arXiv subjects

Timothy C. Y. Chan

Publications and source records attributed to Timothy C. Y. Chan.

36 records · Page 2Linked to original sources

arXiv2022

Robust Direct Aperture Optimization for Radiation Therapy Treatment Planning

Intensity-modulated radiation therapy (IMRT) allows for the design of customized, highly-conformal treatments for cancer patients. Creating IMRT treatment plans, however, is a mathematically complex process, which is often tackled in multiple, simpler stages. This sequential approach typically separates radiation dose requirements from mechanical deliverability considerations, which may result in suboptimal treatment quality. For patient health to be considered paramount, holistic models must address these plan elements concurrently, eliminating quality loss between stages. This combined direct aperture optimization (DAO) approach is rarely paired with uncertainty mitigation techniques, such as robust optimization, due to the inherent complexity of both parts. This paper outlines a robust DAO (RDAO) model and discusses novel methodologies for efficiently integrating salient constraints. Because the highly-complex RDAO model is difficult to solve, an original candidate plan generation (CPG) heuristic is proposed. The CPG produces rapid, high-quality, feasible plans, which are immediately clinically viable, and can also be used to generate a feasible incumbent solution for warm starting the RDAO model. Computational results obtained using clinical patient datasets with motion uncertainty show the benefit of incorporating the CPG, both in terms of first incumbent solution and final output plan quality.

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arXiv2022

OpenKBP-Opt: An international and reproducible evaluation of 76 knowledge-based planning pipelines

We establish an open framework for developing plan optimization models for knowledge-based planning (KBP) in radiotherapy. Our framework includes reference plans for 100 patients with head-and-neck cancer and high-quality dose predictions from 19 KBP models that were developed by different research groups during the OpenKBP Grand Challenge. The dose predictions were input to four optimization models to form 76 unique KBP pipelines that generated 7600 plans. The predictions and plans were compared to the reference plans via: dose score, which is the average mean absolute voxel-by-voxel difference in dose a model achieved; the deviation in dose-volume histogram (DVH) criterion; and the frequency of clinical planning criteria satisfaction. We also performed a theoretical investigation to justify our dose mimicking models. The range in rank order correlation of the dose score between predictions and their KBP pipelines was 0.50 to 0.62, which indicates that the quality of the predictions is generally positively correlated with the quality of the plans. Additionally, compared to the input predictions, the KBP-generated plans performed significantly better (P<0.05; one-sided Wilcoxon test) on 18 of 23 DVH criteria. Similarly, each optimization model generated plans that satisfied a higher percentage of criteria than the reference plans. Lastly, our theoretical investigation demonstrated that the dose mimicking models generated plans that are also optimal for a conventional planning model. This was the largest international effort to date for evaluating the combination of KBP prediction and optimization models. In the interest of reproducibility, our data and code is freely available at https://github.com/ababier/open-kbp-opt.

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arXiv2021

A Markov process approach to untangling intention versus execution in tennis

Value functions are used in sports applications to determine the optimal action players should employ. However, most literature implicitly assumes that the player can perform the prescribed action with known and fixed probability of success. The effect of varying this probability or, equivalently, "execution error" in implementing an action (e.g., hitting a tennis ball to a specific location on the court) on the design of optimal strategies, has received limited attention. In this paper, we develop a novel modeling framework based on Markov reward processes and Markov decision processes to investigate how execution error impacts a player's value function and strategy in tennis. We power our models with hundreds of millions of simulated tennis shots with 3D ball and 2D player tracking data. We find that optimal shot selection strategies in tennis become more conservative as execution error grows, and that having perfect execution with the empirical shot selection strategy is roughly equivalent to choosing one or two optimal shots with average execution error. We find that execution error on backhand shots is more costly than on forehand shots, and that optimal shot selection on a serve return is more valuable than on any other shot, over all values of execution error.

