Amazon Health AI is a new digital health assistant that answers medical questions, explains lab results and connects users with Amazon One Medical providers for care.

Designing optimal treatment plans for patients with comorbidities requires accurate cause-specific mortality prognosis. Motivated by the recent availability of linked electronic health records, we develop a nonparametric Bayesian model for survival analysis with competing risks, which can be used for jointly assessing a patient's risk of multiple (competing) adverse outcomes. The model views a patient's survival times with respect to the competing risks as the outputs of a deep multi-task Gaussian process (DMGP), the inputs to which are the patients' covariates. Unlike parametric survival analysis methods based on Cox and Weibull models, our model uses DMGPs to capture complex non-linear interactions between the patients' covariates and cause-specific survival times, thereby learning flexible patient-specific and cause-specific survival curves, all in a data-driven fashion without explicit parametric assumptions on the hazard rates. We propose a variational inference algorithm that is capable of learning the model parameters from time-to-event data while handling right censoring. Experiments on synthetic and real data show that our model outperforms the state-of-the-art survival models.

Medical researchers are coming to appreciate that many diseases are in fact complex, heterogeneous syndromes composed of subpopulations that express different variants of a related complication. Longitudinal data extracted from individual electronic health records (EHR) offer an exciting new way to study subtle differences in the way these diseases progress over time. In this paper, we focus on answering two questions that can be asked using these databases of longitudinal EHR data. First, we want to understand whether there are individuals with similar disease trajectories and whether there are a small number of degrees of freedom that account for differences in trajectories across the population. Second, we want to understand how important clinical outcomes are associated with disease trajectories. To answer these questions, we propose the Disease Trajectory Map (DTM), a novel probabilistic model that learns low-dimensional representations of sparse and irregularly sampled longitudinal data. We propose a stochastic variational inference algorithm for learning the DTM that allows the model to scale to large modern medical datasets. To demonstrate the DTM, we analyze data collected on patients with the complex autoimmune disease, scleroderma. We find that DTM learns meaningful representations of disease trajectories and that the representations are significantly associated with important clinical outcomes.

Accuracy and interpretability are two dominant features of successful predictive models. Typically, a choice must be made in favor of complex black box models such as recurrent neural networks (RNN) for accuracy versus less accurate but more interpretable traditional models such as logistic regression. This tradeoff poses challenges in medicine where both accuracy and interpretability are important. We addressed this challenge by developing the REverse Time AttentIoN model (RETAIN) for application to Electronic Health Records (EHR) data. RETAIN achieves high accuracy while remaining clinically interpretable and is based on a two-level neural attention model that detects influential past visits and significant clinical variables within those visits (e.g.

Deep learning models exhibit state-of-the-art performance for many predictive healthcare tasks using electronic health records (EHR) data, but these models typically require training data volume that exceeds the capacity of most healthcare systems. External resources such as medical ontologies are used to bridge the data volume constraint, but this approach is often not directly applicable or useful because of inconsistencies with terminology. To solve the data insufficiency challenge, we leverage the inherent multilevel structure of EHR data and, in particular, the encoded relationships among medical codes. We propose Multilevel Medical Embedding (MiME) which learns the multilevel embedding of EHR data while jointly performing auxiliary prediction tasks that rely on this inherent EHR structure without the need for external labels. We conducted two prediction tasks, heart failure prediction and sequential disease prediction, where MiME outperformed baseline methods in diverse evaluation settings. In particular, MiME consistently outperformed all baselines when predicting heart failure on datasets of different volumes, especially demonstrating the greatest performance improvement (15% relative gain in PR-AUC over the best baseline) on the smallest dataset, demonstrating its ability to effectively model the multilevel structure of EHR data.

Your Out-of-Distribution Detection Method is Not Robust!

In a number of disciplines, the data (e.g., graphs, manifolds) to be analyzed are non-Euclidean in nature. Geometric deep learning corresponds to techniques that generalize deep neural network models to such non-Euclidean spaces. Several recent papers have shown how convolutional neural networks (CNNs) can be extended to learn with graph-based data. In this work, we study the setting where the data (or measurements) are ordered, longitudinal or temporal in nature and live on a Riemannian manifold -- this setting is common in a variety of problems in statistical machine learning, vision and medical imaging. We show how recurrent statistical recurrent network models can be defined in such spaces. We give an efficient algorithm and conduct a rigorous analysis of its statistical properties. We perform extensive numerical experiments demonstrating competitive performance with state of the art methods but with significantly less number of parameters. We also show applications to a statistical analysis task in brain imaging, a regime where deep neural network models have only been utilized in limited ways.

We present a new approach to the problems of evaluating and learning personalized decision policies from observational data of past contexts, decisions, and outcomes. Only the outcome of the enacted decision is available and the historical policy is unknown. These problems arise in personalized medicine using electronic health records and in internet advertising. Existing approaches use inverse propensity weighting (or, doubly robust versions) to make historical outcome (or, residual) data look like it were generated by a new policy being evaluated or learned. But this relies on a plug-in approach that rejects data points with a decision that disagrees with the new policy, leading to high variance estimates and ineffective learning. We propose a new, balance-based approach that too makes the data look like the new policy but does so directly by finding weights that optimize for balance between the weighted data and the target policy in the given, finite sample, which is equivalent to minimizing worst-case or posterior conditional mean square error.

Frequency-specific patterns of neural activity are traditionally interpreted as sustained rhythmic oscillations, and related to cognitive mechanisms such as attention, high level visual processing or motor control. While alpha waves (8--12\,Hz) are known to closely resemble short sinusoids, and thus are revealed by Fourier analysis or wavelet transforms, there is an evolving debate that electromagnetic neural signals are composed of more complex waveforms that cannot be analyzed by linear filters and traditional signal representations. In this paper, we propose to learn dedicated representations of such recordings using a multivariate convolutional sparse coding (CSC) algorithm. Applied to electroencephalography (EEG) or magnetoencephalography (MEG) data, this method is able to learn not only prototypical temporal waveforms, but also associated spatial patterns so their origin can be localized in the brain. Our algorithm is based on alternated minimization and a greedy coordinate descent solver that leads to state-of-the-art running time on long time series. To demonstrate the implications of this method, we apply it to MEG data and show that it is able to recover biological artifacts. More remarkably, our approach also reveals the presence of non-sinusoidal mu-shaped patterns, along with their topographic maps related to the somatosensory cortex.

Electronic health records provide a rich source of data for machine learning methods to learn dynamic treatment responses over time. However, any direct estimation is hampered by the presence of time-dependent confounding, where actions taken are dependent on time-varying variables related to the outcome of interest. Drawing inspiration from marginal structural models, a class of methods in epidemiology which use propensity weighting to adjust for time-dependent confounders, we introduce the Recurrent Marginal Structural Network - a sequence-to-sequence architecture for forecasting a patient's expected response to a series of planned treatments.