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A Conservative Q-Learning approach for handling distribution shift in sepsis treatment strategies
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Sepsis is a leading cause of mortality and its treatment is very expensive. Sepsis treatment is also very challenging because there is no consensus on what interventions work best and different patients respond very differently to the same treatment. Deep Reinforcement Learning methods can be used to come up with optimal policies for treatment strategies mirroring physician actions. In the healthcare scenario, the available data is mostly collected offline with no interaction with the environment, which necessitates the use of offline RL techniques. The Offline RL paradigm suffers from action distribution shifts which in turn negatively affects learning an optimal policy for the treatment. In this work, a Conservative-Q Learning (CQL) algorithm is used to mitigate this shift and its corresponding policy reaches closer to the physicians policy than conventional deep Q Learning. The policy learned could help clinicians in Intensive Care Units to make better decisions while treating septic patients and improve survival rate.
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MORE-CLEAR: Multimodal Offline Reinforcement learning for Clinical notes Leveraged Enhanced State Representation
A multimodal offline RL framework that fuses LLM-encoded clinical notes with structured vitals and labs modestly improves sepsis policy scores on some datasets, with evaluation caveats.
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