arXiv subjects

Yingye Zheng

Publications and source records attributed to Yingye Zheng.

6 recordsLinked to original sources

arXiv2026

Primal--Dual Alternating Neural Learning for Timely Classification with Performance Guarantees

Timely risk classification is essential in many clinical monitoring settings, where decisions must balance the benefit of classifying patients early for subsequent intervention against the value of observing additional data. Yet most existing statistical and machine-learning methods are designed for fully observed trajectories and offer limited control over key operating characteristics such as sensitivity, specificity, and monitoring cost. We cast the sequential classification problem within a multi-objective optimization framework targeting these three criteria. We characterize the optimal decision rule through a value recursion that quantifies, at each time point, the trade-off between immediate classification and continued monitoring. To estimate the rule from data, we formulate a constrained optimization problem that maximizes specificity while enforcing prespecified sensitivity and monitoring-cost constraints. We then develop an estimation procedure that employs a recurrent neural network to approximate the evolving value processes and a primal--dual updating scheme to satisfy the performance constraints. Through simulation studies and an application to continuous glucose monitoring for hypoglycemia risk prediction, we demonstrate that the proposed method yields accurate and timely sequential decision rules that adhere to the desired operating characteristics.

stat.ML↗

arXiv2026

Cost-optimal Sequential Testing via Doubly Robust Q-learning

Clinical decision-making often involves selecting tests that are costly, invasive, or time-consuming, motivating individualized, sequential strategies for what to measure and when to stop ascertaining. We study the problem of learning cost-optimal sequential decision policies from retrospective data, where test availability depends on prior results, inducing informative missingness. Under a sequential missing-at-random mechanism, we develop a doubly robust Q-learning framework for estimating optimal policies. The method introduces path-specific inverse probability weights that account for heterogeneous test trajectories and satisfy a normalization property conditional on the observed history. By combining these weights with auxiliary contrast models, we construct orthogonal pseudo-outcomes that enable unbiased policy learning when either the acquisition model or the contrast model is correctly specified. We establish oracle inequalities for the stage-wise contrast estimators, along with convergence rates, regret bounds, and misclassification rates for the learned policy. Simulations demonstrate improved cost-adjusted performance over weighted and complete-case baselines, and an application to a prostate cancer cohort study illustrates how the method reduces testing cost without compromising predictive accuracy.

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arXiv2025

Weighted Brier Score -- an Overall Summary Measure for Risk Prediction Models with Clinical Utility Consideration

As advancements in novel biomarker-based algorithms and models accelerate disease risk prediction and stratification in medicine, it is crucial to evaluate these models within the context of their intended clinical application. Prediction models output the absolute risk of disease; subsequently, patient counseling and shared decision-making are based on the estimated individual risk and cost-benefit assessment. The overall impact of the application is often referred to as clinical utility, which received significant attention in terms of model assessment lately. The classic Brier score is a popular measure of prediction accuracy; however, it is insufficient for effectively assessing clinical utility. To address this limitation, we propose a class of weighted Brier scores that aligns with the decision-theoretic framework of clinical utility. Additionally, we decompose the weighted Brier score into discrimination and calibration components, examining how weighting influences the overall score and its individual components. Through this decomposition, we link the weighted Brier score to the $H$ measure, which has been proposed as a coherent alternative to the area under the receiver operating characteristic curve. This theoretical link to the $H$ measure further supports our weighting method and underscores the essential elements of discrimination and calibration in risk prediction evaluation. The practical use of the weighted Brier score as an overall summary is demonstrated using data from the Prostate Cancer Active Surveillance Study (PASS).

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arXiv2024

Estimating optimal tailored active surveillance strategy under interval censoring

Active surveillance (AS) using repeated biopsies to monitor disease progression has been a popular alternative to immediate surgical intervention in cancer care. However, a biopsy procedure is invasive and sometimes leads to severe side effects of infection and bleeding. To reduce the burden of repeated surveillance biopsies, biomarker-assistant decision rules are sought to replace the fix-for-all regimen with tailored biopsy intensity for individual patients. Constructing or evaluating such decision rules is challenging. The key AS outcome is often ascertained subject to interval censoring. Furthermore, patients will discontinue their participation in the AS study once they receive a positive surveillance biopsy. Thus, patient dropout is affected by the outcomes of these biopsies. In this work, we propose a nonparametric kernel-based method to estimate the true positive rates (TPRs) and true negative rates (TNRs) of a tailored AS strategy, accounting for interval censoring and immediate dropouts. Based on these estimates, we develop a weighted classification framework to estimate the optimal tailored AS strategy and further incorporate the cost-benefit ratio for cost-effectiveness in medical decision-making. Theoretically, we provide a uniform generalization error bound of the derived AS strategy accommodating all possible trade-offs between TPRs and TNRs. Simulation and application to a prostate cancer surveillance study show the superiority of the proposed method.

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arXiv2021

A new weighting method when not all the events are selected as cases in a nested case-control study

Nested case-control (NCC) is a sampling method widely used for developing and evaluating risk models with expensive biomarkers on large prospective cohort studies. The biomarker values are typically obtained on a sub-cohort, consisting of all the events and a subset of non-events. However, when the number of events is not small, it might not be affordable to measure the biomarkers on all of them. Due to the costs and limited availability of bio-specimens, only a subset of events is selected to the sub-cohort as cases. For these "untypical" NCC studies, we propose a new weighting method for the inverse probability weighted (IPW) estimation. We also design a perturbation method to estimate the variance of the IPW estimator with our new weights. It accounts for between-subject correlations induced by the sampling processes for both cases and controls through perturbing their sampling indicator variables, and thus, captures all the variations. Furthermore, we demonstrate, analytically and numerically, that when cases consist of only a subset of events, our new weight produces more efficient IPW estimators than the weight proposed in Samuelsen (1997) for a standard NCC design. We illustrate the estimating procedure with a study that aims to evaluate a biomarker-based risk prediction model using the Framingham cohort study.

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arXiv2019

Constructing Stabilized Dynamic Treatment Regimes for Censored Data

Stabilized dynamic treatment regimes are sequential decision rules for individual patients that not only adaptive throughout the disease progression but also remain consistent over time in format. The estimation of stabilized dynamic treatment regimes becomes more complicated when the clinical outcome of interest is a survival time subject to censoring. To address this challenge, we propose two novel methods, censored shared-Q-learning and censored shared-O-learning. Both methods incorporate clinical preferences into a qualitative rule, where the parameters indexing the decision rules are shared across different stages and estimated simultaneously. We use extensive simulation studies to demonstrate the superior performance of the proposed methods. The methods are further applied to the Framingham Study to derive treatment rules for cardiovascular disease.

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