Developing A Fair Individualized Polysocial Risk Score (iPsRS) for Identifying Increased Social Risk of Hospitalizations in Patients with Type 2 Diabetes (T2D)

Yu Huang; Jingchuan Guo; William T Donahoo; Zhengkang Fan; Ying Lu; Wei-Han Chen; Huilin Tang; Lori Bilello; Elizabeth A Shenkman; Jiang Bian

arXiv · 2309.02467

Developing A Fair Individualized Polysocial Risk Score (iPsRS) for Identifying Increased Social Risk of Hospitalizations in Patients with Type 2 Diabetes (T2D)

Yu Huang·Jingchuan Guo·William T Donahoo·Zhengkang Fan·Ying Lu·Wei-Han Chen·Huilin Tang·Lori Bilello·Elizabeth A Shenkman·Jiang Bian

View original source ↗Read source document ↗Export metadata ↓

Abstract

Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is therefore crucial to implement effective social risk management strategies at the point of care. Objective: To develop an EHR-based machine learning (ML) analytical pipeline to identify the unmet social needs associated with hospitalization risk in patients with T2D. Methods: We identified 10,192 T2D patients from the EHR data (from 2012 to 2022) from the University of Florida Health Integrated Data Repository, including contextual SDoH (e.g., neighborhood deprivation) and individual-level SDoH (e.g., housing stability). We developed an electronic health records (EHR)-based machine learning (ML) analytic pipeline, namely individualized polysocial risk score (iPsRS), to identify high social risk associated with hospitalizations in T2D patients, along with explainable AI (XAI) techniques and fairness assessment and optimization. Results: Our iPsRS achieved a C statistic of 0.72 in predicting 1-year hospitalization after fairness optimization across racial-ethnic groups. The iPsRS showed excellent utility for capturing individuals at high hospitalization risk; the actual 1-year hospitalization rate in the top 5% of iPsRS was ~13 times as high as the bottom decile. Conclusion: Our ML pipeline iPsRS can fairly and accurately screen for patients who have increased social risk leading to hospitalization in T2D patients.

Explore related subjects

cs.LG cs.CY

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Yu Huang, Jingchuan Guo, William T Donahoo, Zhengkang Fan, Ying Lu, Wei-Han Chen, Huilin Tang, Lori Bilello, Elizabeth A Shenkman, Jiang Bian. 2023-09-05. Developing A Fair Individualized Polysocial Risk Score (iPsRS) for Identifying Increased Social Risk of Hospitalizations in Patients with Type 2 Diabetes (T2D). https://arxiv.org/abs/2309.02467

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Incentivizing Honesty among Competitors in Collaborative Learning and Optimization

Collaborative learning techniques have the potential to enable training machine learning models that are superior to models trained on a single entity's data. However, in many cases, potential participants in such collaborative schemes are competitors on a downstream task, such as firms that each aim to attract customers by providing the best recommendations. This can incentivize dishonest updates that damage other participants' models, potentially undermining the benefits of collaboration. In this work, we formulate a game that models such interactions and study two learning tasks within this framework: single-round mean estimation and multi-round SGD on strongly-convex objectives. For a natural class of player actions, we show that rational clients are incentivized to strongly manipulate their updates, preventing learning. We then propose mechanisms that incentivize honest communication and ensure learning quality comparable to full cooperation. Lastly, we empirically demonstrate the effectiveness of our incentive scheme on a standard non-convex federated learning benchmark. Our work shows that explicitly modeling the incentives and actions of dishonest clients, rather than assuming them malicious, can enable strong robustness guarantees for collaborative learning.

cs.LG↗

arXiv2026

Hierarchical Deep Counterfactual Regret Minimization

Imperfect Information Games (IIGs) are used to model games under uncertainty or lack complete information. Counterfactual Regret Minimization (CFR) is one of the most successful families of algorithms for IIGs. The integration of skill-based strategy learning with CFR could potentially mirror more human-like decision-making and improve learning on complex IIGs. It enables the learning of a hierarchical strategy, wherein low-level components represent skills for solving subgames and the high-level component manages the transition between skills. In this paper, we introduce the first hierarchical version of Deep CFR (HDCFR), an innovative method that boosts learning efficiency in tasks involving extensively large state spaces and deep game trees. Notably, HDCFR enables learning with predefined (human) expertise and extracting skills transferable to similar tasks. We first present the algorithm and establish its theory in a tabular setting, including hierarchical CFR update rules and a variance-reduced Monte Carlo sampling extension for the model-free setting, where backtracking is infeasible. We then extend HDCFR to large-scale tasks via deep learning objectives that match the tabular targets under exact function fitting. Code: https://anonymous.4open.science/r/HDCFR_RUN-677B.

cs.LG↗

arXiv2026

Achieving Linear Speedup with ProxSkip in Distributed Stochastic Optimization

The ProxSkip algorithm for distributed optimization is gaining increasing attention due to its effectiveness in reducing communication. However, existing analyses of ProxSkip are limited to the strongly convex setting and fail to achieve linear speedup with respect to the number of nodes. Key questions regarding its behavior in the non-convex setting and the achievability of linear speedup remain open. In this paper, we revisit decentralized ProxSkip and answer these questions affirmatively. We provide a unified convergence analysis for stochastic non-convex, convex, and strongly convex problems, revealing how gradient noise, local updates, network connectivity, and data heterogeneity jointly determine the convergence behavior. To the best of our knowledge, this is the first analysis showing that decentralized ProxSkip achieves linear speedup in the number of nodes under stochastic gradients. Moreover, our results demonstrate that local updates can effectively reduce communication frequency and improve communication efficiency.

cs.LG↗