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arXiv2021

Inverse Mixed Integer Optimization: Polyhedral Insights and Trust Region Methods

Inverse optimization, determining parameters of an optimization problem that render a given solution optimal, has received increasing attention in recent years. While significant inverse optimization literature exists for convex optimization problems, there have been few advances for discrete problems, despite the ubiquity of applications that fundamentally rely on discrete decision-making. In this paper, we present a new set of theoretical insights and algorithms for the general class of inverse mixed integer linear optimization problems. Specifically, a general characterization of optimality conditions is established and leveraged to design new cutting plane solution algorithms. Through an extensive set of computational experiments, we show that our methods provide substantial improvements over existing methods in solving the largest and most difficult instances to date.

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arXiv2021

An Inverse Optimization Approach to Measuring Clinical Pathway Concordance

Clinical pathways outline standardized processes in the delivery of care for a specific disease. Patient journeys through the healthcare system, though, can deviate substantially from these pathways. Given the positive benefits of clinical pathways, it is important to measure the concordance of patient pathways so that variations in health system performance or bottlenecks in the delivery of care can be detected, monitored, and acted upon. This paper proposes the first data-driven inverse optimization approach to measuring pathway concordance in any problem context. Our specific application considers clinical pathway concordance for stage III colon cancer. We develop a novel concordance metric and demonstrate using real patient data from Ontario, Canada that it has a statistically significant association with survival. Our methodological approach considers a patient's journey as a walk in a directed graph, where the costs on the arcs are derived by solving an inverse shortest path problem. The inverse optimization model uses two sources of information to find the arc costs: reference pathways developed by a provincial cancer agency (primary) and data from real-world patient-related activity from patients with both positive and negative clinical outcomes (secondary). Thus, our inverse optimization framework extends existing models by including data points of both varying "primacy" and "alignment". Data primacy is addressed through a two-stage approach to imputing the cost vector, while data alignment is addressed by a hybrid objective function that aims to minimize and maximize suboptimality error for different subsets of input data.

stat.AP↗

arXiv2021

OpenKBP: The open-access knowledge-based planning grand challenge

The purpose of this work is to advance fair and consistent comparisons of dose prediction methods for knowledge-based planning (KBP) in radiation therapy research. We hosted OpenKBP, a 2020 AAPM Grand Challenge, and challenged participants to develop the best method for predicting the dose of contoured CT images. The models were evaluated according to two separate scores: (1) dose score, which evaluates the full 3D dose distributions, and (2) dose-volume histogram (DVH) score, which evaluates a set DVH metrics. Participants were given the data of 340 patients who were treated for head-and-neck cancer with radiation therapy. The data was partitioned into training (n=200), validation (n=40), and testing (n=100) datasets. All participants performed training and validation with the corresponding datasets during the validation phase of the Challenge, and we ranked the models in the testing phase based on out-of-sample performance. The Challenge attracted 195 participants from 28 countries, and 73 of those participants formed 44 teams in the validation phase, which received a total of 1750 submissions. The testing phase garnered submissions from 28 teams. On average, over the course of the validation phase, participants improved the dose and DVH scores of their models by a factor of 2.7 and 5.7, respectively. In the testing phase one model achieved significantly better dose and DVH score than the runner-up models. Lastly, many of the top performing teams reported using generalizable techniques (e.g., ensembles) to achieve higher performance than their competition. This is the first competition for knowledge-based planning research, and it helped launch the first platform for comparing KBP prediction methods fairly and consistently. The OpenKBP datasets are available publicly to help benchmark future KBP research, which has also democratized KBP research by making it accessible to everyone.

physics.med-ph↗

arXiv2020

An Ensemble Learning Framework for Model Fitting and Evaluation in Inverse Linear Optimization

We develop a generalized inverse optimization framework for fitting the cost vector of a single linear optimization problem given multiple observed decisions. This setting is motivated by ensemble learning, where building consensus from base learners can yield better predictions. We unify several models in the inverse optimization literature under a single framework and derive assumption-free and exact solution methods for each one. We extend a goodness-of-fit metric previously introduced for the problem with a single observed decision to this new setting, and demonstrate several important properties. Finally, we demonstrate our framework in a novel inverse optimization-driven procedure for automated radiation therapy treatment planning. Here, the inverse optimization model leverages an ensemble of dose predictions from different machine learning models to construct a consensus treatment plan that outperforms baseline methods. The consensus plan yields better trade-offs between the competing clinical criteria used for plan evaluation.

