用因果发现提升重症预警模型的可解释性与泛化能力
Causally-informed Deep Learning towards Explainable and Generalizable Outcomes Prediction in Critical Care
- 基于因果发现识别预测背后的因果关系
- 在6种危重症预测中准确率优于基线方法
- 提供明确因果路径,辅助临床决策与干预
深度学习(DL)在早期预警评分(EWS)系统中取得进展,可预测急性肾损伤、心肌梗死或循环衰竭等临床恶化。尽管性能优异,但其缺乏可解释性和泛化能力,限制了临床应用。本文提出一种因果感知的可解释早期预测模型,通过因果发现识别预测的潜在因果关系,兼具预测解释性与跨环境良好表现。该方法在6种不同危重症预测中均取得优异准确率,并在不同患者群体间展现出更强的泛化能力。此外,模型还输出明确的因果路径,可作为临床诊断辅助和潜在干预参考。该方法显著提升了深度学习在医疗场景中的实用性。
原文摘要 · Abstract (English)
Recent advances in deep learning (DL) have prompted the development of high-performing early warning score (EWS) systems, predicting clinical deteriorations such as acute kidney injury, acute myocardial infarction, or circulatory failure. DL models have proven to be powerful tools for various tasks but come with the cost of lacking interpretability and limited generalizability, hindering their clinical applications. To develop a practical EWS system applicable to various outcomes, we propose causally-informed explainable early prediction model, which leverages causal discovery to identify the underlying causal relationships of prediction and thus owns two unique advantages: demonstrating the explicit interpretation of the prediction while exhibiting decent performance when applied to unfamiliar environments. Benefiting from these features, our approach achieves superior accuracy for 6 different critical deteriorations and achieves better generalizability across different patient groups, compared to various baseline algorithms. Besides, we provide explicit causal pathways to serve as references for assistant clinical diagnosis and potential interventions. The proposed approach enhances the practical application of deep learning in various medical scenarios.
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