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Few-shot Cross-country Generalization of Tabular Machine Learning and Foundation Models for Childhood Anemia Prediction under Distribution Shift

arXiv.org Machine Learning

Background Childhood Anemia affects an estimated 40% of children aged 6-59 months globally and arises from heterogeneous nutritional, infectious, and socioeconomic factors that vary substantially across settings. This variability challenges the generalizability of predictive machine learning models, which often degrade under cross-population or temporal shifts. We investigated the utility a modern transformer-based tabular foundation model (TabPFN) as a complementatry framework with respect to supervised classical machine learning methods across diverse country contexts, with particular attention to data-scarce settings where surveillance capacity is most limited. Methods We conducted a multi-country prediction study using Demographic and Health Surveys (DHS) children's recode data from 16 countries spanning Africa, Asia, Latin America, the Caucasus, and the Middle East. The harmonized analytic cohort comprised of (n = 68,856)children aged 6-59 months with valid hemoglobin measurements. Anemia was defined using WHO age and altitude-adjusted thresholds and treated as a binary outcome. We trained Logistic Regression, XGBoost, and LightGBM models using standard supervised learning, and evaluated TabPFN v2.6 in an in-context learning setting. Performance was assessed using Area Under the Receiver Operating Characteristic Curve (AUC-ROC) and other standard classification metrics, with calibration evaluated via Brier score and expected calibration error (ECE). Uncertainty in performance estimates was quantified using bootstrap resampling to derive 95% confidence intervals. Robustness was assessed in a few-shot learning setting. Cross-population generalization was examined using leave-one-country-out (LOCO) validation and reverse-LOCO experiments to assess directional transferability. Subgroup analyses were conducted across five demographic strata: child age group, sex, maternal education, residence type, and household wealth quintile. Feature importance was assessed using standard linear and tree-based explainer SHAP values for the three supervised models and an adapted version of SHAP for TabPFN, aggregated across countries and examined at the country level. TabPFN also yielded the best probabilistic calibration across all 16 countries, achieving the lowest mean Brier score (0.203) and Expected Calibration Error (ECE = 0.042) of all models evaluated; LightGBM and Logistic Regression exhibited the greatest miscalibration, particularly at higher predicted probabilities. Under full-data conditions, within-country discrimination was moderate across all models (AUC-ROC 0.59-0.76) Under LOCO validation, performance declined modestly (AUC-ROC 0.58-0.69) Reverse-LOCO analyses revealed asymmetric and directional transferability, with epidemiologically diverse populations serving as more informative training sources and certain target populations remaining persistently difficult to predict regardless of model or training data.


AI-Driven anemia diagnosis: A review of advanced models and techniques

arXiv.org Artificial Intelligence

Anemia, a condition marked by insufficient levels of red blood cells or hemoglobin, remains a widespread health issue affecting millions of individuals globally. Accurate and timely diagnosis is essential for effective management and treatment of anemia. In recent years, there has been a growing interest in the use of artificial intelligence techniques, i.e., machine learning (ML) and deep learning (DL) for the detection, classification, and diagnosis of anemia. This paper provides a systematic review of the recent advancements in this field, with a focus on various models applied to anemia detection. The review also compares these models based on several performance metrics, including accuracy, sensitivity, specificity, and precision. By analyzing these metrics, the paper evaluates the strengths and limitation of discussed models in detecting and classifying anemia, emphasizing the importance of addressing these factors to improve diagnostic accuracy.


Universal Laboratory Model: prognosis of abnormal clinical outcomes based on routine tests

arXiv.org Artificial Intelligence

Clinical laboratory results are ubiquitous in any diagnosis making. Predicting abnormal values of not prescribed tests based on the results of performed tests looks intriguing, as it would be possible to make early diagnosis available to everyone. The special place is taken by the Common Blood Count (CBC) test, as it is the most widely used clinical procedure. Combining routine biochemical panels with CBC presents a set of test-value pairs that varies from patient to patient, or, in common settings, a table with missing values. Here we formulate a tabular modeling problem as a set translation problem where the source set comprises pairs of GPT-like label column embedding and its corresponding value while the target set consists of the same type embeddings only. The proposed approach can effectively deal with missing values without implicitly estimating them and bridges the world of LLM with the tabular domain. Applying this method to clinical laboratory data, we achieve an improvement up to 8% AUC for joint predictions of high uric acid, glucose, cholesterol, and low ferritin levels.


Step-by-Step Guidance to Differential Anemia Diagnosis with Real-World Data and Deep Reinforcement Learning

arXiv.org Artificial Intelligence

Clinical diagnostic guidelines outline the key questions to answer to reach a diagnosis. Inspired by guidelines, we aim to develop a model that learns from electronic health records to determine the optimal sequence of actions for accurate diagnosis. Focusing on anemia and its sub-types, we employ deep reinforcement learning (DRL) algorithms and evaluate their performance on both a synthetic dataset, which is based on expert-defined diagnostic pathways, and a real-world dataset. We investigate the performance of these algorithms across various scenarios. Our experimental results demonstrate that DRL algorithms perform competitively with state-of-the-art methods while offering the significant advantage of progressively generating pathways to the suggested diagnosis, providing a transparent decision-making process that can guide and explain diagnostic reasoning.


AI tongue scanner can diagnose illnesses with 96 percent accuracy

Popular Science

A new artificial intelligence machine learning model is capable of accurately diagnosing certain illnesses nearly every time by simply looking at a patient's tongue. The novel technology, while state-of-the-art, draws its inspiration from medical approaches utilized by humans for over 2,000 years. When it comes to diagnosing ailments, traditional Chinese medicine and other practices often turn to the tongue for clues. Based on its color, shape, and thickness, the muscle can reveal a number of possible health issues--from cancer, to diabetes, to even asthma and gastrointestinal issues. Now, after more than two millennia of peering into patient mouths for answers, doctors may soon receive a second opinion from artificial eyes powered by machine learning.


