Reproducibility remains a significant challenge in machine learning (ML) for healthcare. Datasets, model pipelines, and even task or cohort definitions are often private in this field, leading to a significant barrier in sharing, iterating, and understanding ML results on electronic health record (EHR) datasets. We address a significant part of this problem by introducing the Automatic Cohort Extraction System (ACES) for event-stream data. This library is designed to simultaneously simplify the development of tasks and cohorts for ML in healthcare and also enable their reproduction, both at an exact level for single datasets and at a conceptual level across datasets. To accomplish this, ACES provides: (1) a highly intuitive and expressive domain-specific configuration language for defining both dataset-specific concepts and dataset-agnostic inclusion or exclusion criteria, and (2) a pipeline to automatically extract patient records that meet these defined criteria from real-world data. ACES can be automatically applied to any dataset in either the Medical Event Data Standard (MEDS) or Event Stream GPT (ESGPT) formats, or to *any* dataset in which the necessary task-specific predicates can be extracted in an event-stream form. ACES has the potential to significantly lower the barrier to entry for defining ML tasks in representation learning, redefine the way researchers interact with EHR datasets, and significantly improve the state of reproducibility for ML studies using this modality. ACES is available at: https://github.com/justin13601/aces.

Health AI suffers from a systemic reproducibility crisis that irreparably hinders research across both academia and industry [4,5].One key tool poised to solve this crisis is the Medical Event Data Standard (MEDS), a comprehensive data format and open-source ecosystem designed to enhance reproducibility and interoperability of AI research using longitudinal Electronic Health Records (EHR) [6].Currently adopted by over 15 institutions globally, MEDS encompasses various open-source tools, published models, and data processing pipelines, enabling streamlined model development and robust benchmarking.In this tutorial, participants will gain key hands-on experience in working with the MEDS format to perform efficient, reproducible, state-of-the-art AI research over real health data.Participants will transform data into the MEDS format, preprocess data, build predictive models, and contribute to the decentralized MEDS-DEV benchmarking platform.Interactive exercises using Jupyter notebooks will provide hands-on experience and practical skills for reproducible health AI research.Attendees will leave equipped

In machine learning (ML), a widespread claim is that the area under the precision-recall curve (AUPRC) is a superior metric for model comparison to the area under the receiver operating characteristic (AUROC) for tasks with class imbalance. This paper refutes this notion on two fronts. First, we theoretically characterize the behavior of AUROC and AUPRC in the presence of model mistakes, establishing clearly that AUPRC is not generally superior in cases of class imbalance. We further show that AUPRC can be a harmful metric as it can unduly favor model improvements in subpopulations with more frequent positive labels, heightening algorithmic disparities. Next, we empirically support our theory using experiments on both semi-synthetic and real-world fairness datasets. Prompted by these insights, we conduct a review of over 1.5 million scientific papers to understand the origin of this invalid claim, finding that it is often made without citation, misattributed to papers that do not argue this point, and aggressively over-generalized from source arguments. Our findings represent a dual contribution: a significant technical advancement in understanding the relationship between AUROC and AUPRC and a stark warning about unchecked assumptions in the ML community.

Generative, pre-trained transformers (GPTs, a type of "Foundation Models") have reshaped natural language processing (NLP) through their versatility in diverse downstream tasks. However, their potential extends far beyond NLP. This paper provides a software utility to help realize this potential, extending the applicability of GPTs to continuous-time sequences of complex events with internal dependencies, such as medical record datasets. Despite their potential, the adoption of foundation models in these domains has been hampered by the lack of suitable tools for model construction and evaluation. To bridge this gap, we introduce Event Stream GPT (ESGPT), an open-source library designed to streamline the end-to-end process for building GPTs for continuous-time event sequences. ESGPT allows users to (1) build flexible, foundation-model scale input datasets by specifying only a minimal configuration file, (2) leverage a Hugging Face compatible modeling API for GPTs over this modality that incorporates intra-event causal dependency structures and autoregressive generation capabilities, and (3) evaluate models via standardized processes that can assess few and even zero-shot performance of pre-trained models on user-specified fine-tuning tasks.

Gene expression data can offer deep, physiological insights beyond the static coding of the genome alone. We believe that realizing this potential requires specialized, high-capacity machine learning methods capable of using underlying biological structure, but the development of such models is hampered by the lack of published benchmark tasks and well characterized baselines. In this work, we establish such benchmarks and baselines by profiling many classifiers against biologically motivated tasks on two curated views of a large, public gene expression dataset (the LINCS corpus) and one privately produced dataset. We provide these two curated views of the public LINCS dataset and our benchmark tasks to enable direct comparisons to future methodological work and help spur deep learning method development on this modality. In addition to profiling a battery of traditional classifiers, including linear models, random forests, decision trees, K nearest neighbor (KNN) classifiers, and feed-forward artificial neural networks (FF-ANNs), we also test a method novel to this data modality: graph convolugtional neural networks (GCNNs), which allow us to incorporate prior biological domain knowledge. We find that GCNNs can be highly performant, with large datasets, whereas FF-ANNs consistently perform well. Non-neural classifiers are dominated by linear models and KNN classifiers.

The biomedical field offers many learning tasks that share unique challenges: large amounts of unpaired data, and a high cost to generate labels. In this work, we develop a method to address these issues with semi-supervised learning in regression tasks (e.g., translation from source to target). Our model uses adversarial signals to learn from unpaired datapoints, and imposes a cycle-loss reconstruction error penalty to regularize mappings in either direction against one another. We first evaluate our method on synthetic experiments, demonstrating two primary advantages of the system: 1) distribution matching via the adversarial loss and 2) regularization towards invertible mappings via the cycle loss. We then show a regularization effect and improved performance when paired data is supplemented by additional unpaired data on two real biomedical regression tasks: estimating the physiological effect of medical treatments, and extrapolating gene expression (transcriptomics) signals. Our proposed technique is a promising initial step towards more robust use of adversarial signals in semi-supervised regression, and could be useful for other tasks (e.g., causal inference or modality translation) in the biomedical field.