提出首个学习医疗治疗多结局联合分布的扩散方法,支持不确定性量化决策。
A Diffusion-Based Method for Learning the Multi-Outcome Distribution of Medical Treatments
- 基于扩散模型构建条件掩码机制,建模多结局间的依赖关系。
- 可处理二元、分类、连续型混合结局,提升预测可靠性。
- 适合临床决策支持系统,尤其关注多目标治疗评估的研究者。
在医学中,治疗常影响多个相互关联的结局,如主要终点、并发症、不良事件或其他次要终点。因此,为做出最优治疗决策,临床医生需要学习多维治疗结局的分布。然而,现有机器学习方法大多聚焦单一结局,而真实医疗数据通常包含多个互相关联的结局。为此,我们提出一种名为 DIME 的新型扩散方法,用于学习医疗治疗的多结局联合分布。该方法解决三大临床挑战:(i) 专为学习多结局的联合干预分布设计,支持不确定性量化而非仅依赖点估计;(ii) 显式捕捉结局间的依赖结构;(iii) 可处理二元、分类和连续型混合结局。DIME 通过因果掩码机制融入因果推断基础。训练时,将联合分布分解为一系列条件分布,并采用定制化条件掩码以建模结局间依赖;推理时,采用自回归生成方式,突破传统点估计局限,实现联合干预分布学习。据我们所知,DIME 是首个专门用于学习医疗治疗多结局联合分布的神经方法。在多种实验中,验证了其有效学习联合分布并捕捉多结局间共享信息的能力。
原文摘要 · Abstract (English)
In medicine, treatments often influence multiple, interdependent outcomes, such as primary endpoints, complications, adverse events, or other secondary endpoints. Hence, to make optimal treatment decisions, clinicians are interested in learning the distribution of multi-dimensional treatment outcomes. However, the vast majority of machine learning methods for predicting treatment effects focus on single-outcome settings, despite the fact that medical data often include multiple, interdependent outcomes. To address this limitation, we propose a novel diffusion-based method called DIME to learn the joint distribution of multiple outcomes of medical treatments. We addresses three challenges relevant in medical practice: (i)it is tailored to learn the joint interventional distribution of multiple medical outcomes, which enables reliable decision-making with uncertainty quantification rather than relying solely on point estimates; (ii)it explicitly captures the dependence structure between outcomes; (iii)it can handle outcomes of mixed type, including binary, categorical, and continuous variables. In DIME, we take into account the fundamental problem of causal inference through causal masking. For training, our method decomposes the joint distribution into a series of conditional distributions with a customized conditional masking to account for the dependence structure across outcomes. For inference, our method auto-regressively generates predictions. This allows our method to move beyond point estimates of causal quantities and thus learn the joint interventional distribution. To the best of our knowledge, DIME is the first neural method tailored to learn the joint, multi-outcome distribution of medical treatments. Across various experiments, we demonstrate that our method effectively learns the joint distribution and captures shared information among multiple outcomes.
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