<i>In silico</i> perturbations provide multivariate interpretability in predicting post-lung transplant outcomes
Bibliographic record
Abstract
Abstract Lung transplantation is a life-saving therapy for end-stage lung disease but has the poorest survival among solid organ transplants. We analyzed standardized electronic health record (EHR) data from the United Network for Organ Sharing (UNOS) to predict one-, three-, and five-year survival and favorable long-term outcomes post-lung transplant. We applied two multivariate machine learning approaches, XGBoost or a tabular BERT model called EHRFormer, to data from 43,869 first-time lung transplant recipients (1987–2022). XGBoost and EHRFormer identified features that align closely with established risk factors for worse outcomes such as length of index stay, recipient age, and creatinine at the time of transplant. We developed a simple perturbation method with EHRFormer to probe in silico multivariate interactions between features that influence model prediction. Despite their attention to known risk factors, machine learning applied to EHR data collected by UNOS poorly predict one-, three-, and five-year mortality after lung transplant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".