatment. Parameters of this form include standard average treatment effects used to compare one treatment relative to another, but also include parameters which may be of interest in the analysis of factorial designs. We first establish conditions under which a sample analogue estimator is asymptotically normal and construct a consistent estimator of its corresponding asymptotic variance. Combining these results establishes the asymptotic exactness of tests based on these estimators. In contrast, we show that, for two common testing procedures based on t-tests constructed from linear regressions, one test is generally conservative while the other generally invalid. We go on to apply our results to study the asymptotic properties of what we call "fully-blocked" 2^K factorial designs, which are simply matched tuples designs applied to a full factorial experiment. Leveraging our previous results, we establish that our estimator achieves a lower asymptotic variance under the fully-blocked design than that under any stratified factorial design which stratifies the experimental sample into a finite number of "large" strata. A simulation study and empirical application illustrate the practical relevance of our results.

Consider learning an imitation policy on the basis of demonstrated behavior from multiple environments, with an eye towards deployment in an unseen environment. Since the observable features from each setting may be different, directly learning individual policies as mappings from features to actions is prone to spurious correlations -- and may not generalize well. However, the expert's policy is often a function of a shared latent structure underlying those observable features that is invariant across settings. By leveraging data from multiple environments, we propose Invariant Causal Imitation Learning (ICIL), a novel technique in which we learn a feature representation that is invariant across domains, on the basis of which we learn an imitation policy that matches expert behavior. To cope with transition dynamics mismatch, ICIL learns a shared representation of causal features (for all training environments), that is disentangled from the specific representations of noise variables (for each of those environments). Moreover, to ensure that the learned policy matches the observation distribution of the expert's policy, ICIL estimates the energy of the expert's observations and uses a regularization term that minimizes the imitator policy's next state energy. Experimentally, we compare our methods against several benchmarks in control and healthcare tasks and show its effectiveness in learning imitation policies capable of generalizing to unseen environments.

The rapid digitization of real-world data offers an unprecedented opportunity for optimizing healthcare delivery and accelerating biomedical discovery. In practice, however, such data is most abundantly available in unstructured forms, such as clinical notes in electronic medical records (EMRs), and it is generally plagued by confounders. In this paper, we present TRIALSCOPE, a unifying framework for distilling real-world evidence from population-level observational data. TRIALSCOPE leverages biomedical language models to structure clinical text at scale, employs advanced probabilistic modeling for denoising and imputation, and incorporates state-of-the-art causal inference techniques to combat common confounders. Using clinical trial specification as generic representation, TRIALSCOPE provides a turn-key solution to generate and reason with clinical hypotheses using observational data. In extensive experiments and analyses on a large-scale real-world dataset with over one million cancer patients from a large US healthcare network, we show that TRIALSCOPE can produce high-quality structuring of real-world data and generates comparable results to marquee cancer trials. In addition to facilitating in-silicon clinical trial design and optimization, TRIALSCOPE may be used to empower synthetic controls, pragmatic trials, post-market surveillance, as well as support fine-grained patient-like-me reasoning in precision diagnosis and treatment.

It has been shown that deep neural networks are prone to overfitting on biased training data. Towards addressing this issue, meta-learning employs a meta model for correcting the training bias. Despite the promising performances, super slow training is currently the bottleneck in the meta learning approaches. In this paper, we introduce a novel Faster Meta Update Strategy (FaMUS) to replace the most expensive step in the meta gradient computation with a faster layer-wise approximation. We empirically find that FaMUS yields not only a reasonably accurate but also a low-variance approximation of the meta gradient. We conduct extensive experiments to verify the proposed method on two tasks. We show our method is able to save two-thirds of the training time while still maintaining the comparable or achieving even better generalization performance. In particular, our method achieves the state-of-the-art performance on both synthetic and realistic noisy labels, and obtains promising performance on long-tailed recognition on standard benchmarks.

Human doctors with well-structured medical knowledge can diagnose a disease merely via a few conversations with patients about symptoms. In contrast, existing knowledge-grounded dialogue systems often require a large number of dialogue instances to learn as they fail to capture the correlations between different diseases and neglect the diagnostic experience shared among them. To address this issue, we propose a more natural and practical paradigm, i.e., low-resource medical dialogue generation, which can transfer the diagnostic experience from source diseases to target ones with a handful of data for adaptation. It is capitalized on a commonsense knowledge graph to characterize the prior disease-symptom relations. Besides, we develop a Graph-Evolving Meta-Learning (GEML) framework that learns to evolve the commonsense graph for reasoning disease-symptom correlations in a new disease, which effectively alleviates the needs of a large number of dialogues. More importantly, by dynamically evolving disease-symptom graphs, GEML also well addresses the real-world challenges that the disease-symptom correlations of each disease may vary or evolve along with more diagnostic cases. Extensive experiment results on the CMDD dataset and our newly-collected Chunyu dataset testify the superiority of our approach over state-of-the-art approaches. Besides, our GEML can generate an enriched dialogue-sensitive knowledge graph in an online manner, which could benefit other tasks grounded on knowledge graph.

Ensembles over neural network weights trained from different random initialization, known as deep ensembles, achieve state-of-the-art accuracy and calibration. The recently introduced batch ensembles provide a drop-in replacement that is more parameter efficient. In this paper, we design ensembles not only over weights, but over hyperparameters to improve the state of the art in both settings. For best performance independent of budget, we propose hyper-deep ensembles, a simple procedure that involves a random search over different hyperparameters, themselves stratified across multiple random initializations. Its strong performance highlights the benefit of combining models with both weight and hyperparameter diversity. We further propose a parameter efficient version, hyper-batch ensembles, which builds on the layer structure of batch ensembles and self-tuning networks. The computational and memory costs of our method are notably lower than typical ensembles. On image classification tasks, with MLP, LeNet, and Wide ResNet 28-10 architectures, our methodology improves upon both deep and batch ensembles.

Deep neural networks (DNNs) are successful in many computer vision tasks. However, the most accurate DNNs require millions of parameters and operations, making them energy, computation and memory intensive. This impedes the deployment of large DNNs in low-power devices with limited compute resources. Recent research improves DNN models by reducing the memory requirement, energy consumption, and number of operations without significantly decreasing the accuracy. This paper surveys the progress of low-power deep learning and computer vision, specifically in regards to inference, and discusses the methods for compacting and accelerating DNN models. The techniques can be divided into four major categories: (1) parameter quantization and pruning, (2) compressed convolutional filters and matrix factorization, (3) network architecture search, and (4) knowledge distillation. We analyze the accuracy, advantages, disadvantages, and potential solutions to the problems with the techniques in each category. We also discuss new evaluation metrics as a guideline for future research.