Interpretable Additive Recurrent Neural Networks For Multivariate Clinical Time Series

Time series models with recurrent neural networks (RNNs) can have high accuracy but are unfortunately difficult to interpret as a result of feature-interactions, temporal-interactions, and non-linear transformations. Interpretability is important in domains like healthcare where constructing models that provide insight into the relationships they have learned are required to validate and trust model predictions. We want accurate time series models where users can understand the contribution of individual input features. We present the Interpretable-RNN (I-RNN) that balances model complexity and accuracy by forcing the relationship between variables in the model to be additive. Interactions are restricted between hidden states of the RNN and additively combined at the final step. I-RNN specifically captures the unique characteristics of clinical time series, which are unevenly sampled in time, asynchronously acquired, and have missing data. Importantly, the hidden state activations represent feature coefficients that correlate with the prediction target and can be visualized as risk curves that capture the global relationship between individual input features and the outcome. We evaluate the I-RNN model on the Physionet 2012 Challenge dataset to predict in-hospital mortality, and on a real-world clinical decision support task: predicting hemodynamic interventions in the intensive care unit. I-RNN provides explanations in the form of global and local feature importances comparable to highly intelligible models like decision trees trained on hand-engineered features while significantly outperforming them. I-RNN remains intelligible while providing accuracy comparable to state-of-the-art decay-based and interpolation-based recurrent time series models. The experimental results on real-world clinical datasets refute the myth that there is a tradeoff between accuracy and interpretability.