Deep Reinforcement Learning for Personalized Diagnostic Decision Pathways Using Electronic Health Records: A Comparative Study on Anemia and Systemic Lupus Erythematosus

arXiv.org Artificial Intelligence

Background: Clinical diagnosis is typically reached by following a series of steps recommended by guidelines authored by colleges of experts. Accordingly, guidelines play a crucial role in rationalizing clinical decisions but suffer from limitations as they are built to cover the majority of the population and fail at covering patients with uncommon conditions. Moreover, their updates are long and expensive, making them unsuitable for emerging diseases and practices. Methods: Inspired by guidelines, we formulate the task of diagnosis as a sequential decision-making problem and study the use of Deep Reinforcement Learning (DRL) algorithms to learn the optimal sequence of actions to perform in order to obtain a correct diagnosis from Electronic Health Records (EHRs). We apply DRL on synthetic, but realistic EHRs and develop two clinical use cases: Anemia diagnosis, where the decision pathways follow the schema of a decision tree; and Systemic Lupus Erythematosus (SLE) diagnosis, which follows a weighted criteria score. We particularly evaluate the robustness of our approaches to noisy and missing data since these frequently occur in EHRs. Results: In both use cases, and in the presence of imperfect data, our best DRL algorithms exhibit competitive performance when compared to the traditional classifiers, with the added advantage that they enable the progressive generation of a pathway to the suggested diagnosis which can both guide and explain the decision-making process. Conclusion: DRL offers the opportunity to learn personalized decision pathways to diagnosis. We illustrate with our two use cases their advantages: they generate step-by-step pathways that are self-explanatory; and their correctness is competitive when compared to state-of-the-art approaches.


The Identification and Categorization of Anemia Through Artificial Neural Networks: A Comparative Analysis of Three Models

arXiv.org Artificial Intelligence

This paper presents different neural network-based classifier algorithms for diagnosing and classifying Anemia. The study compares these classifiers with established models such as Feed Forward Neural Network (FFNN), Elman network, and Non-linear Auto-Regressive Exogenous model (NARX). Experimental evaluations were conducted using data from clinical laboratory test results for 230 patients. The proposed neural network features nine inputs (age, gender, RBC, HGB, HCT, MCV, MCH, MCHC, WBCs) and one output. The simulation outcomes for diverse patients demonstrate that the suggested artificial neural network rapidly and accurately detects the presence of the disease. Consequently, the network could be seamlessly integrated into clinical laboratories for automatic generation of Anemia patients' reports Additionally, the suggested method is affordable and can be deployed on hardware at low costs.


Extracting Diagnosis Pathways from Electronic Health Records Using Deep Reinforcement Learning

arXiv.org Artificial Intelligence

Clinical diagnosis guidelines aim at specifying the steps that may lead to a diagnosis. Inspired by guidelines, we aim to learn the optimal sequence of actions to perform in order to obtain a correct diagnosis from electronic health records. We apply various deep reinforcement learning algorithms to this task and experiment on a synthetic but realistic dataset to differentially diagnose anemia and its subtypes and particularly evaluate the robustness of various approaches to noise and missing data. Experimental results show that the deep reinforcement learning algorithms show competitive performance compared to the state-of-the-art methods with the added advantage that they enable the progressive generation of a pathway to the suggested diagnosis, which can both guide and explain the decision process.


Electronic records predict premature babies' health risks - Futurity

#artificialintelligence

You are free to share this article under the Attribution 4.0 International license. Using machine learning to sift through the electronic health records of both mothers and newborns can predict how premature babies will fare in their first two months of life, researchers report. The new method, reported in the journal Science Translational Medicine, allows physicians to classify, at or before birth, which infants are likely to develop complications of prematurity. "Preterm birth is the single largest cause of death in children under age 5 worldwide." "This is a new way of thinking about preterm birth, placing the focus on individual health factors of the newborns rather than looking only at how early they are born," says senior author Nima Aghaeepour, an associate professor of anesthesiology, perioperative and pain medicine and of pediatrics Stanford University School of Medicine.


Towards Trustworthy Automatic Diagnosis Systems by Emulating Doctors' Reasoning with Deep Reinforcement Learning

arXiv.org Artificial Intelligence

The automation of the medical evidence acquisition and diagnosis process has recently attracted increasing attention in order to reduce the workload of doctors and democratize access to medical care. However, most works proposed in the machine learning literature focus solely on improving the prediction accuracy of a patient's pathology. We argue that this objective is insufficient to ensure doctors' acceptability of such systems. In their initial interaction with patients, doctors do not only focus on identifying the pathology a patient is suffering from; they instead generate a differential diagnosis (in the form of a short list of plausible diseases) because the medical evidence collected from patients is often insufficient to establish a final diagnosis. Moreover, doctors explicitly explore severe pathologies before potentially ruling them out from the differential, especially in acute care settings. Finally, for doctors to trust a system's recommendations, they need to understand how the gathered evidences led to the predicted diseases. In particular, interactions between a system and a patient need to emulate the reasoning of doctors. We therefore propose to model the evidence acquisition and automatic diagnosis tasks using a deep reinforcement learning framework that considers three essential aspects of a doctor's reasoning, namely generating a differential diagnosis using an exploration-confirmation approach while prioritizing severe pathologies. We propose metrics for evaluating interaction quality based on these three aspects. We show that our approach performs better than existing models while maintaining competitive pathology prediction accuracy.