Objective: Machine learning (ML) predictive models are often developed without considering downstream value trade-offs and clinical interpretability. This paper introduces a cost-aware prediction (CAP) framework that combines cost-benefit analysis assisted by large language model (LLM) agents to communicate the trade-offs involved in applying ML predictions. Materials and Methods: We developed an ML model predicting 1-year mortality in patients with heart failure (N = 30,021, 22% mortality) to identify those eligible for home care. We then introduced clinical impact projection (CIP) curves to visualize important cost dimensions - quality of life and healthcare provider expenses, further divided into treatment and error costs, to assess the clinical consequences of predictions. Finally, we used four LLM agents to generate patient-specific descriptions. The system was evaluated by clinicians for its decision support value. Results: The eXtreme gradient boosting (XGB) model achieved the best performance, with an area under the receiver operating characteristic curve (AUROC) of 0.804 (95% confidence interval (CI) 0.792-0.816), area under the precision-recall curve (AUPRC) of 0.529 (95% CI 0.502-0.558) and a Brier score of 0.135 (95% CI 0.130-0.140). Discussion: The CIP cost curves provided a population-level overview of cost composition across decision thresholds, whereas LLM-generated cost-benefit analysis at individual patient-levels. The system was well received according to the evaluation by clinicians. However, feedback emphasizes the need to strengthen the technical accuracy for speculative tasks. Conclusion: CAP utilizes LLM agents to integrate ML classifier outcomes and cost-benefit analysis for more transparent and interpretable decision support.

Emerging in December 2019, the COVID-19 pandemic caused widespread health, economic, and social disruptions. Rapid global transmission overwhelmed healthcare systems, resulting in high infection rates, hospitalisations, and fatalities. To minimise the spread, governments implemented several non-pharmaceutical interventions like lockdowns and travel restrictions. While effective in controlling transmission, these measures also posed significant economic and societal challenges. Although the WHO declared COVID-19 no longer a global health emergency in May 2023, its impact persists, shaping public health strategies. The vast amount of data collected during the pandemic offers valuable insights into disease dynamics, transmission, and intervention effectiveness. Leveraging these insights can improve forecasting models, enhancing preparedness and response to future outbreaks while mitigating their social and economic impact. This paper presents a large-scale case study on COVID-19 forecasting in Cyprus, utilising a two-year dataset that integrates epidemiological data, vaccination records, policy measures, and weather conditions. We analyse infection trends, assess forecasting performance, and examine the influence of external factors on disease dynamics. The insights gained contribute to improved pandemic preparedness and response strategies.

Speech is a cost-effective and non-intrusive data source for identifying acute and chronic heart failure (HF). However, there is a lack of research on whether Chinese syllables contain HF-related information, as observed in other well-studied languages. This study presents the first Chinese speech database of HF patients, featuring paired recordings taken before and after hospitalisation. The findings confirm the effectiveness of the Chinese language in HF detection using both standard'patient-wise' and personalised'pair-wise' classification approaches, with the latter serving as an ideal speaker-decoupled baseline for future research. Statistical tests and classification results highlight individual differences as key contributors to inaccuracy. Additionally, an adaptive frequency filter (AFF) is proposed for frequency importance analysis. The data and demonstrations are published at https://github.com/

Causal machine learning (ML) algorithms recover graphical structures that tell us something about cause-and-effect relationships. The causal representation praovided by these algorithms enables transparency and explainability, which is necessary for decision making in critical real-world problems. Yet, causal ML has had limited impact in practice compared to associational ML. This paper investigates the challenges of causal ML with application to COVID-19 UK pandemic data. We collate data from various public sources and investigate what the various structure learning algorithms learn from these data. We explore the impact of different data formats on algorithms spanning different classes of learning, and assess the results produced by each algorithm, and groups of algorithms, in terms of graphical structure, model dimensionality, sensitivity analysis, confounding variables, predictive and interventional inference. We use these results to highlight open problems in causal structure learning and directions for future research. To facilitate future work, we make all graphs, models, data sets, and source code publicly available online.

We focus on the problem of uncertainty informed allocation of medical resources (vaccines) to heterogeneous populations for managing epidemic spread. We tackle two related questions: (1) For a compartmental ordinary differential equation (ODE) model of epidemic spread, how can we estimate and integrate parameter uncertainty into resource allocation decisions? (2) How can we computationally handle both nonlinear ODE constraints and parameter uncertainties for a generic stochastic optimization problem for resource allocation? To the best of our knowledge current literature does not fully resolve these questions. Here, we develop a data-driven approach to represent parameter uncertainty accurately and tractably in a novel stochastic optimization problem formulation. We first generate a tractable scenario set by estimating the distribution on ODE model parameters using Bayesian inference with Gaussian processes. Next, we develop a parallelized solution algorithm that accounts for scenario-dependent nonlinear ODE constraints. Our scenario-set generation procedure and solution approach are flexible in that they can handle any compartmental epidemiological ODE model. Our computational experiments on two different non-linear ODE models (SEIR and SEPIHR) indicate that accounting for uncertainty in key epidemiological parameters can improve the efficacy of time-critical allocation decisions by 4-8%. This improvement can be attributed to data-driven and optimal (strategic) nature of vaccine allocations, especially in the early stages of the epidemic when the allocation strategy can crucially impact the long-term trajectory of the disease.

