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迈向因果关系感知推理:一种用于医学诊断的序列判别方法。

Towards Causality-Aware Inferring: A Sequential Discriminative Approach for Medical Diagnosis.

作者信息

Lin Junfan, Wang Keze, Chen Ziliang, Liang Xiaodan, Lin Liang

出版信息

IEEE Trans Pattern Anal Mach Intell. 2023 Nov;45(11):13363-13375. doi: 10.1109/TPAMI.2023.3292363. Epub 2023 Oct 3.

Abstract

Medical diagnosis assistant (MDA) aims to build an interactive diagnostic agent to sequentially inquire about symptoms for discriminating diseases. However, since the dialogue records for building a patient simulator are collected passively, the collected records might be deteriorated by some task-unrelated biases, such as the preference of the collectors. These biases might hinder the diagnostic agent to capture transportable knowledge from the simulator. This work identifies and resolves two representative non-causal biases, i.e., (i) default-answer bias and (ii) distributional inquiry bias. Specifically, Bias (i) originates from the patient simulator which tries to answer the unrecorded inquiries with some biased default answers. To eliminate this bias and improve upon a well-known causal inference technique, i.e., propensity score matching, we propose a novel propensity latent matching in building a patient simulator to effectively answer unrecorded inquiries; Bias (ii) inherently comes along with the passively collected data that the agent might learn by remembering what to inquire within the training data while not able to generalize to the out-of-distribution cases. To this end, we propose a progressive assurance agent, which includes the dual processes accounting for symptom inquiry and disease diagnosis respectively. The diagnosis process pictures the patient mentally and probabilistically by intervention to eliminate the effect of the inquiry behavior. And the inquiry process is driven by the diagnosis process to inquire about symptoms to enhance the diagnostic confidence which alters as the patient distribution changes. In this cooperative manner, our proposed agent can improve upon the out-of-distribution generalization significantly. Extensive experiments demonstrate that our framework achieves new state-of-the-art performance and possesses the advantage of transportability.

摘要

医学诊断助手(MDA)旨在构建一个交互式诊断代理,以便依次询问症状以鉴别疾病。然而,由于构建患者模拟器的对话记录是被动收集的,收集到的记录可能会受到一些与任务无关的偏差影响,例如收集者的偏好。这些偏差可能会阻碍诊断代理从模拟器中获取可迁移的知识。这项工作识别并解决了两种具有代表性的非因果偏差,即(i)默认答案偏差和(ii)分布查询偏差。具体而言,偏差(i)源于患者模拟器,它试图用一些有偏差的默认答案来回答未记录的询问。为了消除这种偏差并改进一种著名的因果推理技术,即倾向得分匹配,我们在构建患者模拟器时提出了一种新颖的倾向潜在匹配方法,以有效地回答未记录的询问;偏差(ii)本质上伴随着被动收集的数据,即代理可能通过记住在训练数据中询问的内容来学习,但无法推广到分布外的情况。为此,我们提出了一种渐进保证代理,它包括分别用于症状询问和疾病诊断的双重过程。诊断过程通过干预在心理上和概率上描绘患者,以消除询问行为的影响。而询问过程由诊断过程驱动,以询问症状来增强诊断信心,随着患者分布的变化,诊断信心也会改变。通过这种协作方式,我们提出的代理可以显著提高分布外的泛化能力。大量实验表明,我们的框架实现了新的最优性能,并具有可迁移性的优势。

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