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arXiv2020

Machine Learning as a Catalyst for Value-Based Health Care

In this manuscript, we present an argument that machine learning, a subfield of artificial intelligence, can drive improvement in value-based health care through reducing error in clinical decision making. Much of what has been previously published on machine learning in medicine represent single-use or proof-of-concept cases, as well as broad reviews of the advantages and limitations of machine learning. It is timely to look at the broader strategy for artificial intelligence implementation in medicine and emphasize how machine learning can positively influence value-based care.

cs.CY↗

arXiv2019

The importance of evaluating the complete automated knowledge-based planning pipeline

We determine how prediction methods combine with optimization methods in two-stage knowledge-based planning (KBP) pipelines to produce radiation therapy treatment plans. We trained two dose prediction methods, a generative adversarial network (GAN) and a random forest (RF) with the same 130 treatment plans. The models were applied to 87 out-of-sample patients to create two sets of predicted dose distributions that were used as input to two optimization models. The first optimization model, inverse planning (IP), estimates weights for dose-objectives from a predicted dose distribution and generates new plans using conventional inverse planning. The second optimization model, dose mimicking (DM), minimizes the sum of one-sided quadratic penalties between the predictions and the generated plans using several dose-objectives. Altogether, four KBP pipelines (GAN-IP, GAN-DM, RF-IP, and RF-DM) were constructed and benchmarked against the corresponding clinical plans using clinical criteria; the error of both prediction methods was also evaluated. The best performing plans were GAN-IP plans, which satisfied the same criteria as their corresponding clinical plans (78%) more often than any other KBP pipeline. However, GAN did not necessarily provide the best prediction for the second-stage optimization models. Specifically, both the RF-IP and RF-DM plans satisfied all clinical criteria 25% and 15% more often than GAN-DM plans (the worst performing planning), respectively. GAN predictions also had a higher mean absolute error (3.9 Gy) than those from RF (3.6 Gy). We find that state-of-the-art prediction methods when paired with different optimization algorithms, produce treatment plans with considerable variation in quality.

physics.med-ph↗

arXiv2019

Ambulance Emergency Response Optimization in Developing Countries

The lack of emergency medical transportation is viewed as the main barrier to the access of emergency medical care in low and middle-income countries (LMICs). In this paper, we present a robust optimization approach to optimize both the location and routing of emergency response vehicles, accounting for uncertainty in travel times and spatial demand characteristic of LMICs. We traveled to Dhaka, Bangladesh, the sixth largest and third most densely populated city in the world, to conduct field research resulting in the collection of two unique datasets that inform our approach. This data is leveraged to develop machine learning methodologies to estimate demand for emergency medical services in a LMIC setting and to predict the travel time between any two locations in the road network for different times of day and days of the week. We combine our robust optimization and machine learning frameworks with real data to provide an in-depth investigation into three policy-related questions. First, we demonstrate that outpost locations optimized for weekday rush hour lead to good performance for all times of day and days of the week. Second, we find that significant improvements in emergency response times can be achieved by re-locating a small number of outposts and that the performance of the current system could be replicated using only 30% of the resources. Lastly, we show that a fleet of small motorcycle-based ambulances has the potential to significantly outperform traditional ambulance vans. In particular, they are able to capture three times more demand while reducing the median response time by 42% due to increased routing flexibility offered by nimble vehicles on a larger road network. Our results provide practical insights for emergency response optimization that can be leveraged by hospital-based and private ambulance providers in Dhaka and other urban centers in LMICs.

