Learning to Treat Sepsis with Multi-Output Gaussian Process Deep Recurrent Q-Networks
Sepsis is a life-threatening complication from infection and a leading cause of mortality in hospitals. While early detection of sepsis improves patient outcomes, there is little consensus on exact treatment guidelines, and treating septic patients remains an open problem. In this work we present a new deep reinforcement learning method that we use to learn optimal personalized treatment policies for septic patients. We model patient continuous-valued physiological time series using multi-output Gaussian processes, a probabilistic model that easily handles missing values and irregularly spaced observation times while maintaining estimates of uncertainty. The Gaussian process is directly tied to a deep recurrent Q-network that learns clinically interpretable treatment policies, and both models are learned together end-to-end. We evaluate our approach on a heterogeneous dataset of septic spanning 15 months from our university health system, and find that our learned policy could reduce patient mortality by as much as 8.2\% from an overall baseline mortality rate of 13.3\%. Our algorithm could be used to make treatment recommendations to physicians as part of a decision support tool, and the framework readily applies to other reinforcement learning problems that rely on sparsely sampled and frequently missing multivariate time series data.
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