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Your health app may be failing you

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Confounder Detection via Treatment Intent: A New Observational Study Design

arXiv.org Machine Learning

Understanding the effects of interventions is central to scientific progress, with randomized controlled trials (RCTs) regarded as the gold standard for causal inference in many applied fields. However, RCTs are costly, time-consuming, and often constrained by ethical or practical limitations, motivating the need for causal methods able to draw conclusions from observational data. While such data is collected at ever larger scale, making its use for causal inference is often hindered by the fact that not all variables affecting treatment allocation and the outcome are observed - an issue known as unobserved confounding. In this paper, we introduce a new study design called confounder detection via treatment intent. The idea is to query a human expert who makes treatment decisions, and ask them to compare pairs of units proposed by a principled matching strategy, with the goal of eliciting unobserved variables that explain why treatment decisions differ. We provide a theoretical basis for such a procedure, ascertaining conditions under which such a study design may elicit unobserved confounders. Building on this newly established foundations, we study treatment effects of interventions in the intensive care unit (ICU). First, we show empirical evidence strongly indicating that electronic health records (EHRs) collected in ICUs are subject to unobserved confounding. By using clinical text notes as a proxy for physicians' knowledge and leveraging natural language processing, we provide a proof of concept for our methodology in a semi-synthetic environment with a known ground truth.


Causal Discovery in Structural VAR Models Under Equal Noise Variance

arXiv.org Machine Learning

Causal discovery from multivariate time series is challenging when causal effects may occur both across time and within the same sampling interval. This issue is especially important in applications such as neuroscience, where the sampling rate may be coarse relative to the underlying dynamics and contemporaneous effects need not form an acyclic graph. We study causal discovery in linear Gaussian structural VAR models under an equal noise variance assumption, meaning that the structural noise terms have a common variance. Unlike the DAG-based cross-sectional equal noise variance setting, the time-series setting considered here does not generally yield point identification of a unique causal graph. Instead, multiple structural VAR parameterizations can induce the same stationary observed process law. We introduce a notion of observational equivalence tailored to this setting and show that the corresponding equivalence class is characterized by orthogonal transformations of the structural equations together with a global positive scale. This characterization leads to an equivalence-aware model discrepancy, the observational alignment discrepancy, which compares structural models modulo transformations that preserve the observed law. Building on this theory, we propose ENVAR, a sparsity-based procedure that searches over the induced observational equivalence class for a sparse normalized structural representative. We evaluate the proposed methodology on synthetic structural VAR data and on an fMRI dataset.


Causal Inference with Categorical Unobserved Confounder via Mixture Learning

arXiv.org Machine Learning

Unobserved confounding is a fundamental challenge for estimating causal effects. To address unobserved confounding, recent literature has turned to two different approaches -- proxy variables and the use of multiple treatments. The first approach, commonly referred to as proximal causal inference, requires proxies to be assigned to specific asymmetric roles: treatment-inducing proxies (negative control exposures), variables that act as common causes of the treatment and outcome, and outcome-inducing proxies (negative control outcomes). In practice, however, identifying variables that satisfy these asymmetric roles can be difficult depending on the application domain. The second approach, commonly referred to as the ``Deconfounder," deals with multiple conditionally independent treatments. There has been limited progress towards developing a consistent estimation method for this setting. As the primary contribution of this work, we establish that causal effects are identifiable in both settings when the unobserved confounder is categorical under suitable conditions. Our approach builds on a mixture learning perspective: we show that the underlying confounding structure can be recovered by identifying the corresponding mixture distribution. We propose an estimation procedure based on tensor decomposition, which allows consistent recovery of the latent structure and comes with non-asymptotic guarantees. Simulation studies and real data experiments demonstrate that the proposed method performs well even with limited data.


Learning Interpretable Point-Based Clinical Risk Scores via Direct Optimization

arXiv.org Machine Learning

Many clinical risk scores are deployed as additive rules with nonnegative integer points assigned to relevant binary predictive features. These integer weights not only make the score easier to use in practice but also promote sparsity in the resulting prediction model. Such risk scores are often derived by first fitting a regression model and then rounding the estimated coefficients to the nearest integer after appropriate scaling. This approach is computationally fast but does not guarantee optimality of the resulting score. Alternatively, one may search over all possible integer weights to directly optimize a value function by posing the problem as an integer programming task. However, the associated computational burden can be substantial, especially when the value function is nonconcave or even discontinuous. In this paper, we develop new machine learning algorithms that employ a flexible greedy optimization strategy to learn such additive scoring directly under explicit and sensible optimality objectives. We apply the proposed method to a large electronic health record (EHR) cohort in Epic Cosmos to construct an integer-weighted comorbidity score for measuring the risk of post-discharge mortality. We also conduct a simulation study to examine the finite-sample operating characteristics.


Isolating Nonlinear Independent Sources in fMRI with $β$-TCVAE Models

arXiv.org Machine Learning

Learning meaningful latent representations from nonlinear fMRI data remains a fundamental challenge in neuroimaging analysis. Traditional independent component analysis, widely used due to its ability to estimate interpretable functional brain networks, relies on a linear mixing assumption for latent sources, limiting its ability to capture the inherently nonlinear and complex organization of brain dynamics. More recently, deep representation learning methods have emerged as promising alternatives for modeling nonlinear latent structure. However, many of these approaches have been evaluated primarily on simulated datasets or natural image benchmarks, with comparatively limited validation on real-world neuroimaging data such as fMRI. In this work, we are motivated by the $β$-TCVAE (Total Correlation Variational Autoencoder), a refinement of the $β$-VAE framework for learning latent representations without introducing additional hyperparameters during training. We adapt and modify this model to fMRI data for nonlinear source disentanglement, aiming to separate mixed spatial and temporal brain signals into interpretable components. We show that the $β$-TCVAE framework can recover meaningful nonlinear spatial components with biological relevance, including well-established intrinsic connectivity networks such as the default mode network. Furthermore, we evaluate the learned representations using functional network connectivity, showing that the latent structure captures coherent and interpretable brain organization patterns. This study provides a pilot investigation that bridges nonlinear representation learning and fMRI analysis.