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arXiv2019

Response time optimization for drone-delivered automated external defibrillators

Out-of-hospital cardiac arrest (OHCA) claims over 400,000 lives each year in North America and is one of the most time-sensitive medical emergencies. Drone-delivered automated external defibrillators (AEDs) have the potential to be a transformative innovation in the provision of emergency care for OHCA. In this paper, we propose a simulation-optimization framework to minimize the total number of drones required to meet a pre-specified response time goal, while guaranteeing a sufficient number of drones are located at each base. To do this, we develop a location-queuing model that is based on the p-median architecture, where each base constitutes an explicit M/M/d queue, and that incorporates estimated baseline response times to the demand points. We then develop a reformulation technique that exploits the baseline response times, allowing us to solve real-world instances to optimality using an off-the-shelf solver. To test our model, we develop a two-stage machine learning approach to simulate both the locations and baseline response times for future OHCAs. We demonstrate the application of our framework using eight years of real data from an area covering 26,000 square kilometres around Toronto, Canada. A modest number of drones are required to significantly reduce response times in all regions. Furthermore, an objective function focused on improving the 90th percentile is well-suited for use in practice because the model reduces the entire response time distribution, while providing equitable coverage in both cities and rural areas. Overall, this paper provides a realistic framework that can be leveraged by healthcare providers seeking to implement a drone network.

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arXiv2019

Inverse optimization for the recovery of constraint parameters

Most inverse optimization models impute unspecified parameters of an objective function to make an observed solution optimal for a given optimization problem with a fixed feasible set. We propose two approaches to impute unspecified left-hand-side constraint coefficients in addition to a cost vector for a given linear optimization problem. The first approach identifies parameters minimizing the duality gap, while the second minimally perturbs prior estimates of the unspecified parameters to satisfy strong duality, if it is possible to satisfy the optimality conditions exactly. We apply these two approaches to the general linear optimization problem. We also use them to impute unspecified parameters of the uncertainty set for robust linear optimization problems under interval and cardinality constrained uncertainty. Each inverse optimization model we propose is nonconvex, but we show that a globally optimal solution can be obtained either in closed form or by solving a linear number of linear or convex optimization problems.

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arXiv2018

Knowledge-based automated planning with three-dimensional generative adversarial networks

We develop a knowledge-based automated planning (KBAP) pipeline that generates treatment plans using deep neural network architectures for predicting 3D doses. Our pipeline consisted of a generative adversarial network (GAN) to predict dose from a CT image followed by two optimization models to learn objective function weights and generate fluence-based plans, respectively. We investigated three different GAN models. The first two models predicted dose for each axial slice independently. One predicted dose as a RGB color map, while the other predicted a scalar value for dose directly. The third GAN model predicted scalar doses for the full 3D CT image at once, considering correlations between adjacent CT slices. For all models, we also investigated the impact of scaling the GAN predictions before optimization. Each GAN model was trained on 130 previously delivered oropharyngeal treatment plans. Performance was tested on 87 out-of-sample plans, by evaluating using clinical planning criteria and compared to their corresponding clinical plans. The best performing KBAP plans were generated with the 3D GAN, which predicted dose values followed by scaling. These plans satisfied close to 77% of all clinical criteria, compared to the clinical plans, which satisfied 64% of all criteria. Additionally, these KBAP plans satisfied the same criteria as the clinical plans 84% more frequently compared to the 2D GAN model using RGB dose prediction. The 3D GAN predictions were also more similar to the final plan compared to the other approaches, as it better captured the vertical dosimetric relationship between adjacent axial slices. The deliverable plans better captured implicit constraints associated with physical deliverability. Overall, our final plans had superior performance in satisfying clinical criteria and generated more realistic predictions compared to the previous state-of-the-art.

physics.med-ph↗

arXiv2018

Automated Treatment Planning in Radiation Therapy using Generative Adversarial Networks

Knowledge-based planning (KBP) is an automated approach to radiation therapy treatment planning that involves predicting desirable treatment plans before they are then corrected to deliverable ones. We propose a generative adversarial network (GAN) approach for predicting desirable 3D dose distributions that eschews the previous paradigms of site-specific feature engineering and predicting low-dimensional representations of the plan. Experiments on a dataset of oropharyngeal cancer patients show that our approach significantly outperforms previous methods on several clinical satisfaction criteria and similarity metrics.