We modelled emergence and spread of the Omicron variant of SARS-CoV-2 in Australia between December 2021 and June 2022. This pandemic stage exhibited a diverse epidemiological profile with emergence of co-circulating sub-lineages of Omicron, further complicated by differences in social distancing behaviour which varied over time. Our study delineated distinct phases of the Omicron-associated pandemic stage, and retrospectively quantified the adoption of social distancing measures, fluctuating over different time periods in response to the observable incidence dynamics. We also modelled the corresponding disease burden, in terms of hospitalisations, intensive care unit occupancy, and mortality. Supported by good agreement between simulated and actual health data, our study revealed that the nonlinear dynamics observed in the daily incidence and disease burden were determined not only by introduction of sub-lineages of Omicron, but also by the fluctuating adoption of social distancing measures. Our high-resolution model can be used in design and evaluation of public health interventions during future crises.

Individual-based epidemiological models support the study of fine-grained preventive measures, such as tailored vaccine allocation policies, in silico. As individual-based models are computationally intensive, it is pivotal to identify optimal strategies within a reasonable computational budget. Moreover, due to the high societal impact associated with the implementation of preventive strategies, uncertainty regarding decisions should be communicated to policy makers, which is naturally embedded in a Bayesian approach. We present a novel technique for evaluating vaccine allocation strategies using a multi-armed bandit framework in combination with a Bayesian anytime $m$-top exploration algorithm. $m$-top exploration allows the algorithm to learn $m$ policies for which it expects the highest utility, enabling experts to inspect this small set of alternative strategies, along with their quantified uncertainty. The anytime component provides policy advisors with flexibility regarding the computation time and the desired confidence, which is important as it is difficult to make this trade-off beforehand. We consider the Belgian COVID-19 epidemic using the individual-based model STRIDE, where we learn a set of vaccination policies that minimize the number of infections and hospitalisations. Through experiments we show that our method can efficiently identify the $m$-top policies, which is validated in a scenario where the ground truth is available. Finally, we explore how vaccination policies can best be organised under different contact reduction schemes. Through these experiments, we show that the top policies follow a clear trend regarding the prioritised age groups and assigned vaccine type, which provides insights for future vaccination campaigns.

This Digital Health News industry roundup includes an Innovate UK Smart Award for a smart inhaler tracker, details on the digital transformation programme for Research Data Scotland and Cera's commitment to reduce hospitalisations with its digital healthcare approach. Customer analysis of a care home admin platform has revealed that it can save a significant number of hours in admin time for care homes. The CoolCare software focuses on making admin more efficient and more profitable. Its most recent analysis found that many of its customers were seeing results above pre-pandemic levels, including above-national increases in weekly fees, occupancy and private payer ratios. With increased occupancy, comes more admin.

A tool has been developed to help healthcare professionals identify hospitalised patients most at risk of dying from COVID-19 using artificial intelligence (AI). The algorithm could help doctors to direct critical care resources to those in most immediate need, which the developers of the AI tool say could be especially valuable to resource-limited countries. And with no end in sight for the coronavirus pandemic, with new variants leading to fresh waves of sickness and hospitalisation, the scientists behind the tool say there is a need for generalised tools like this which can be easily rolled out. To develop the tool, scientists used biochemical data from routine blood samples taken from nearly 30,000 patients hospitalised in over 150 hospitals in Spain, the US, Honduras, Bolivia and Argentina between March 2020 and February 2022. Taking blood from so many patients meant the team were able to capture data from people with different immune statuses – vaccinated, unvaccinated and those with natural immunity – and from people infected with every variant of COVID-19.

Objectives: To evaluate the consequences of the framing of machine learning risk prediction models. We evaluate how framing affects model performance and model learning in four different approaches previously applied in published artificial-intelligence (AI) models. Setting and participants: We analysed structured secondary healthcare data from 221,283 citizens from four Danish municipalities who were 18 years of age or older. Results: The four models had similar population level performance (a mean area under the receiver operating characteristic curve of 0.73 to 0.82), in contrast to the mean average precision, which varied greatly from 0.007 to 0.385. Correspondingly, the percentage of missing values also varied between framing approaches. The on-clinical-demand framing, which involved samples for each time the clinicians made an early warning score assessment, showed the lowest percentage of missing values among the vital sign parameters, and this model was also able to learn more temporal dependencies than the others. The Shapley additive explanations demonstrated opposing interpretations of SpO2 in the prediction of sepsis as a consequence of differentially framed models. Conclusions: The profound consequences of framing mandate attention from clinicians and AI developers, as the understanding and reporting of framing are pivotal to the successful development and clinical implementation of future AI technology. Model framing must reflect the expected clinical environment. The importance of proper problem framing is by no means exclusive to sepsis prediction and applies to most clinical risk prediction models.