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arXiv 2302.07549cs.LG
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面向真实世界治疗优化应用的深度离线强化学习

Deep Offline Reinforcement Learning for Real-world Treatment Optimization Applications

Microsoft(微软);Singapore General Hospital(新加坡综合医院)

Milashini Nambiar, Supriyo Ghosh, Priscilla Ong, Yu En Chan, Yong Mong Bee, Pavitra Krishnaswamy

AI总结:

针对真实世界医疗治疗优化中离线强化学习的动作不平衡问题,提出有理论依据的转移采样方法,在糖尿病和脓毒症任务上较DDQN、CQL基准显著提升健康结果且符合安全规范。

摘要:

在众多慢性病管理和重症监护应用中,人们对采用数据驱动方法推荐最优治疗策略的兴趣日益浓厚。强化学习方法非常适合这类序贯决策问题,但由于直接在线探索存在安全风险且不可行,因此必须完全基于回顾性医疗记录数据集进行训练和评估。尽管有这一要求,绝大多数治疗优化研究仍采用离策略RL方法(例如Double Deep Q Networks(DDQN,双深度Q网络)及其变体),而这类方法在纯离线场景下的表现众所周知很差。离线RL领域的最新进展,例如Conservative Q-Learning(CQL,保守Q学习),提供了合适的替代方案。但要将这些方法适配到真实世界应用中仍存在挑战,这类应用里回顾性数据集中次优样本占主导,且需要满足严格的安全约束。在本研究中,我们提出了一种实用且有理论依据的转移采样方法,用于解决离线RL训练过程中的动作不平衡问题。我们在糖尿病和脓毒症治疗优化这两个真实世界任务上开展了大量实验,将所提方法的性能与主流的离策略及离线RL基准(DDQN和CQL)进行对比。在一系列符合原则且具有临床相关性的指标上,我们的研究表明,所提方法能大幅改善预期健康结果,且符合相关临床实践与安全指南。

英文摘要:

There is increasing interest in data-driven approaches for recommending optimal treatment strategies in many chronic disease management and critical care applications. Reinforcement learning methods are well-suited to this sequential decision-making problem, but must be trained and evaluated exclusively on retrospective medical record datasets as direct online exploration is unsafe and infeasible. Despite this requirement, the vast majority of treatment optimization studies use off-policy RL methods (e.g., Double Deep Q Networks (DDQN) or its variants) that are known to perform poorly in purely offline settings. Recent advances in offline RL, such as Conservative Q-Learning (CQL), offer a suitable alternative. But there remain challenges in adapting these approaches to real-world applications where suboptimal examples dominate the retrospective dataset and strict safety constraints need to be satisfied. In this work, we introduce a practical and theoretically grounded transition sampling approach to address action imbalance during offline RL training. We perform extensive experiments on two real-world tasks for diabetes and sepsis treatment optimization to compare performance of the proposed approach against prominent off-policy and offline RL baselines (DDQN and CQL). Across a range of principled and clinically relevant metrics, we show that our proposed approach enables substantial improvements in expected health outcomes and in accordance with relevant practice and safety guidelines.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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