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arxiv 2404.07148 v1 pith:ECJXP5ED submitted 2024-04-10 cs.LG cs.HC

How Consistent are Clinicians? Evaluating the Predictability of Sepsis Disease Progression with Dynamics Models

classification cs.LG cs.HC
keywords sepsisactionsdiseaseclinicianclinicianspoliciesprogressionsuggest
verification ladder T0 review T1 audit T2 compute T3 formal T4 reserved
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Reinforcement learning (RL) is a promising approach to generate treatment policies for sepsis patients in intensive care. While retrospective evaluation metrics show decreased mortality when these policies are followed, studies with clinicians suggest their recommendations are often spurious. We propose that these shortcomings may be due to lack of diversity in observed actions and outcomes in the training data, and we construct experiments to investigate the feasibility of predicting sepsis disease severity changes due to clinician actions. Preliminary results suggest incorporating action information does not significantly improve model performance, indicating that clinician actions may not be sufficiently variable to yield measurable effects on disease progression. We discuss the implications of these findings for optimizing sepsis treatment.

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