arXiv:2507.17056cs.LGcs.AI2025-07

用可解释的树模型提炼医疗数据中的常见治疗模式,提升策略可读性与评估可靠性。

Pragmatic Policy Development via Interpretable Behavior Cloning

  • 基于树模型分析患者状态,提取高频治疗行为构建策略
  • 在类风湿关节炎和败血症数据中,新策略优于现行临床实践
  • 兼顾可解释性与评估稳定性,适合医疗等高安全场景

离线强化学习虽有望从观测数据中生成最优策略,但其黑箱特性与评估敏感性限制了其在安全关键领域的应用。为解决这一问题,本文提出一种实用方法:通过可解释的行为策略模型,提取每个患者状态下最常采用的治疗动作来构建治疗策略。采用专为挖掘数据模式设计的树模型,自然形成按治疗分组的状态划分;树结构本身保证可解释性,调整考虑动作数量可控制与原始行为策略的重叠程度,实现可靠的离线评估。该方法标准化了常见治疗模式,捕捉数据中蕴含的集体临床判断。在类风湿关节炎和败血症的真实数据上验证,所提策略表现优于当前临床实践,提供可解释的替代方案。

原文摘要 · Abstract (English)

Offline reinforcement learning (RL) holds great promise for deriving optimal policies from observational data, but challenges related to interpretability and evaluation limit its practical use in safety-critical domains. Interpretability is hindered by the black-box nature of unconstrained RL policies, while evaluation -- typically performed off-policy -- is sensitive to large deviations from the data-collecting behavior policy, especially when using methods based on importance sampling. To address these challenges, we propose a simple yet practical alternative: deriving treatment policies from the most frequently chosen actions in each patient state, as estimated by an interpretable model of the behavior policy. By using a tree-based model, which is specifically designed to exploit patterns in the data, we obtain a natural grouping of states with respect to treatment. The tree structure ensures interpretability by design, while varying the number of actions considered controls the degree of overlap with the behavior policy, enabling reliable off-policy evaluation. This pragmatic approach to policy development standardizes frequent treatment patterns, capturing the collective clinical judgment embedded in the data. Using real-world examples in rheumatoid arthritis and sepsis care, we demonstrate that policies derived under this framework can outperform current practice, offering interpretable alternatives to those obtained via offline RL.

离线强化学习可解释性医疗决策树模型

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