arXiv:2510.09895cs.LGcs.AI2025-10

提出可追踪临床变量时序影响路径的可解释模型,提升预测透明度。

Chain-of-Influence: Tracing Interdependencies Across Time and Features in Clinical Predictive Modelings

  • 构建时序展开的特征交互图,显式建模变量间动态影响链
  • 在肾病和重症监护数据上达到0.960和0.950的预测性能
  • 能揭示患者特异的疾病进展模式,适合临床决策辅助

临床时序数据建模面临捕捉特征间潜在、时变依赖关系的挑战。现有方法多依赖黑箱机制或简单聚合,未能显式建模某一临床变量如何随时间影响其他变量。本文提出可解释深度学习框架Chain-of-Influence(CoI),构建显式的时序展开特征交互图,实现影响路径追踪,提供从任一时间点任一特征到最终预测的细粒度归因路径,涵盖直接与间接影响。在MIMIC-IV数据集和慢性肾病队列上评估,CoI在肾病进展与重症死亡任务中分别取得0.960与0.950的AUROC,删除敏感性分析验证其归因忠实反映决策过程。案例研究显示,CoI能发现具有临床意义的患者特异性疾病演变模式,增强对时间与跨特征依赖关系的透明理解,助力临床决策。

原文摘要 · Abstract (English)

Modeling clinical time-series data is hampered by the challenge of capturing latent, time-varying dependencies among features. State-of-the-art approaches often rely on black-box mechanisms or simple aggregation, failing to explicitly model how the influence of one clinical variable propagates through others over time. We propose $\textbf{Chain-of-Influence (CoI)}$, an interpretable deep learning framework that constructs an explicit, time-unfolded graph of feature interactions. CoI enables the tracing of influence pathways, providing a granular audit trail that shows how any feature at any time contributes to the final prediction, both directly and through its influence on other variables. We evaluate CoI on mortality and disease progression tasks using the MIMIC-IV dataset and a chronic kidney disease cohort. Our framework achieves state-of-the-art predictive performance (AUROC of 0.960 on CKD progression and 0.950 on ICU mortality), with deletion-based sensitivity analyses confirming that CoI's learned attributions faithfully reflect its decision process. Through case studies, we demonstrate that CoI uncovers clinically meaningful, patient-specific patterns of disease progression, offering enhanced transparency into the temporal and cross-feature dependencies that inform clinical decision-making.

可解释模型临床预测时序依赖影响追踪

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