cs.LG↗

arXiv2017

Inverse Optimization: Closed-form Solutions, Geometry and Goodness of fit

In classical inverse linear optimization, one assumes a given solution is a candidate to be optimal. Real data is imperfect and noisy, so there is no guarantee this assumption is satisfied. Inspired by regression, this paper presents a unified framework for cost function estimation in linear optimization comprising a general inverse optimization model and a corresponding goodness-of-fit metric. Although our inverse optimization model is nonconvex, we derive a closed-form solution and present the geometric intuition. Our goodness-of-fit metric, $ρ$, the coefficient of complementarity, has similar properties to $R^2$ from regression and is quasiconvex in the input data, leading to an intuitive geometric interpretation. While $ρ$ is computable in polynomial-time, we derive a lower bound that possesses the same properties, is tight for several important model variations, and is even easier to compute. We demonstrate the application of our framework for model estimation and evaluation in production planning and cancer therapy.

math.OC↗

arXiv2017

Trade-off preservation in inverse multi-objective convex optimization

We present a new inverse optimization methodology for multi-objective convex optimization that accommodates an input solution that may not be Pareto optimal and determines a weight vector that produces a Pareto optimal solution that approximates the input solution and preserves the decision maker's intention encoded in it. We introduce a notion of trade-off preservation, which we use as a measure of similarity for approximating the input solution, and show its connection with minimizing an optimality gap. Our inverse model maintains the complexity of the traditional inverse convex models. We propose a linear approximation to the model and a successive linear programming algorithm that balance between trade-off preservation and computational efficiency, and show that our model encompasses many of the existing models from the literature. We demonstrate the proposed method using clinical data from prostate cancer radiation therapy.

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arXiv2017

Robust Defibrillator Deployment Under Cardiac Arrest Location Uncertainty via Row-and-Column Generation

Sudden cardiac arrest is a significant public health concern. Successful treatment of cardiac arrest is extremely time sensitive, and use of an automated external defibrillator (AED) where possible significantly increases the probability of survival. Placement of AEDs in public locations can improve survival by enabling bystanders to treat victims of cardiac arrest prior to the arrival of emergency medical responders. However, since the exact locations of future cardiac arrests cannot be known a priori, AEDs must be placed strategically in public locations to ensure their accessibility in the event of an out-of-hospital cardiac arrest emergency. In this paper, we propose a data-driven optimization model for deploying AEDs in public spaces while accounting for uncertainty in future cardiac arrest locations. Our approach involves discretizing a continuous service area into a large set of scenarios, where the probability of cardiac arrest at each location is itself uncertain. We model uncertainty in the spatial risk of cardiac arrest using a polyhedral uncertainty set that we calibrate using historical cardiac arrest data. We propose a solution technique based on row-and-column generation that exploits the structure of the uncertainty set, allowing the algorithm to scale gracefully with the total number of scenarios. Using real cardiac arrest data from the City of Toronto, we conduct an extensive numerical study on AED deployment public locations. We find that hedging against cardiac arrest location uncertainty can produce AED deployments that outperform a intuitive sample average approximation by 9 to 15%, and cuts the performance gap with respect to an ex-post model by half. Our findings suggest that accounting for cardiac arrest location uncertainty can lead to improved accessibility of AEDs during cardiac arrest emergencies and the potential for improved survival outcomes.

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arXiv2015

Stability and Continuity in Robust Linear and Linear Semi-Infinite Optimization

We consider the stability of Robust Optimization problems with respect to perturbations in their uncertainty sets. We focus on Linear Optimization problems, including those with a possibly infinite number of constraints, also known as Linear Semi-Infinite Optimization (LSIO) problems, and consider uncertainty in both the cost function and constraints. We prove Lipschitz continuity of the optimal value and ε-approximate optimal solution set with respect to the Hausdorff distance between uncertainty sets and with an explicit Lipschitz constant that can be calculated. In addition, we prove closedness and upper semi-continuity for the optimal solution set mapping with respect to the uncertainty set.

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