Application of Deep Reinforcement Learning to Event-Triggered Control for Networked Artificial Pancreas Systems

arXiv.org Machine Learning

This paper proposes a deep reinforcement learning (DRL)-based event-triggered controller design for networked artificial pancreas (AP) systems. Although existing DRL-based AP controllers typically assume periodic control updates, networked control systems (NCSs) require a reduction in communication frequency to achieve energy-efficient operation, which is directly tied to control updates. However, jointly learning both insulin dosing and update timing significantly increases the complexity of the learning problem. To alleviate this complexity, we develop a practical DRL-based controller design that avoids explicitly learning update timing by introducing a rule-based criterion defined by changes in blood glucose. As a result, decision-making occurs at irregular intervals, and the problem is naturally formulated as a semi-Markov decision process (SMDP), for which we extend a standard DRL algorithm. Numerical experiments demonstrate that the proposed method improves communication efficiency while maintaining control performance.


SurvivalPFN: Amortizing Survival Prediction via In-Context Bayesian Inference

arXiv.org Machine Learning

Survival analysis provides a powerful statistical framework for modeling time-to-event outcomes in the presence of censoring. However, selecting an appropriate estimator from the many specialized survival approaches often requires substantial methodological and domain expertise. We introduce SurvivalPFN, a prior-data fitted network that amortizes Bayesian inference for censored observations through in-context learning. SurvivalPFN is pretrained on a diverse family of synthetic, identifiable, and right-censored data-generating processes, enabling it to amortize survival analysis in a single forward pass during inference. As a result, the model adapts to the effective complexity of each dataset without task-specific training or hyperparameter tuning, avoids restrictive parametric assumptions, and produces calibrated survival distributions. In a large-scale benchmark spanning 61 datasets, 21 methods, and 5 evaluation metrics, SurvivalPFN achieves strong predictive performance and often improves upon established survival models. These results suggest that SurvivalPFN offers a principled and practical foundation model for survival analysis, with potential applications in high-impact domains such as healthcare, finance, and engineering (https://github.com/rgklab/SurvivalPFN).


FRESH: Information-Geometric Calibration of Patient-Level Models to Aggregate Evidence

arXiv.org Machine Learning

Many decision in clinical science and epidemiology -- estimating probability of technical success for a clinical trial, assessing comparative effectiveness of two therapies, imputing a placebo effect onto natural history data -- rely on combining sources of information about a clinical cohort that comes from different kinds of studies. Specifically we contrast patient-level sources that provide granular pictures of individual disease course (clinical trial, registries, or electronic health records) with aggregate sources such as published clinical trial results and the TFLs (tables figures and listings). One strategy for combining aggregate with patient-level data sources is to bring each into a common format for a unified analysis. If one wants to maintain the analytic flexibility of patient-level data, then a natural solution is to convert the aggregate data information into a simulated patient-level dataset that recapitulate those aggregate statistics. This is an under-determined inverse problem in that there are many such datasets, and it cannot be well specified without further constraints. FRESH(Fusion of Recent Evidence with Subject Histories) provides a well-defined method for solving this problem, and therefore providing maximal analytic flexibility.


TabPFN-3: Technical Report

arXiv.org Machine Learning

Tabular data underpins most high-value prediction problems in science and industry, and TabPFN has driven the foundation model revolution for this modality. Designed with feedback from our users, TabPFN-3 builds on this foundation to scale state-of-the-art performance to datasets with 1M training rows and substantially reduce training and inference time. Pretrained exclusively on synthetic data from our prior, TabPFN-3 dramatically pushes the frontier of tabular prediction and brings substantial gains on time series, relational, and tabular-text data. On the standard tabular benchmark TabArena, a forward pass of TabPFN-3 outperforms all other models, including tuned and ensembled baselines, by a significant margin, and pareto-dominates the speed/performance frontier. On more diverse datasets, TabPFN-3 ranks first on datasets with many classes, and beats 8-hour-tuned gradient-boosted-tree baselines on datasets up to 1M training rows and 200 features. TabPFN-3 introduces test-time compute scaling to tabular foundation models. Our API offering TabPFN-3-Plus (Thinking) exploits this to beat all non-TabPFN models by over 200 Elo on TabArena, rising to 420 Elo on the largest data subset, and outperforms AutoGluon 1.5 extreme while being 10x faster, without using LLMs, real data, internet search or any other model besides TabPFN. TabPFN-3 extends the capabilities of our models, enabling SOTA prediction on relational data (new SOTA foundation model on RelBenchV1) and tabular-text data (SOTA on TabSTAR via TabPFN-3-Plus); and improves existing integrations: a specialized checkpoint, TabPFN-TS-3, ranks 2nd on the time-series benchmark fev-bench, and SHAP-value computation is up to 120x faster. TabPFN-3 achieves this performance while being up to 20x faster than TabPFN-2.5. In addition, a reduced KV cache and row-chunking scale to 1M rows on one H100 with fast inference speed.