The dosing of intravenous fluids and vasopressors in sepsis is a sequential decision made under uncertainty and guided largely by clinical judgment, which makes it a natural target for reinforcement learning from historical care. Because a learned policy cannot be trialed on patients, its value must be estimated off-policy, and such estimates can be fragile and optimistic.
arXiv:2608. 11410v1 Announce Type: new Abstract: Offline reinforcement learning (RL) offers considerable promise for optimizing ICU treatment decisions, yet standard evaluation metrics Mean Squared Error (MSE) and Fitted Q-Evaluation (FQE) assess only behavioral imitation and cannot detect Toxic Mimicry, a failure mode in which agents replicate harmful patterns such as treatment withdrawal during comfort-care transitions.
By Hangqi Ren, Junyi Liao
arXiv:2607. 08793v1 Announce Type: cross Abstract: Sepsis is a leading cause of mortality, yet optimal treatment policies remain contested.
By Joshua Pickard, Wei Qi, Na Li, Ann Woolley, Lisa Cosimi, Roy Kishony, Deborah Hung
arXiv:2606. 04632v1 Announce Type: new Abstract: Mechanical ventilation for Acute Respiratory Distress Syndrome (ARDS) requires balancing competing physiological goals, including oxygenation, lung protection, and acid-base homeostasis.
By Teqi Hao, Yuxuan Fu, Xiaoyu Tan, Shaojie Shi, Bohao Lv, Yinghui Xu, Xihe Qiu
arXiv:2510. 15127v3 Announce Type: replace-cross Abstract: Identifying the effects of mechanical ventilation (MV) protocols in critical care requires analyzing data from heterogeneous patient-ventilator systems in the clinical decision-making environment.
By David J. Albers, Tell D. Bennett, Jana de Wiljes, George Hripcsak, Bradford J. Smith, Peter D. Sottile, J. N. Stroh
arXiv:2608. 07418v1 Announce Type: new Abstract: In medical education, physicians convert academic knowledge into clinical expertise through residency: years of training across thousands of encounters, with diverse sources of feedback and progressively greater autonomy.
By Valentin Li\'{e}vin, Samuel Schmidgall, Tim Strother, Alex Bijamov, Akshay Goel, Anil Palepu, Chunjong Park, Vahid Balazadeh, Min Woo Sun, Marius Guerard, Justin Chen, Dave Steiner, Vikram Dhillon, Ibrahim Azar, Akhil Mehta, Nicholas Spetsieris, Shilpan Shah, Maen Abdelrahim, Amit Dahiya, Yun Liu, Katherine Chou, Yossi Matias, Avinatan Hassidim, Dale R. Webster, Quoc V. Le, Raia Hadsell, Joelle Barral, Carey Radebaugh, Aleksandra Faust, Shekoofeh Azizi, Mike Schaekermann, Po-Hsuan Cameron Chen, Tao Tu, David Racz, Lin Yang
arXiv:2606. 20206v1 Announce Type: cross Abstract: In offline Reinforcement Learning, immediate rewards in logged batch data are often unobserved due to sparse or irregular record-keeping, or censored beyond certain reward values.
By Ziheng Wei, Annie Qu, Rui Miao
arXiv:2607. 19020v1 Announce Type: cross Abstract: Background: Clinical decision support systems degrade silently as treatment protocols evolve, yet standard adaptation methods treat models as monolithic blocks, unable to distinguish stable patient physiology from shifting institutional practice.
By Fatema Ferdous Tamanna, K. M. Merajul Arefin, Md. Abdul Masud
arXiv:2510. 19893v2 Announce Type: replace Abstract: Medical AI systems demonstrated impressive diagnostic performance, yet they routinely show uneven accuracy across demographic groups, disadvantaging underrepresented populations.
By Shiqi Dai, Wei Dai, Jiaee Cheong, Paul Pu Liang
arXiv:2604. 16763v3 Announce Type: replace Abstract: Causal inference from electronic health records (EHR) is fundamentally limited by unmeasured confounding: critical clinical states such as frailty, goals of care, and mental status are documented in free-text notes but absent from structured data.
By Lei Liu, Jialin Chen, Kathy Macropol
arXiv:2606. 19481v1 Announce Type: new Abstract: Offline reinforcement learning (ORL) offers the potential to improve the quality of clinical decision-making using historical electronic health record (EHR) data.
By Thomas Frost, Steve Harris
arXiv:2607. 02206v1 Announce Type: cross Abstract: Predictions are increasingly used to guide high-stakes decisions, from treatment selection to policy making.
By Yurui Zheng, Ying Jin