ICML 2024 论文列表

The use of machine learning models to predict clinical outcomes from (longitudinal) electronic health record (EHR) data is becoming increasingly popular due to advances in deep architectures, representation learning, and the growing availability of large EHR datasets. Existing models generally assume access to the same data sources during both training and inference stages. However, this assumption is often challenged by the fact that real-world clinical datasets originate from various data sources (with distinct sets of covariates), which though can be available for training (in a research or retrospective setting), are more realistically only partially available (a subset of such sets) for inference when deployed. So motivated, we introduce Contrastive Learning for clinical Outcome Prediction with Partial data Sources (CLOPPS), that trains encoders to capture information across different data sources and then leverages them to build classifiers restricting access to a single data source. This approach can be used with existing cross-sectional or longitudinal outcome classification models. We present experiments on two real-world datasets demonstrating that CLOPPS consistently outperforms strong baselines in several practical scenarios.

Electrocardiograms (ECGs) are non-invasive diagnostic tools crucial for detecting cardiac arrhythmic diseases in clinical practice. While ECG Self-supervised Learning (eSSL) methods show promise in representation learning from unannotated ECG data, they often overlook the clinical knowledge that can be found in reports. This oversight and the requirement for annotated samples for downstream tasks limit eSSL's versatility. In this work, we address these issues with the **M**ultimodal **E**CG **R**epresentation **L**earning (**MERL**) framework. Through multimodal learning on ECG records and associated reports, MERL is capable of performing zero-shot ECG classification with text prompts, eliminating the need for training data in downstream tasks. At test time, we propose the **C**linical **K**nowledge **E**nhanced **P**rompt **E**ngineering (**CKEPE**) approach, which uses Large Language Models (LLMs) to exploit external expert-verified clinical knowledge databases, generating more descriptive prompts and reducing hallucinations in LLM-generated content to boost zero-shot classification. Based on MERL, we perform the first benchmark across six public ECG datasets, showing the superior performance of MERL compared against eSSL methods. Notably, MERL achieves an average AUC score of 75.2% in zero-shot classification (**without training data**), 3.2% higher than linear probed eSSL methods with 10% annotated training data, averaged across all six datasets.

In drug development, early phase dose-finding clinical trials are carried out to identify an optimal dose to administer to patients in larger confirmatory clinical trials. Standard trial procedures do not optimize for participant benefit and do not consider participant heterogeneity, despite consequences to participants' health and downstream impacts to under-represented population subgroups. Many novel drugs also do not obey parametric modelling assumptions made in common dose-finding procedures. We present Safe Allocation for Exploration of Treatments SAFE-T, a procedure for adaptive dose-finding that adheres to safety constraints, improves utility for heterogeneous participants, and works well with small sample sizes. SAFE-T flexibly learns non-parametric multi-output Gaussian process models for dose toxicity and efficacy, using Bayesian optimization, and provides accurate final dose recommendations. We provide theoretical guarantees for the satisfaction of safety constraints. Using a comprehensive set of realistic synthetic scenarios, we demonstrate empirically that SAFE-T generally outperforms comparable methods and maintains performance across variations in sample size and subgroup distribution. Finally, we extend SAFE-T to a new adaptive setting, demonstrating its potential to improve traditional clinical trial procedures.