论文标题
表示整合多域结果以优化个性化处理的学习
Representation Learning for Integrating Multi-domain Outcomes to Optimize Individualized Treatments
论文作者
论文摘要
对于精神障碍,患者的潜在精神状态是非观察到的潜在构造,必须从观察到的多域测量值(例如诊断症状和患者功能分数)中推断出来。此外,需要解决患者之间疾病诊断的实质异质性,以优化个性化的治疗政策,以实现精确医学。为了应对这些挑战,我们提出了一个综合学习框架,可以同时学习患者的基本心理状态,并为每个人推荐最佳治疗方法。该学习框架基于精神病学的测量理论,用于建模由基本原因(真正的精神状态)引起的多种疾病诊断措施进行建模。它允许纳入多元前后治疗后和生物学措施,同时保留代表患者潜在精神状态的不变结构。多层神经网络用于允许复杂的治疗效应异质性。可以通过比较观察到的多域治疗预处理测量值,可以通过比较不同治疗方法下的潜在精神状态,来推断未来患者的最佳治疗政策。对模拟数据和现实世界中的临床试验数据进行的实验表明,学识渊博的治疗政策与异质治疗效果的替代方法相比有利,并且具有广泛的公用事业,从而可以在多个领域上带来更好的患者结果。
For mental disorders, patients' underlying mental states are non-observed latent constructs which have to be inferred from observed multi-domain measurements such as diagnostic symptoms and patient functioning scores. Additionally, substantial heterogeneity in the disease diagnosis between patients needs to be addressed for optimizing individualized treatment policy in order to achieve precision medicine. To address these challenges, we propose an integrated learning framework that can simultaneously learn patients' underlying mental states and recommend optimal treatments for each individual. This learning framework is based on the measurement theory in psychiatry for modeling multiple disease diagnostic measures as arising from the underlying causes (true mental states). It allows incorporation of the multivariate pre- and post-treatment outcomes as well as biological measures while preserving the invariant structure for representing patients' latent mental states. A multi-layer neural network is used to allow complex treatment effect heterogeneity. Optimal treatment policy can be inferred for future patients by comparing their potential mental states under different treatments given the observed multi-domain pre-treatment measurements. Experiments on simulated data and a real-world clinical trial data show that the learned treatment polices compare favorably to alternative methods on heterogeneous treatment effects, and have broad utilities which lead to better patient outcomes on multiple domains.