Srinivasan Srivatsan, Doshi-Velez Finale
Harvard University, Paulson School of Engineering and Applied Sciences, Cambridge, MA.
AMIA Jt Summits Transl Sci Proc. 2020 May 30;2020:636-645. eCollection 2020.
Exposing and understanding the motivations of clinicians is an important step for building robust assistive agents as well as improving care. In this work, we focus on understanding the motivations for clinicians managing hypotension in the ICU. We model the ICU interventions as a batch, sequential decision making problem and develop a novel interpretable batch variant of Adversarial Inverse Reinforcement Learning algorithm that not only learns rewards which induce treatment policies similar to clinical treatments, but also ensure that the learned functional form of rewards is consistent with the decision mechanisms of clinicians in the ICU. We apply our approach to understanding vasopressor and IVfluid administration in the ICU and posit that this interpretability enables inspection and validation of the rewards robustly.
揭示并理解临床医生的动机是构建强大的辅助智能体以及改善医疗护理的重要一步。在这项工作中,我们专注于理解临床医生在重症监护病房(ICU)管理低血压的动机。我们将ICU中的干预措施建模为一个批量、序列决策问题,并开发了一种新颖的可解释的批量对抗逆强化学习算法变体,该算法不仅能学习到能诱导出与临床治疗相似的治疗策略的奖励,还能确保所学习的奖励函数形式与ICU中临床医生的决策机制一致。我们将我们的方法应用于理解ICU中血管加压药和静脉输液的使用情况,并认为这种可解释性能够有力地检查和验证奖励。