用于医疗保健应用的连续时间决策变压器。

Zhiyue Zhang, Hongyuan Mei, Yanxun Xu
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引用次数: 0

摘要

离线强化学习(RL)是一种很有前途的方法,可用于训练智能医疗代理学习治疗策略,并在许多医疗保健应用中协助决策制定,例如为慢性病患者安排门诊和分配剂量。在本文中,我们研究了决策转换器(Chen 等人,2021 年)--一种新的离线 RL 范例--在需要连续时间决策的医疗领域中的潜在用途。由于决策转换器只能处理离散时间(或基于回合的)顺序决策场景,我们将其推广到连续时间决策转换器,它不仅考虑了过去的临床测量和治疗,还考虑了以前就诊的时间,并学会建议未来就诊的时间以及每次就诊的治疗方案。在合成数据集和现实世界医疗应用模拟器上进行的大量实验表明,连续时间决策转换器能够超越竞争对手,并通过从使用不同质量水平的策略生成的日志数据中学习高性能策略,在改善患者健康状况和延长患者生存期方面具有临床实用性。
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Continuous-Time Decision Transformer for Healthcare Applications.

Offline reinforcement learning (RL) is a promising approach for training intelligent medical agents to learn treatment policies and assist decision making in many healthcare applications, such as scheduling clinical visits and assigning dosages for patients with chronic conditions. In this paper, we investigate the potential usefulness of Decision Transformer (Chen et al., 2021)-a new offline RL paradigm-in medical domains where decision making in continuous time is desired. As Decision Transformer only handles discrete-time (or turn-based) sequential decision making scenarios, we generalize it to Continuous-Time Decision Transformer that not only considers the past clinical measurements and treatments but also the timings of previous visits, and learns to suggest the timings of future visits as well as the treatment plan at each visit. Extensive experiments on synthetic datasets and simulators motivated by real-world medical applications demonstrate that Continuous-Time Decision Transformer is able to outperform competitors and has clinical utility in terms of improving patients' health and prolonging their survival by learning high-performance policies from logged data generated using policies of different levels of quality.

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