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Michael Skinner

Publications and source records attributed to Michael Skinner.

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A Neurosymbolic Approach for Constructing Planning Domain Models from Clinical Narratives

Surgical procedures such as laparoscopic appendectomy are complex, high-stakes processes, yet formalizing their workflows for decision support remains a significant challenge. Inducing probabilistic planning domain models in this setting is particularly difficult due to the lack of structured event data and the prevalence of implicit actions in clinical narratives, which neither empirical symbolic methods nor Large Language Models (LLMs) can adequately address on their own. We introduce NSPIN, a neurosymbolic framework for inducing probabilistic planning domain models from unstructured clinical narratives. Our method extracts and imputes structured event sequences from raw text using a pretrained LLM, then induces a PPDDL model and refines its preconditions with LLM-proposed revisions, guided by empirical validation. We evaluate the approach on 2,660 laparoscopic appendectomy notes written by 9 surgeons. NSPIN yields models that generalize to unseen notes, and expert clinical review indicates its induced knowledge is largely consistent with surgical practice.

cs.LG

Imitation learning for clinical decision support in pediatric ECMO

Pediatric critical care is a dynamic, high-stakes process involving constant monitoring and adjustments in life-saving treatments. Modeling these interventions is crucial for effective decision support. To address the challenges of high complexity and data scarcity in pediatric Extracorporeal Membrane Oxygenation (ECMO), we frame clinical decision-making as learning to act from trajectories, i.e., imitation learning that learns action models from observational data, with a key feature that actions are not directly observed. We consider TabPFN, a recent transformer-based approach for tabular data, and traditional baselines including XGBoost and Multi-Layer Perceptrons(MLPs) on real-world pediatric ECMO data to learn the action models. We find that the TabPFN-based approach consistently outperforms these classical baselines, supporting its use as a strong clinician-behavior baseline for pediatric ECMO decision support.

cs.LG