Compositional Q-learning for electrolyte repletion with imbalanced patient sub-populations
Why this work is in the frame
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Bibliographic record
Abstract
Reinforcement learning (RL) is an effective framework for solving sequential decision-making tasks. However, applying RL methods in medical care settings is challenging in part due to heterogeneity in treatment response among patients. Some patients can be treated with standard protocols whereas others, such as those with chronic diseases, need personalized treatment planning. Traditional RL methods often fail to account for this heterogeneity, because they assume that all patients respond to the treatment in the same way (i.e., transition dynamics are shared). We introduce Compositional Fitted $Q$-iteration (CFQI), which uses a compositional task structure to represent heterogeneous treatment responses in medical care settings. A compositional task consists of several variations of the same task, each progressing in difficulty; solving simpler variants of the task can enable efficient solving of harder variants. CFQI uses a compositional $Q$-value function with separate modules for each task variant, allowing it to take advantage of shared knowledge while learning distinct policies for each variant. We validate CFQI's performance using a Cartpole environment and use CFQI to recommend electrolyte repletion for patients with and without renal disease. Our results demonstrate that CFQI is robust even in the presence of class imbalance, enabling effective information usage across patient sub-populations. CFQI exhibits great promise for clinical applications in scenarios characterized by known compositional structures.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it