Continuous, automated surveillance systems that incorporate machine learning models are becoming increasingly more common in healthcare environments. These models can capture temporally dependent changes across multiple patient variables and can enhance a clinician's situational awareness by providing an early warning alarm of an impending adverse event such as sepsis. However, most commonly used methods, e.g., XGBoost, fail to provide an interpretable mechanism for understanding why a model produced a sepsis alarm at a given time. The black-box nature of many models is a severe limitation as it prevents clinicians from independently corroborating those physiologic features that have contributed to the sepsis alarm. To overcome this limitation, we propose a generalized linear model (GLM) approach to fit a Granger causal graph based on the physiology of several major sepsis-associated derangements (SADs). We adopt a recently developed stochastic monotone variational inequality-based estimator coupled with forwarding feature selection to learn the graph structure from both continuous and discrete-valued as well as regularly and irregularly sampled time series. Most importantly, we develop a non-asymptotic upper bound on the estimation error for any monotone link function in the GLM. We conduct real-data experiments and demonstrate that our proposed method can achieve comparable performance to popular and powerful prediction methods such as XGBoost while simultaneously maintaining a high level of interpretability.
翻译:包含机器学习模型的自动化连续监视系统在医疗保健环境中越来越普遍。这些模型可以捕捉多种病人变量之间的时间依赖性变化,并通过提供对败血症等即将发生的不利事件的预警警报,提高临床医生对状况的认识。然而,最常用的方法,例如XGBoost,未能提供可解释的机制,以了解为什么模型在特定时间产生败血症警报。许多模型的黑箱性质是一个严重的局限性,因为它使临床医生无法独立地证实促成败血症警报的那些生理特征。为了克服这一限制,我们提议了一种普遍的线性模型(GLM)方法,以适应Granger因果图,其依据是几个与败血症有关的重大脱节(SADs)的生理学。我们采用了一种最近开发的随机性单体单体差异变化警报仪,并加上转发特征选择,以便从连续和离散估值以及定期和不定期抽样的时间序列中学习图形结构。最重要的是,我们提出了一种通用的线性模型模型模型模型,用以同时根据若干种主要的模型进行不可靠的分析,同时我们提出的一种可比较性、可追溯性、可追溯性、可追溯性、可追溯性、可追溯性、可追溯性、可追溯性、可追溯性、可追溯性、可追溯的模型。