arXiv subjects

Harini Suresh

Publications and source records attributed to Harini Suresh.

25 records · Page 2Linked to original sources

arXiv2019

Modeling Mistrust in End-of-Life Care

In this work, we characterize the doctor-patient relationship using a machine learning-derived trust score. We show that this score has statistically significant racial associations, and that by modeling trust directly we find stronger disparities in care than by stratifying on race. We further demonstrate that mistrust is indicative of worse outcomes, but is only weakly associated with physiologically-created severity scores. Finally, we describe sentiment analysis experiments indicating patients with higher levels of mistrust have worse experiences and interactions with their caregivers. This work is a step towards measuring fairer machine learning in the healthcare domain.

cs.AI↗

arXiv2018

Racial Disparities and Mistrust in End-of-Life Care

There are established racial disparities in healthcare, including during end-of-life care, when poor communication and trust can lead to suboptimal outcomes for patients and their families. In this work, we find that racial disparities which have been reported in existing literature are also present in the MIMIC-III database. We hypothesize that one underlying cause of this disparity is due to mistrust between patient and caregivers, and we develop multiple possible trust metric proxies (using coded interpersonal variables and clinical notes) to measure this phenomenon more directly. These metrics show even stronger disparities in end-of-life care than race does, and they also tend to demonstrate statistically significant higher levels of mistrust for black patients than white ones. Finally, we demonstrate that these metrics improve performance on three clinical tasks: in-hospital mortality, discharge against medical advice (AMA) and modified care status (e.g., DNR, DNI, etc.).

stat.AP↗

arXiv2018

Learning Tasks for Multitask Learning: Heterogenous Patient Populations in the ICU

Machine learning approaches have been effective in predicting adverse outcomes in different clinical settings. These models are often developed and evaluated on datasets with heterogeneous patient populations. However, good predictive performance on the aggregate population does not imply good performance for specific groups. In this work, we present a two-step framework to 1) learn relevant patient subgroups, and 2) predict an outcome for separate patient populations in a multi-task framework, where each population is a separate task. We demonstrate how to discover relevant groups in an unsupervised way with a sequence-to-sequence autoencoder. We show that using these groups in a multi-task framework leads to better predictive performance of in-hospital mortality both across groups and overall. We also highlight the need for more granular evaluation of performance when dealing with heterogeneous populations.

cs.LG↗

arXiv2017

Clinical Intervention Prediction and Understanding using Deep Networks

Real-time prediction of clinical interventions remains a challenge within intensive care units (ICUs). This task is complicated by data sources that are noisy, sparse, heterogeneous and outcomes that are imbalanced. In this paper, we integrate data from all available ICU sources (vitals, labs, notes, demographics) and focus on learning rich representations of this data to predict onset and weaning of multiple invasive interventions. In particular, we compare both long short-term memory networks (LSTM) and convolutional neural networks (CNN) for prediction of five intervention tasks: invasive ventilation, non-invasive ventilation, vasopressors, colloid boluses, and crystalloid boluses. Our predictions are done in a forward-facing manner to enable "real-time" performance, and predictions are made with a six hour gap time to support clinically actionable planning. We achieve state-of-the-art results on our predictive tasks using deep architectures. We explore the use of feature occlusion to interpret LSTM models, and compare this to the interpretability gained from examining inputs that maximally activate CNN outputs. We show that our models are able to significantly outperform baselines in intervention prediction, and provide insight into model learning, which is crucial for the adoption of such models in practice.

cs.LG↗

arXiv2017

The Use of Autoencoders for Discovering Patient Phenotypes

We use autoencoders to create low-dimensional embeddings of underlying patient phenotypes that we hypothesize are a governing factor in determining how different patients will react to different interventions. We compare the performance of autoencoders that take fixed length sequences of concatenated timesteps as input with a recurrent sequence-to-sequence autoencoder. We evaluate our methods on around 35,500 patients from the latest MIMIC III dataset from Beth Israel Deaconess Hospital.

cs.LG↗

arXiv2016

Feature Representation for ICU Mortality

Good predictors of ICU Mortality have the potential to identify high-risk patients earlier, improve ICU resource allocation, or create more accurate population-level risk models. Machine learning practitioners typically make choices about how to represent features in a particular model, but these choices are seldom evaluated quantitatively. This study compares the performance of different representations of clinical event data from MIMIC II in a logistic regression model to predict 36-hour ICU mortality. The most common representations are linear (normalized counts) and binary (yes/no). These, along with a new representation termed "hill", are compared using both L1 and L2 regularization. Results indicate that the introduced "hill" representation outperforms both the binary and linear representations, the hill representation thus has the potential to improve existing models of ICU mortality.

cs.AI↗

arXiv2015

Autodetection and Classification of Hidden Cultural City Districts from Yelp Reviews

Topic models are a way to discover underlying themes in an otherwise unstructured collection of documents. In this study, we specifically used the Latent Dirichlet Allocation (LDA) topic model on a dataset of Yelp reviews to classify restaurants based off of their reviews. Furthermore, we hypothesize that within a city, restaurants can be grouped into similar "clusters" based on both location and similarity. We used several different clustering methods, including K-means Clustering and a Probabilistic Mixture Model, in order to uncover and classify districts, both well-known and hidden (i.e. cultural areas like Chinatown or hearsay like "the best street for Italian restaurants") within a city. We use these models to display and label different clusters on a map. We also introduce a topic similarity heatmap that displays the similarity distribution in a city to a new restaurant.

cs.CL↗