Literature DB >> 30815131

Improving Sepsis Treatment Strategies by Combining Deep and Kernel-Based Reinforcement Learning.

Xuefeng Peng1, Yi Ding2, David Wihl1, Omer Gottesman1, Matthieu Komorowski3, Li-Wei H Lehman4, Andrew Ross1, Aldo Faisal3, Finale Doshi-Velez1.   

Abstract

Sepsis is the leading cause of mortality in the ICU. It is challenging to manage because individual patients respond differently to treatment. Thus, tailoring treatment to the individual patient is essential for the best outcomes. In this paper, we take steps toward this goal by applying a mixture-of-experts framework to personalize sepsis treatment. The mixture model selectively alternates between neighbor-based (kernel) and deep reinforcement learning (DRL) experts depending on patient's current history. On a large retrospective cohort, this mixture-based approach outperforms physician, kernel only, and DRL-only experts.

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Year:  2018        PMID: 30815131      PMCID: PMC6371300     

Source DB:  PubMed          Journal:  AMIA Annu Symp Proc        ISSN: 1559-4076


  12 in total

Review 1.  Research in clinical reasoning: past history and current trends.

Authors:  Geoffrey Norman
Journal:  Med Educ       Date:  2005-04       Impact factor: 6.251

2.  Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of "normal" creatinine.

Authors:  Kevin Beier; Sabitha Eppanapally; Heidi S Bazick; Domingo Chang; Karthik Mahadevappa; Fiona K Gibbons; Kenneth B Christopher
Journal:  Crit Care Med       Date:  2011-02       Impact factor: 7.598

3.  Time to Treatment and Mortality during Mandated Emergency Care for Sepsis.

Authors:  Christopher W Seymour; Foster Gesten; Hallie C Prescott; Marcus E Friedrich; Theodore J Iwashyna; Gary S Phillips; Stanley Lemeshow; Tiffany Osborn; Kathleen M Terry; Mitchell M Levy
Journal:  N Engl J Med       Date:  2017-05-21       Impact factor: 91.245

Review 4.  The demise of early goal-directed therapy for severe sepsis and septic shock.

Authors:  P E Marik
Journal:  Acta Anaesthesiol Scand       Date:  2015-02-06       Impact factor: 2.105

5.  Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014.

Authors:  Chanu Rhee; Raymund Dantes; Lauren Epstein; David J Murphy; Christopher W Seymour; Theodore J Iwashyna; Sameer S Kadri; Derek C Angus; Robert L Danner; Anthony E Fiore; John A Jernigan; Greg S Martin; Edward Septimus; David K Warren; Anita Karcz; Christina Chan; John T Menchaca; Rui Wang; Susan Gruber; Michael Klompas
Journal:  JAMA       Date:  2017-10-03       Impact factor: 56.272

6.  The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation.

Authors:  Alan E Jones; Stephen Trzeciak; Jeffrey A Kline
Journal:  Crit Care Med       Date:  2009-05       Impact factor: 7.598

7.  Fluid overload in patients with severe sepsis and septic shock treated with early goal-directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death.

Authors:  Diana J Kelm; Jared T Perrin; Rodrigo Cartin-Ceba; Ognjen Gajic; Louis Schenck; Cassie C Kennedy
Journal:  Shock       Date:  2015-01       Impact factor: 3.454

8.  The Artificial Intelligence Clinician learns optimal treatment strategies for sepsis in intensive care.

Authors:  Matthieu Komorowski; Leo A Celi; Omar Badawi; Anthony C Gordon; A Aldo Faisal
Journal:  Nat Med       Date:  2018-10-22       Impact factor: 53.440

9.  Combining Kernel and Model Based Learning for HIV Therapy Selection.

Authors:  Sonali Parbhoo; Jasmina Bogojeska; Maurizio Zazzi; Volker Roth; Finale Doshi-Velez
Journal:  AMIA Jt Summits Transl Sci Proc       Date:  2017-07-26

10.  MIMIC-III, a freely accessible critical care database.

Authors:  Alistair E W Johnson; Tom J Pollard; Lu Shen; Li-Wei H Lehman; Mengling Feng; Mohammad Ghassemi; Benjamin Moody; Peter Szolovits; Leo Anthony Celi; Roger G Mark
Journal:  Sci Data       Date:  2016-05-24       Impact factor: 6.444

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  9 in total

1.  Predicting Volume Responsiveness Among Sepsis Patients Using Clinical Data and Continuous Physiological Waveforms.

Authors:  Rishikesan Kamaleswaran; Jiaoying Lian; Dong-Lien Lin; Himasagar Molakapuri; SriManikanth Nunna; Parth Shah; Shiv Dua; Rema Padman
Journal:  AMIA Annu Symp Proc       Date:  2021-01-25

2.  Deconfounding Actor-Critic Network with Policy Adaptation for Dynamic Treatment Regimes.

Authors:  Changchang Yin; Ruoqi Liu; Jeffrey Caterino; Ping Zhang
Journal:  KDD       Date:  2022-08-13

3.  Is Deep Reinforcement Learning Ready for Practical Applications in Healthcare? A Sensitivity Analysis of Duel-DDQN for Hemodynamic Management in Sepsis Patients.

Authors:  MingYu Lu; Zachary Shahn; Daby Sow; Finale Doshi-Velez; Li-Wei H Lehman
Journal:  AMIA Annu Symp Proc       Date:  2021-01-25

4.  Editorial: Clinical Application of Artificial Intelligence in Emergency and Critical Care Medicine, Volume II.

Authors:  Zhongheng Zhang; Rahul Kashyap; Nan Liu; Longxiang Su; Qinghe Meng
Journal:  Front Med (Lausanne)       Date:  2022-05-06

5.  Deep reinforcement learning for the control of microbial co-cultures in bioreactors.

Authors:  Neythen J Treloar; Alex J H Fedorec; Brian Ingalls; Chris P Barnes
Journal:  PLoS Comput Biol       Date:  2020-04-10       Impact factor: 4.475

Review 6.  Reinforcement Learning for Clinical Decision Support in Critical Care: Comprehensive Review.

Authors:  Siqi Liu; Kay Choong See; Kee Yuan Ngiam; Leo Anthony Celi; Xingzhi Sun; Mengling Feng
Journal:  J Med Internet Res       Date:  2020-07-20       Impact factor: 5.428

7.  How machine-learning recommendations influence clinician treatment selections: the example of the antidepressant selection.

Authors:  Maia Jacobs; Melanie F Pradier; Thomas H McCoy; Roy H Perlis; Finale Doshi-Velez; Krzysztof Z Gajos
Journal:  Transl Psychiatry       Date:  2021-02-04       Impact factor: 6.222

8.  Establishment and Implementation of Potential Fluid Therapy Balance Strategies for ICU Sepsis Patients Based on Reinforcement Learning.

Authors:  Longxiang Su; Yansheng Li; Shengjun Liu; Siqi Zhang; Xiang Zhou; Li Weng; Mingliang Su; Bin Du; Weiguo Zhu; Yun Long
Journal:  Front Med (Lausanne)       Date:  2022-04-14

9.  Deep reinforcement learning for personalized treatment recommendation.

Authors:  Mingyang Liu; Xiaotong Shen; Wei Pan
Journal:  Stat Med       Date:  2022-06-18       Impact factor: 2.497

  9 in total

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