Evidence map›Paper›PMID 36396808›Full record

ArticleNPJ digital medicine2022

An interpretable RL framework for pre-deployment modeling in ICU hypotension management.

Kristine Zhang, Henry Wang, Jianzhun Du, Brian Chu, Aldo Robles Arévalo, Ryan Kindle, Leo Anthony Celi, Finale Doshi-Velez

Open access · goldAbstract read
In one paragraph

Article in NPJ digital medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Data-driven decision making in patient management: a systematic review.BMC medical informatics and decision making · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Kristine ZhangHarvard University, Cambridge, MA, USA.
Henry WangHarvard University, Cambridge, MA, USA.
Jianzhun DuHarvard University, Cambridge, MA, USA.
Brian ChuHarvard University, Cambridge, MA, USA.
Aldo Robles ArévaloIDMEC, Instituto Superior Técnico - Universidade de Lisboa, NTT DATA Portugal, Lisbon, Portugal.ORCID http://orcid.org/0000-0003-4324-7890
Ryan KindleMassachusetts General Hospital, Boston, MA, USA.
Leo Anthony CeliMassachusetts Institute of Technology, Cambridge, MA, USA. lceli@mit.edu.
Finale Doshi-VelezHarvard University, Cambridge, MA, USA. finale@seas.harvard.edu.ORCID http://orcid.org/0000-0003-2886-3898
Harvard University Press · USInstituto de Engenharia de Sistemas e Computadores Investigação e Desenvolvimento · PTMassachusetts General Hospital · USMassachusetts Institute of Technology · US

Funding

Critical Care Informatics: Ethical considerations around the use and sharing of health-related dataR01EB017205 · NIBIB · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI CELI, LEO ANTHONY G, MARK, ROGER GREENWOOD · 2014 to 2021
$3.8M
NIBIB NIH HHS R01 EB017205
6 · The paper itself

Abstract

Computational methods from reinforcement learning have shown promise in inferring treatment strategies for hypotension management and other clinical decision-making challenges. Unfortunately, the resulting models are often difficult for clinicians to interpret, making clinical inspection and validation of these computationally derived strategies challenging in advance of deployment. In this work, we develop a general framework for identifying succinct sets of clinical contexts in which clinicians make very different treatment choices, tracing the effects of those choices, and inferring a set of recommendations for those specific contexts. By focusing on these few key decision points, our framework produces succinct, interpretable treatment strategies that can each be easily visualized and verified by clinical experts. This interrogation process allows clinicians to leverage the model's use of historical data in tandem with their own expertise to determine which recommendations are worth investigating further e.g. at the bedside. We demonstrate the value of this approach via application to hypotension management in the ICU, an area with critical implications for patient outcomes that lacks data-driven individualized treatment strategies; that said, our framework has broad implications on how to use computational methods to assist with decision-making challenges on a wide range of clinical domains.

Identifiers

PMID36396808
PMCPMC9671896
OpenAlexW4309474164

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.